One Year On: The Youth Mental Health Crisis We Saw Coming Has Exploded
We tasked young people with protecting adults at a significant cost to their wellbeing and futures. It is long past time that we start protecting them.
Just over a year ago, I wrote a blog for the University of Nottingham’s ‘After the Virus’ series. At that time, I outlined my concerns about the impact of mandated restrictions on the mental health and wellbeing of children and adolescents. Several key areas had me concerned about how our youngsters would cope – especially those living in challenging circumstances and those with pre-existing mental health conditions. I was not alone in my misgivings: two other significant opinion pieces discussed the potential impact on mental health and suicide prevention across the life span, and young people were highlighted as a group of concern in both articles.
As social beings, we thrive on human contact and companionship. Indeed, when starved of human interaction, we crave it in the same way that we crave food when starved of nourishment. Our interactions with other people shape our development and even how our brains rewire themselves in the teenage years, which is when the majority of mental health conditions begin to emerge. Mid-to-late adolescence is generally a ‘sensitive time‘ psychologically and developmentally. I felt strongly that isolating young people could cause them enormous harm. Unfortunately, with very few exceptions, study after study has shown just how significantly lockdowns have impacted young people across the globe. It is utterly heartbreaking.
While not an exhaustive list, here is a flavour of some of the devastation wreaked on the mental health of young people globally:
- There are now likely five children in a class of 30 who have a diagnosable mental health condition so severe that it requires clinical intervention, and the ‘vulnerable group’ size increased from 1 in 9 young people to just 1 in 6 following the first lockdown in the UK.
- Depression has markedly increased in young people, whilst anxiety has remained largely stable, according to one study of young people from three countries. Impacts were worse for young people from a multiracial background and for those living under ‘lockdown’ restrictions.
- Eating disorders have increased dramatically during lockdown restrictions. Clinical colleagues tell me that they are not surprised by this as eating disorders offer a way for the suffer to exert control over their lives in an ever-increasing, uncertain world.
Having researched adolescent self-harm and suicide prevention for the past 20 or so years, I was particularly aware of what would happen if we increased known risk factors for self-harmful behaviours. Even before lockdown, self-harm (self-injury or self-poisoning, regardless of intent or motivation) was increasing in young people. The risk of both self-harm and suicide is known to rise during the teenage years, representing the steepest increase for any age group and, over the past year, we forced this already vulnerable group into conditions that exacerbated key risk factors for self-harm, including social isolation, loneliness, entrapment, defeat and hopelessness.
Suicide ideation has increased across all ages, with one in ten people experiencing suicidal thoughts during the first English lockdown. Findings were even more dramatic for younger people. There is now an enormous unmet need in youth mental health highlighted by decreased hospital attendance for self-harm and psychiatric care. These patients didn’t stop needing care – they lost access. And this is a global issue: in the US, the state of Colorado recently declared a state of emergency for youth mental health. Chief Medical Officer for Children’s Colorado David Brumbaugh said recently, “There have been many weeks in 2021 that the number one reason for presenting to our emergency department is a suicide attempt. Our kids have run out of resilience – their tanks are empty.” Some believe that the current generation will be traumatised for years to come because of the COVID-19 crisis.
When writing my first University of Nottingham blog on this topic, I wondered which experts were ‘… advising the government from a ‘meta’ or holistic position weighing benefits and costs.’ It now appears that the government does not want – or feel it needs – a ‘360 degree’ approach to public health since the cabinet has never been briefed on the potential impact of their policies on non-COVID health issues, including cancer and mental health. Moreover, there has been scant investment in research investigating how we can mitigate the impact of COVID-19 and mandated restrictions on mental health. A notable exception is the SPARKLE trial which is studying a digital parenting support app tackling behaviour problems and parental stress as part of a UK-wide cohort study on family coping (Co-Space).
Getting children back to normal must now be our number one priority – and quickly. We need a trauma-informed recovery programme in schools. They need to socialise, take part in music, singing, dancing and sports and have fun. We owe them so much for the sacrifices they bravely endured over the last 18 months when we tasked them with the burden of protecting adults at a significant cost to their wellbeing and futures. It is long past time that we protected them.
The announcement by Gavin Williamson, Secretary of State, on 6th July 2021 regarding the future of COVID-19 restrictions in schools indicates that the government has started to realise the importance of getting young people back to normal. Beginning September 2021, so-called ‘bubbles’ (distinct student groups intended not to mix) will be dissembled, and only those with positive tests will be required to isolate (vs the previous strategy of isolating all close contacts of those with positive tests). Extra curricula activities can return – and return they must to help our young people not only recover what they’ve lost but re-learn how to thrive.
Looking forward, one serious concern is that the government will reinstitute restrictions in the autumn and winter when cases will most likely rise. This would be a grave mistake. One can only hope that our leaders hold fast to the current message; that we must accept COVID-19 as an endemic virus and allow young people to get on with living.
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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