Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review

Abstract

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children’s and adolescent’s mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children’s and adolescents’ mental health. Methodology: We conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included experimental randomized and nonrandomized controlled trials, observational studies, and qualitative studies. Results: Of the 5828 articles that we retrieved, 18 articles met the inclusion criteria. We thematically analyzed them and put the major findings under the thematic areas of impact of the pandemic on children’s and adolescents’ mental health. These studies reported that pandemics cause stress, worry, helplessness, and social and risky behavioral problems among children and adolescents (e.g., substance abuse, suicide, relationship problems, academic issues, and absenteeism from work). Interventions such as art-based programs, support services, and clinician-led mental health and psychosocial services effectively decrease mental health issues among children and adolescents. Conclusion: Children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic. It is critical that future researchers explore effective mental health strategies that are tailored to the needs of children and adolescents. Explorations of effective channels regarding the development and delivery of evidenced-based, age-appropriate services are vital to lessen the effects and improve long-term capacities for mental health services for children and adolescents. Key Practitioner Message: The COVID-19 pandemic’s physical restrictions and social distancing measures have affected each and every domain of life. Although the number of children and adolescents affected by the disease is small, the disease and the containment measures such as social distancing, school closure, and isolation have negatively impacted the mental health and well-being of children and adolescents. The impact of COVID-19 on the mental health of children and adolescents is of great concern. Anxiety, depression, disturbances in sleep and appetite, as well as impairment in social interactions are the most common presentations. It has been indicated that compared to adults, this pandemic may continue to have increased long term adverse consequences on children’s and adolescents’ mental health. As the pandemic continues, it is important to monitor the impact on children’s and adolescents’ mental health status and how to help them to improve their mental health outcomes in the time of the current or future pandemics.

Consequences of Lockdown During COVID-19 Pandemic in Lifestyle and Emotional State of Children in Argentina

“…Younger children were also happier to staying at home, which may reflect their interest in spending more time with their parents/caregivers. No gender differences were observed, in agreement with other studies in children ( 20 , 27 ), although some studies in adolescents show higher depression and anxiety levels in females ( 16 ). On the whole, our results are in line with the observations of other authors.…”

“…Family lifestyle was also drastically affected: parents suffered psychological distress due to unstable financial circumstances, school closures, and suspended educational services ( 9 , 10 ). Children and adolescents also started to experience adverse emotional responses (stress, worry, helplessness, social and risky behavioral problems, anxiety, and depression) ( 11 – 16 ) and changes in lifestyle such as sleeping problems, increased screen exposure, reduced physical activity and unhealthy eating habits ( 17 – 20 ).…”

Children and Adolescent Mental Health in a Time of COVID-19: A Forgotten Priority

“…For those children with mental health conditions that predated the pandemic, their ability to obtain needed follow-up treatment such as medications or therapy was hindered due to disruptions in mental health services throughout the pandemic [ 22 ]. Without adequate health professional support, children and adolescents are forced to cope with conditions such as anxiety, loneliness, depression, and substance-use disorders – all of which were exacerbated by the pandemic and are associated with reduced quality of life during adulthood [ 23 24 ].…”

Mitigating the Impacts of COVID-19 on Global Child Health: a Call to Action

“…The capacity to provide mental health services for children is woefully inadequate worldwide, with limited access even in high-income regions, but particularly in many resource-limited settings where the psychosocial impacts of COVID-19 are likely to exact a tremendous long-term toll on children’s well-being [ 47 , 48 ]. Many of these concerns have been born out, with emerging data showing an increase in pediatric mental health issues [ 49 , 50 ]. The pandemic represents an opportunity to prioritize child and adolescent mental health needs and reimagine how pediatric mental health services could be improved and delivered globally.…”