Mental health impacts of the COVID-19 pandemic on children with underlying health and disability issues, and their families and health care providers

Abstract

Objectives The COVID-19 pandemic has impacted mental health at a population level. Families of children with health vulnerabilities have been disproportionately affected by pandemic-related policies and service disruptions as they substantially rely on the health and social care system. We elicited the impact of the COVID-19 pandemic on children with health and disability-related vulnerabilities, their families, and their health care providers (HCPs). Methods Children with diverse health vulnerabilities (cardiac transplantation, respiratory conditions, sickle cell disease, autism spectrum disorder, mental health issues, and nearing the end of life due to a range of underlying causes), as well as their parents and HCPs, participated in semi-structured interviews. Data were analyzed using qualitative content analysis in determining themes related to impact and recommendations for practice improvement. Results A total of 262 participants (30 children, 76 parents, 156 HCPs) were interviewed. Children described loneliness and isolation; parents described feeling burnt out; and HCPs described strain and a sense of moral distress. Themes reflected mental health impacts on children, families, and HCPs, with insufficient resources to support mental health; organizational and policy influences that shaped service delivery; and recommendations to enhance service delivery. Conclusion Children with health vulnerabilities, their families and HCPs incurred profound mental health impacts due to pandemic-imposed public health restrictions and care shifts. Recommendations include the development and application of targeted pandemic information and mental health supports. These findings amplify the need for capacity building, including proactive strategies and mitigative planning in the event of a future pandemic.

It’s made a really hard situation even more difficult: The impact of COVID-19 on families of children with chronic illness

“…Despite experiencing lower levels of COVID-19 than many other parts of the world, especially during 2020, disruptions to health, education and social support have had an acute psychosocial impact on Australian families of children with chronic illness. These themes of mental health impact, feelings of loneliness and isolation, and changes to organisations and policies shaped by COVID-19, have been similarly identified among other populations where COVID-19 was more prevalent and school closures more prolonged [ 20 ]. Adequately responding to and addressing the needs of families of children with chronic illness, as well as planning for the minimization of longer-term impacts om well-being is critical.…”

Health Care Utilization During the COVID-19 Pandemic Among Individuals Born Preterm

“…Understanding the factors associated with overall health care use as well as symptom-related use during the COVID-19 pandemic may identify optimal practice strategies and target care, particularly during pandemic surges. Potential approaches could include COVID-19–related educational tools that address specific preterm birth–related conditions and how this may affect symptoms, 42 refining telemedicine services tailored to individuals with special health care needs 43 and identifying strategies that may foster parental well-being during child illness, such as coping mechanisms and resiliency. 44 , 45 For this cohort, it was reassuring to see that there were no differences in overall missed health care appointments between preterm vs term-born individuals, particularly due to parental worry about entering the health care practitioner office.…”

Reflections of Moral Suffering, Resilience, and Wisdom of Pediatric Oncology Social Workers during the COVID-19 Pandemic

“…The participants eloquently described needing to change their home life (telework), change how they practiced (virtual individual, family, and group sessions), change how they think about self-care, and consider changes in how they will lead their lives post pandemic. This speaks to an ability to identify and act upon their own resilience while navigating the demands of the COVID-19 pandemic [ 8 ]. Examples included exploring opportunities for broadening practice modalities, improvising and adapting, and making use of peer-based learning.…”

“…In some instances where social workers and other healthcare professionals were tasked with enforcing infection control protocols, they became the target of verbal aggression from families. This contributed to a sense of fatigue, burnout, fear, and anxiety [ 8 ].…”