COVID-19 KIDS EVIDENCE UPDATE – Adolescent Health

Professor George Patton – Group Leader, Adolescent Health, Population Health, Murdoch Children’s Research Institute; Director of Adolescent Health Research, University of Melbourne; Consultant Child and Adolescent Psychiatrist, Royal Children’s Hospital COVID-19 and the Mental Health of Young People.

COVID-19 and the Mental Health of Young People

The COVID-19 pandemic has affected the mental health of all age groups, but the effects have been most prominent in the young.(1, 2) Online surveys of adolescents suggest that around a third report high levels of anxiety and depression during lockdowns.(3) Mental health problems may arise for a range of reasons including worry about other family members, bereavements for some, breaks from school, disruption to friendships, home confinement, increased internet and social media use and heightened concerns about the future. School closures affect not only learning but also the relationships and activities that sustain good mental health with a loss of extracurricular activities, opportunities to socialise with peers and a transition to electronic-based learning platforms.(4) Around a third of adolescents and half of the young adults have reported high loneliness during lockdowns.(5) Families have also been under pressure with parents commonly reporting greater mental health problems. Parental roles have become difficult with juggling work from home with home schooling with consequences for parental mental health, domestic violence and abuse.(6) Physical inactivity, increased screen time, irregular sleep and poor diets affect adolescent mental health, and all have been altered by lockdowns and school closures.(7) Falls in physical activity have come about from suspension of school-based physical education as well as closures of community based sporting activities and fitness centres and restrictions in movement beyond local areas. An increase in social and digital media use during lockdowns has been essential for continued engagement with education and maintaining friends. However, social and digital media use might disrupt sleep, heighten vigilance of the news cycle and for some, bring more negative peer interactions.

The pandemic has undoubtedly made pre-existing adolescent mental health problems worse, and this has been compounded by limited access to school counsellors and nurses. For young people, the effects on mental health are likely to be among the most significant in the longer term. We need to know more about the recovery of mental health problems that have emerged during lockdowns. There is also a need to look ahead at the mental health consequences arising from the economic fallout, with disruption to employment, further education and training opportunities likely to have marked mental health consequences.

1. Pierce M, Hope H, Ford T, Hatch S, Hotopf M, John A, et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. The Lancet Psychiatry. 2020;7(10):883-92.
2. McGinty EE, Presskreischer R, Han H, Barry CL. Psychological Distress and Loneliness Reported by US Adults in 2018 and April 2020. Jama. 2020.
3. Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Globalization and health. 2020;16(1):1-11.
4. Becker SP, Gregory AM. Editorial Perspective: Perils and promise for child and adolescent sleep and associated psychopathology during the COVID‐19 pandemic. Journal of Child Psychology and Psychiatry. 2020.
5. Loades ME, Chatburn E, Higson-Sweeney N, Reynolds S, Shafran R, Brigden A, et al. Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19. Journal of the American Academy of Child & Adolescent Psychiatry. 2020.
6. Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health. 2020;14:1-11.
7. Hoare E, Werneck AO, Stubbs B, Firth J, Collins S, Corder K, et al. Association of Child and Adolescent Mental Health With Adolescent Health Behaviors in the UK Millennium Cohort. JAMA network open. 2020;3(8):e2011381-e.

Interview with A/Prof Peter Azzopardi

Daniel Lamanna – 3rd Year Medical Student, Department of Paediatrics, The University of Melbourne interviews Associate Professor Peter Azzopardi – Co-Head of Adolescent Health, Burnet Institute.

COVID-19 and adolescent health

This editorial was first published by the Department of Paediatrics within the Melbourne Medical School of the Faculty of Medicine, Dentistry and Health Sciences. Read the original editorial.