Impact of the COVID-19 Pandemic on Adolescent Mental Health

Even before the COVID-19 pandemic began, mental health trends and large treatment gaps were identified among teenagers in the United States. According to the National Drug Use and Health Survey, an estimated 13.3% of US teenagers ages 12-17 had at least one episode of major depression in 2017, but 60.1% of those people received no treatment for their disease. 1

In addition, survey results from the Centers for Disease Control and Prevention showed the number of U.S. students suffering from persistent sadness or hopelessness (from about 26% in 2009 to 37% in 2019) and a serious suicide watch (from 14% to 19%), suicide planning (from 11% to 16%) and suicide attempts (from 6% to 9%). The highest risk was seen in minority white, female, and sexual students compared to non-white, male, and heterosexual students. 2

Initial results suggest that the current crisis is further exacerbating these problems, with the risk of mental health deterioration being particularly high for those with pre-existing mental health problems. These results have shown that symptoms of depression, anxiety and post-traumatic stress disorder are more likely to occur in adolescents of different age groups.3,5 “The number, severity and duration of these symptoms are determined by age, trauma history and psychological status before the event, and hours in which the media reported about the event, a deceased family member and the presence or absence of social and economic support, ”wrote Hertz and Barrios in an article published in Injury Prevention.2 in February 2021

Continue reading

They found that school closings can limit access to screening and care for vulnerable students, considering that large numbers of youth – nearly 3.5 million in 2018 – receive such services in educational institutions.2 These institutions are the only one The source of mental health services is many youth, particularly from low-income households and ethnic and racial minorities. The authors therefore emphasized the increasing importance of collaboration between schools and community health professionals to meet the growing needs of students for mental health.

Teenagers and other teenagers are also affected by the effects of the pandemic on their caregivers, including unemployment, financial and emotional stress, and fear of infection. This underscores the need for adults to receive adequate care and support.6,7 Some youths have done so due to quarantine requirements being forced to spend more time in abusive or otherwise dysfunctional homes.

"Assessing the relative safety of a child at home is one of the greatest challenges mental health professionals face during a pandemic," stated a November 2020 paper published by Dr. Cécile Rousseau, researcher, psychiatrist and professor in the department, was co-authored on social and transcultural psychiatry at McGill University in Montreal, Canada.6 “Due to parental stress and without the benevolent view of school or daycare, the risk of abuse increases , as the number of cases reported to the protection of minors is decreasing. ”

US hospitals have reported alarming increases in attempted and completed suicides among teenagers – especially teenagers. A Las Vegas school district has lost 19 children to suicide since the pandemic began. Regarding the increasing number of pediatric patients presenting in hospitals across the country with thoughts of suicide, doctors have reported that they are “in poorer mental health” when compared to similar patients typically seen prior to the pandemic

Such trends underscore the critical importance of youth work and creative intervention and support in these times. Mental health providers "must continue to work to ensure that families and children have the mental health support they need to support resilience, reduce family conflict and child abuse, and reduce risky, unsafe and dangerous behaviors," such as already mentioned in November 2020 Article 6

We recently met Dr. Rousseau interviewed to further discuss these problems and possible solutions.

Cécile Rousseau, MD

What are believed to be the reasons for the generally low rates of mental health treatment among adolescents living even before the pandemic?

I think there are two main reasons: First, MH services are generally difficult to access and often not very user-friendly for young people. While some emerging models address this, they are not generalized. Second, there is a widespread tendency to confuse mental distress and its expression – through sadness, fear, and anger – and mental disorders.

The first is associated with a violation of life, which is very common, while the second is associated with more individual vulnerabilities. Of course, the two phenomena overlap, but in ancient times the distress was not medically treated or treated. Rather, it was addressed through interpersonal networks, spirituality, etc. In the past few decades the paradigm has changed.

How has the pandemic affected and exacerbated mental health problems in this population?

The pandemic initially triggered an acute stress reaction – which is normal, including fear and panic reactions. This has, to some extent, helped compliance with public health measures. Over time this becomes a chronic stress response with avoidance symptoms predominating such as denial and minimizing the risk of a pandemic. Frustration and anger over coercion have also increased, leading to scapegoats through conspiracy theories and legitimation of violence.

These are widespread reactions that are not in the fault range. For many people with vulnerabilities, however, the pandemic has made their symptoms worse, with the exception of a few cases of phobia – particularly school phobia – or cyber addiction as these individuals may enjoy incarceration.

What are the relevant recommendations for clinicians on how to address these issues in practice and advocate for their adolescent patients?

Clinically, contact with our patients is critical to maintaining continuity of care. In cases of frequent family conflicts, virtual care should be used with caution as it may not provide the necessary confidentiality and security and, in some cases, can exacerbate the family conflict.

In new cases, management should include reducing the impact of the collateral effects of the pandemic – most often due to social isolation and lack of stimulation – on adolescent development.

What are some of the broader, longer-term solutions that are also warranted?

Schools and colleges should be at the forefront of prevention. In Canada, pediatricians have campaigned for the youth to return to school and maintain their social network (not partying, of course!). Adolescents need their peers to pursue their task of separation from individuation, and this has been made impossible during childbirth. We need to find a balance between the safety of older people and meeting the development needs of young people.

References