The Youth Mental Health Crisis We Can’t Ignore

Our recent 2021 hindsight is beginning to elucidate the psychological ramifications of the COVID-19 pandemic. There appears to be a looming mental health crisis with potential long-standing repercussions. Dealing with the catastrophic events has been a huge challenge for adults, but consider the added burden on children and adolescents. What have we uncovered so far?

Effects of the Pandemic on Children and Adolescents

Studies reveal significant negative effects of the pandemic on the mental health and well-being of children and adolescents (Schwartz & Costello, 2021). Even before the COVID-19 outbreak, mental health problems in young people were evident. Approximately 1 in 5 children, ages 3 to 17, had a diagnosable mental or emotional disorder. Thus, it was expected that the pandemic would create further psychological distress in this age group. This prediction was borne out by a notable increase in young people seeking emergency mental health care over the past year (Cloutier & Marshaal, 2020).

The anxiety and isolation during the pandemic were compounded by the physical closing of schools and the abrupt transition to remote learning (Liu, Pinder-Amaker, Hahm & Chen, 2020). The loss of a concrete network of teachers and classmates caused many young people to feel disconnected, lonely and hopeless. Interviews conducted with a number of teens at The Washington Post elicited a recurring statement in various communications: “I feel so alone.”

Vulnerable populations, such as disadvantaged youth and those with special needs or pre-existing behavioral issues, have been the most severely affected by these considerable changes (Fegert, Vitello, Plener, & Clemens, 2020). Children are also highly susceptible because of their limited understanding of the pandemic and lack of coping skills. Let’s examine some of the pressing concerns facing children and adolescents today.

Child and adolescent under stress

Source: Kyle Broad/Unsplash (left); Ben Hershey/Unsplash (right)

Substance Abuse Issues

Risk factors for adolescent substance use, such as social isolation, stress and boredom, have been heightened by the pandemic (Sarvey & Welsh, 2021). According to a 2020 CDC report, drug use is also associated with mental health and suicide risk, along with sexual risk behaviors and violence. Research has shown a rise in alcohol and cannabis use in adolescents related to constraints of social distancing and extreme stress (Dumas, Ellis & Litt, 2020).

The greater reliance on virtual connections with friends has encouraged substance use as a way to maintain popularity and peer approval. Conversely, solitary substance use, such as alcohol, has been linked to depression, anxiety and unhealthy coping mechanisms in adolescents. (Dumas, Ellis & Litt, 2020). Alterations in mood, motivation, or attention spans may be warning signs of substance use, but it may be more difficult for parents to assess these behavioral changes in the context of the turbulent pandemic.

Disordered Eating Attitudes and Behaviors

Individuals with eating disorders have been at elevated risk for worsening symptoms during the pandemic. The increase in both newly diagnosed and previously diagnosed adolescents with eating disorders seeking help is further evidence of this occurrence (Schwartz & Costello, 2021). One reason might be fears connected with food insecurity. This may encourage binge eating, fasting, and compensatory disordered eating behaviors (Cooper, Reilly, Siegel, Coniglio, Sadeh-Sharvit, Pisetsky, & Anderson, 2020).

Adolescents with eating disorders frequently have co-existing mental health conditions or behavioral problems. The sudden life changes brought about by the pandemic are tied to feelings of confusion, uncertainty and loss of control. With the influx of social media messages about weight and food and “perfect” photo images, more restrictive eating patterns and body image concerns are likely to occur. The lack of social support, coupled with disruptions in daily eating routines, may also contribute to disordered eating attitudes and behaviors in this population (Schwartz & Costello, 2021).

Depression and Suicide Risk

Depression, suicidal thoughts and actions, and other self-harming behaviors are more prevalent in adolescents under crisis situations (Sarvey & Welsh, 2021). The overwhelming stressors related to the pandemic have not been experienced before, so successful coping mechanisms are not readily identifiable. Lockdown and social distancing mandates have severely hampered vital interpersonal connections. Since peer relationships are extremely important for socialization during adolescence, this may intensify feelings of loneliness and despair (Alvis, Douglas, Shook & Osterhoff, 2020).

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Psychological problems have been observed in children in quarantine, including irritability, anxiety and excessive clinginess (Imran, Aamer, Sharif, Bodia & Neveed, 2020). Children have been struggling with adaptations to unfamiliar circumstances and an accompanying degree of palpable social and emotional stress. Parental support and reassurance are crucial to validate these feelings and ease stress levels as much as possible.

Directions for the Future

As we gradually emerge from the pandemic into our “new normal” lives, how should we respond to the impact on the mental health of children and adolescents? The younger generation has been confronted with an unprecedented trauma that will require multidimensional solutions and strategies. From an educational perspective, schools must provide a safe, supportive space for students returning to in-person learning. In addition to reaching out and asking students if they’re OK, quality mental health and behavioral resources must be available. Mental health prevention and education programs for students, parents and the community are also needed to increase attention and awareness.

There is still a great deal we need to learn about the mental health consequences of the pandemic. Promoting resilience in youth is highlighted by the stark contrast between the power of connectedness and the destructiveness of isolation. Continued research is essential for the development of appropriate psychological interventions and to inform health policy. It may also be useful to implement more effective screening tools, without creating further stigmatization. We must be better prepared to address mental health issues in the future and protect our youth from harmful behaviors.