On 24 September, Baroness Massey of Darwen will ask the Government about the expansion of mental health services for young people to deal with concerns expressed during the Covid-19 pandemic. This article will examine how the pandemic has affected young people’s mental health, how services have been impacted, and what the Government has done so far.

Impact of Covid-19 on young people

Research on the mental health consequences of the Covid-19 pandemic is still quite limited. A rapid review of international studies showed an increase in depressive and anxious symptoms in children as a result of Covid-19. This is likely attributable to a wide range of factors, including:

  • social isolation;
  • anxiety about illness;
  • uncertainty about the future; and
  • strained familial relationships.

Similar conclusions were drawn by a second international review, with the authors noting that any international disaster constitutes a form of trauma, and children living through Covid-19 should be considered at elevated risk of developing post-traumatic stress disorder. The pandemic may also have increased health anxiety in young people, encouraging a preoccupation with infection.

School and university closures

The charity YoungMinds conducted two studies looking at the impact of Covid-19 on young people with existing mental health needs.

The first study was carried out over the first weekend of lockdown. In this study, 2,111 young people with existing mental health needs were surveyed between 20 March and 25 March. The study highlighted the negative impact the closure of schools and universities would have young people’s mental health. Concerns raised in their survey responses included:

  • loss of contact with friends;
  • concerns over whether exam grades would be negatively impacted; and
  • loss of everyday structure and routine.

The second YoungMinds study was conducted three months later, between 5 June and 6 July. 1,081 young people were surveyed, all of whom had accessed some form of mental health support during the first three months of the year. During this period the Government announced plans to ease restrictions, including a target of reopening schools in the autumn.

The survey found that many young people were pleased at the thought of schools reopening in the autumn. Many looked forward to seeing their friends, recommencing their studies and returning to a form of normality. However, the prospect of a return to education was also a source of anxiety. Respondents’ concerns included:

  • that they had fallen behind academically during lockdown;
  • that they would not perform well in future assessments; and
  • that social distancing in a busy school environment would be problematic.

Researchers at the University of Manchester reported similar findings around education and lockdown. They also reported that those aged between 18 and 24 were the most affected group.

A report published in the Lancet: Child and Adolescent Health highlights the importance of routine for maintaining good mental health across the population. It argues that this is particularly important for young people. For children with special educational needs, school provides not only an opportunity for learning, but also an environment in which other interventions can be offered. These include speech and language therapy, applied behaviour analysis and social skills training. The pandemic has negatively affected these interventions.

Young people with existing mental health needs

The first YoungMinds report conducted during the first weekend of lockdown found that, among young people with pre-existing mental health needs:

  • 32% stated that the pandemic had made their mental health a lot worse;
  • 51% stated that the pandemic had made their mental health a bit worse;
  • 9% stated that the pandemic had made no difference to their mental health; and
  • 7% stated that the pandemic had improved their mental health.

The report highlighted anxiety about the health of the young person’s family, and for being responsible for older relatives getting infected, as a concern. Young people with obsessive-compulsive disorder (OCD) expressed particular distress at this prospect. Loss of coping mechanisms caused by disruption to routine, and an increased risk of negative coping mechanisms such as self-harm, were also highlighted.

The second YoungMinds report, conducted in June and July, reported significant deterioration in mental health of young people with existing mental health needs, particularly linked to increased loneliness and anxiety. As predicted by the earlier report, this often led to increased condition-specific coping strategies, including:

  • greater levels of food restriction in respondents with eating disorders;
  • worsening of rituals/‘checking’ in respondents with OCD; and
  • an increase in self-harm amongst those already self-harming prior to the pandemic.

Access to mental health support during the pandemic

Many mental health services continue to operate at reduced capacity due to the pandemic. Young people may also have lost access to informal forms of support, including trusted teachers, school nurses, and their social support networks.

The first YoungMinds survey found that 26% of respondents were no longer able to access the mental health support they required due to the lockdown. In some cases, treatments previously delivered in person were being offered remotely. Many respondents found this impractical due to poor internet connection or little privacy in the home. Young people also reported a lack of clarity regarding their ongoing mental health treatment as a significant source of uncertainty and stress.

The second YoungMinds survey found that 31% of respondents were struggling to access the help they need. A survey of parents and carers, also from YoungMinds, found that 25% of respondents said their child was no longer able to access the support they needed as a result of the pandemic. Young people who had sought support for the first time during the pandemic had generally been directed towards websites and apps in the first instance. Many who needed higher levels of intervention had experienced extended waiting times and increased redirection between services.

What action has the Government taken?

Public Health England (PHE) has published guidance for parents and carers on how to support children and young people’s mental health during the pandemic. The Children’s Commissioner has also published the Children’s Guide to Coronavirus, a resource aimed at explaining the pandemic to children.

On 29 May, the Government announced £5 million of funding for community mental health projects, to be administered by Mind, as part of the Mental Health Consortia of charities. An application process was set up entitled the Coronavirus Mental Health Response Fund which would award grants of either £20,000 or £50,000 for projects of up to 12 months. However, this fund received a high level of demand, and was paused for new applications in England on 13 May.

On 9 September, PHE launched the Better Health—Every Mind Matters campaign. Upon launch of this campaign, Public Health Minister Nadine Dorries stated:

The effects of the pandemic on children and young people’s mental health have been challenging and it is vital we continue to do all we can to protect them and prevent long-term effects.

Young people should feel encouraged to speak up, look out for each other, and ask for help. This campaign and these resources are a great way to access support and help parents to understand steps they can take to care even more for their children’s mental health and wellbeing.

The Government has stated its intention to keep schools open. On 28 August, Education Secretary Gavin Williamson stated that any changes to school attendance due to Covid-19 would be a “last resort”.

Image by Dan Meyers on Unsplash.