The first comprehensive study to evaluate research on the mental health of children and young people using evidence that spanned before and during COVID-19 has found an impact on mental health that could result in an increased demand for support services.
The research, led by the University of Exeter and the University of Cambridge, is the first to examine research that has information on young people’s mental health before and during the pandemic. The study gives more insight into changes in the mental health of children and young people of various ages across the globe during the pandemic.
The study is published in the Journal of Child Psychology and Psychiatry and funded by the National Institute for Health and Care Research (NIHR) with some support from NIHR PenARC. Researchers pulled together 51 studies examining how the pandemic affected young people’s mental health across various domains. Crucially, these studies included information on baseline mental health collected before the pandemic rather than relying on retrospective perceptions of change.
The demand for fast-paced research amid the evolving pandemic meant that the standard of the studies was variable, with just four of the studies classed as high quality.
Whilst the evidence suggested some deterioration for a few aspects of mental health, overall, the findings were mixed, with no clear pattern emerging. There were mixed findings from studies that measured the same type of mental health difficulty differently, suggesting that the effects were not universal and depended on the circumstances and contexts of children, young people and families. Researchers say the overall effect is large enough to increase demand for services.
Study author Dr Tamsin Newlove-Delgado, of the University of Exeter said: “The pandemic affected the lives of children and young people worldwide, and we’ve heard a lot of talk around the impact on mental health. Our review of the research in the field provides further evidence that already-stretched services are likely to see an increase in demand but that perhaps things are not as bad for everyone as some headlines make them appear. However, even a small average change in mental health symptoms for each child can mean that, on a societal level, a large number of children tip over from managing OK to needing some professional support. Children and young people must be prioritised in pandemic recovery and explicitly considered in planning for any future pandemic response.”
The researchers found some evidence for deterioration across a range of broader measures of mental health, such as an increase in overall problems with behaviour, emotions or anxiety, as well as finding a lot of studies that reported no change and some reporting improvements in mental health.
The paper highlights that research in this area is particularly difficult to interpret because, developmentally, mental health problems became more common in adolescence than in childhood. This makes it hard to assess to what extent the negative impacts found to result from children in the studies getting older or are related to the pandemic.
Co-author Professor Tamsin Ford of the University of Cambridge said:
“Studying the whole population of children and young people means that our research may not pick up on differences between groups that may have fared better or worse during the pandemic. For example, other research has found that some children and young people reported sleeping and eating better during lockdowns or found it easier to access remote schooling as they could work at their own pace. Others struggled with lacking structure or access to remote schooling or peers.”
Study author Abigail Russell of the University of Exeter said: “The race for answers during the pandemic meant that a lot of research was conducted quickly, using opportunistic samples, for example, by asking people in online surveys how they thought the pandemic had impacted their child’s mental health. Unfortunately, that means the quality of research overall is quite poor, and even the studies that we included in our review with information from before the pandemic were overall not very high quality. This may be partly because of the pressure to publish research quickly about the pandemic and its impacts. As a research community, we urgently need to do better for our young people who struggle with their mental health, to understand the impact on them and their families, and to target support where it’s needed. In the longer term, researchers, funders and policymakers should take a more cohesive approach to support and conducting high-quality research.”
The study is entitled ‘The impact of Covid-19 on psychopathology in children and young people worldwide: a systematic review of studies with pre- and within-pandemic data’, published in the Journal of Child Psychology and Psychiatry is available here: https://doi.org/10.1111/jcpp.13716
About the Authors
Dr Tamsin Newlove-Delgado
Senior Clinical Lecturer and Honorary Consultant in Public Health
Tamsin Newlove-Delgado is a Senior Clinical Lecturer with the Children and Young People’s Mental Health Research Collaboration (ChYMe) and an Honorary Consultant in Public Health Medicine with the Office for Health Improvement and Disparities (OHID). Influenced by her clinical experience in child and adolescent psychiatry before entering public health, Tamsin’s research concentrates on public health aspects of the mental health of children and young people, with a particular interest in the transition from child to adult services and the application of epidemiological methods for service planning. She is funded by an NIHR Advanced Fellowship, which aims to study time trends in child and adolescent mental health and mental health-related service contacts. Tamsin is an academic consultant on the NHS Digital Mental Health of Children and Young People in England survey series and co-leads the academic input to the survey consortium.
Professor Tamsin Ford
Professor of Child and Adolescent Psychiatry
Head of Department of Psychiatry
Tamsin Ford is an internationally renowned Child Psychiatric Epidemiologist who researches the organisation, delivery, and effectiveness of services and interventions for children and young people’s mental health. Her work is inherently translational and cross-disciplinary and focuses on how to promote mental health, prevent mental ill-health and respond effectively to children and young people who are currently struggling. After completing her PhD at the Institute of Psychiatry, Kings College London, she moved to Exeter University Medical School in 2007, where she helped to recruit mental health researchers working across the lifespan in addition to developing a thriving Child Mental Health Research Group.
Tamsin’s research covers the full range of psychopathology and agencies, practitioners and interventions that relate to the mental health of children and young people. Every interaction with a child presents an opportunity to intervene to improve their developmental trajectory. Her work has direct relevance to policy, commissioning and practice.
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