EDITORIAL: Putting children and their social interactions first will be key to mental health recovery in a post-pandemic world

There was a time, not too long ago, when educated, civilised societies felt that putting children first was a good idea. They felt that this idea was so sensible and good that they enshrined it in a global declaration: The United Nations Declaration on the Rights of the Child. Posters about it were displayed in classrooms around the world which teachers and pupils would discuss it together. The declaration declares that no right should be more special than another – so rights to play and rights to education have equal status.

During the pandemic, nations have turned a blind eye to this declaration – in fact, some have pretty much ripped it up. Indeed, I think most nations are guilty of this.

One section has played on my mind throughout the pandemic. I have felt all along that we should have put children first, as Article 3.1 of the convention states. We have totally and utterly failed to do this on a global scale with a few exceptions, such as Sweden.

“Findings show increases in anxiety, stress and worry, depression, helplessness, risky behavioural problems during the pandemic.”

Lockdowns and school closures have been devastating for our children. Face-to-face social interaction is important for all of us – we crave it when we are starved of it. It is particularly important for children and adolescents.  A key finding from an early and important Rapid Systematic Review was that in children and adolescents, the mental health impacts of loneliness can be felt up to nine years later.

Now Prof Carl Heneghan and his CEBM colleagues Jon Brassey, Tom Jefferson have conducted an important ‘review of reviews‘ in the sphere of child and adolescent mental health. The results are utterly damning and must be acted on urgently. They note that, ‘Eight out of ten children and adolescents report worsening of behaviour or any psychological symptoms or an increase in negative feelings due to the covid pandemic. School closures contributed to increased anxiety, loneliness and stress; negative feelings due to COVID-19 increased with the duration of school closures. Deteriorating mental health was found to be worse in females and older adolescents.’

Moreover, this review also shows us what was protective for young people and their mental well-being—no surprises given what I have written above. Socialisation is key.  The authors note that socialisation includes ‘… positive interactions and benefits for other people (prosocial behaviours), along with social connectedness based on experiences of feeling close and connected to others.’

The results of 17 systematic reviews interrogating children and mental health were reviewed and taken together. These studies led the authors to conclude that the impact of the pandemic and associated restrictions to be severe and consistent across many studies now. Findings show increases in anxiety, stress and worry, depression, helplessness, risky behavioural problems during the pandemic. Moreover, school closures and social distancing may be associated with significant harm to the mental well-being of children.

The authors’ recommendations from this review are stark and clear.

1. Put children first in all we do. ‘In all actions concerning children undertaken by public institutions, the child’s best interest shall be a primary consideration’ (Article 3.1 of the convention of human rights for children).
2. We must carefully consider mental health when deciding whether to increase social isolation for young people in future.
3. We need to keep our eye on the ball and monitor the long-term impact. For me, this will include monitoring rates of suicide since we know that whilst suicides may decrease during times of societal upheaval (though we do not have concrete data for children and adolescents yet), they increase after disasters and when economic downturns occur.

So, the results are in. The pandemic and associated mandated restrictions have damaged the mental health of children and adolescents enormously. Social isolation and social connectedness appear to be key risk and protective factors, as many experts warned would be the case.

In June 2020, I wrote a blog on the potential impact of the pandemic and mandated restrictions on the mental health of young people. I (nervously, as so few academics had said anything negative about lockdowns at this point in the pandemic) concluded that I felt we should release young people from lockdowns as soon as possible. I feel at once angry, vindicated, and heartbroken that this assertion stands up. Children and adolescents must be put first moving forward – we adults need to make sure that they are.

German translation available here.

Ellen Townsend is a Professor of Psychology at the University of Nottingham. She specialises in self-harm, suicide prevention, and mental health and is a member of Collateral Global’s Scientific Advisory Board.

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