The Increase of Child and Youth Mental Health Issues Due to COVID-19

COVID-19 has touched every aspect of our lives – the workplace, home, leisure activities, health, social life, and the family unit. For children and youth, their childhood experience has been anything but typical with online schooling, lockdowns, school closures, loss of extracurricular activities and separation from friends and extended family members. School opportunities disappeared that can really make a difference in a young person’s life such as work experience, sports tournaments, school field trips and no graduation activities.

I have written about a number of pandemic issues that have affected families such as caregiver stress, sleep issues, online education, feelings of isolation, and increased instability due to job loss and changes in routines. All of these changes that we’ve faced during the pandemic have taken their toll on children and youth. At the start of the pandemic, they were considered the lowest risk group around medical outcomes and complications from COVID-19. As time has marched on, they are now emerging as the invisible casualties of the pandemic.

It is important to be aware of this growing mental health crisis because as school starts and society continues to open up, children and young people will be experiencing mental health issues which will show up in a number of ways such as behaviours of concern, anxiety, sleep disturbances, inability to concentrate, irritability, depression, and stress. For the adults who support and interact with children in various aspects of their lives, they’ll need to be away of these more invisible issues like never before.

How has the pandemic impacted mental health?

Pediatric hospitals across the country have reported a 100 percent increase in admissions for mental health problems. There has been upward of a 200 percent increase in admissions for substance use and suicide attempts, and 70 percent of children and youth say the pandemic has affected their mental health.

Autistic people, already at an increased risk for mental health issues, were more impacted due to the pandemic directly affecting social functioning and everyday routines. Routines are constructed around and supported by activities such as going to school or being involved with multidisciplinary teams such as speech therapists, physiotherapists and occupational therapists. With the loss of in-person therapy, school and support organization closures, children and their families lost their their care and support network. The lack of access to specialist services may also have hindered the learning and development of autistic children when it comes to essential skills and personal development.

COVID-19 has been an infodemic with the increased spread of both information and misinformation regarding COVID across a multitude of social media platforms. Psychological comorbidities associated with autism such as ADHD and depression, may also cause autistic individuals to be more psychologically vulnerable when exposed to excessive amounts of distressing information. Autistic children’s understanding and reactions to the pandemic have resembled PTSD in individuals with ASD in terms of increased stereotypies, aggression, hypersensitivity, behavioral problems, and sleep and appetite alterations.

How can we help?

There are a number of things we can do help the autistic individuals we support and care for.

Prepare for Upcoming Changes as Much as Possible

I’ve written a few posts about the need for predictability to alleviate anxiety. Prepare as thoroughly as possible for any upcoming transition. Contact the school to make sure all COVID protocols are clear such as mask wearing, classroom cohorts, recess, staggered entry, etc. I wrote a very thorough blog post August 2020 on school changes and protocols with supporting resources that are helpful to prepare for the start of school.

Separation Anxiety

This may be the first time since the pandemic began that parents are able to return to work or that children are returning to school. After months of being altogether, we may now have periods of the day apart. To ease this transition, take small separation steps. Start by sitting out in the backyard or walking down the block and back just to have your child get used to you being away for short periods of time. Gradually lengthen the time away.

Always say where you are going, when you’ll be back and what you are going to do. A Social Story™ may help create predictability and take the mystery out of what you are doing when out of the house. It can also give your child some ideas of what they can do in your absence.

Re-establish Routines

Children need routines to feel secure and understand expectations. Many of the strategies used to reduce the spread of COVID-19 such as staying indoors on lockdown disrupted routines and increased screen time.

For any changes to routines:

• Start slowly and ahead of time. If a person has to start getting up earlier in the morning, establish the new rising time 1 to 2 weeks ahead of time. Maybe use small increments of time.
• Use visual supports to show schedule/routine changes.
• Do not change the schedule all at once as this is too big of an adjustment to make.
• Add one change to the schedule every few days and get that established before adding in another change. Small steps will lessen anxiety.

Incorporate Physical Activity into the Day

Regular exercise lessens anxiety, improves sleep, increases endurance, builds muscles, develops motor skills and offers opportunities for socializing. It also supports good mental health and well-being. Whether being involved in organized sports on a team, solo activities (swimming, archery, martial arts), or just playing outdoors, physical activity offers the chance to grow stronger, expand interests, and adds to the enjoyment of life.

If you’re not sure how to get started with physical activities or what to do, have a look at this blog post on the topic of physical activity.

Address Underlying Causes of Concerning Behavior

If you are observing distressing behavior, changes in behavior, or difficult moments, dig deeper to find out the underlying cause. Think of the behavior you observe as just the tip of an iceberg; below the surface of the waterline lies the cause of behavior. We need to delve below the waterline and address the root cause, not the behavior itself. This topic has been addressed in this blog post.

As we continue to go onward in the pandemic, it will be paramount to understand the impact COVID-19 is having on mental health issues. While we are still lacking in resources in the area of child and adolescent mental health, there are ways to access supports. The Canadian Mental Health Association has chapters all over Canada, for example. The Government of Canada website also has a list of mental health services. Reach out to your local autism society too – they should have a list of mental health community supports.