The COVID-19 pandemic and subsequent lockdowns meant to help curb the infection have been around for a year now. When the quarantine, social distancing and lockdown were first enforced, they were handled with gusto — it was all very sudden, but in doing the responsible thing to #StopTheSpread, unprecedented times called for unprecedented actions. The road wasn’t without challenges, however — transitioning to remote work impaired work-life boundaries, online or blended classrooms were tricky to navigate for everyone involved, the consequences on the mental health and safeguarding of children were pronounced — the looming dread of the pandemic not helping.
And because all of this was happening in an emergency-like situation, it became harder to optimise the action plan. Soon enough, note was taken of the vulnerable populations, the marginalised children who may not have had a smooth experience in the quarantines and lockdowns due to various reasons.
As the vaccines get rolled out, going forward, what we also need to account for are the possible long-term negative consequences of the pandemic for children and adolescents. Psychologists and researchers have been warning about the lifelong — or at least the long-term — impact of loneliness and isolation on children. What may have started out as benign regressions and children “acting out” soon evolved into separation anxiety, cabin fever, and either horribly frequent skirmishes or totally silent despair. A review by the University of Bath pointed out that children and adolescents “who are lonely might be as much as three times more likely to develop depression in the future, and that the impact of loneliness on mental health could last for at least 9 years.”
The studies also show evidence that the duration of loneliness may be a relatively more critical factor than the intensity of loneliness in increasing the risk of future depression among young people. Considering how long we’ve been under lockdown, this does not bode well. On top of it, parents, who are usually the ones to model calm for the children have been in a state of panic themselves, yet another experience the children will carry with them through life.
Dr Sarah Mundy, Consultant Clinical Psychologist who specialises in working with children and families & Author of Parenting Through Stories reinforces that we are in this for the long haul and it isn't going to be a linear answer to this, “Imagine the impact of high levels of anxiety over the long-term, particularly when children don't have the support to manage them (as is the case with their supportive adults being stressed themselves). There are both psychological and physical implications of this. The University of Bath study also suggested that the scale of the impact of the pandemic upon young people's mental health may not show fully for a number of years.”
Let us look at these implications and how they could linger on for a while, one by one:
Lag in academic development
A very obvious impact on children’s developmental progress comes on the academic front. Prolonged school closures have been detrimental to the academic progress of many children, especially those in key year groups, like Year 1 or Year 6, requiring uninterrupted learning and acquisition of numeracy and literacy skills. The lag is similar to what’s referred to as the “summer slide” or “summer melt” effect that typically results in achievement slowing or declining over the summer months when schools are closed.
With lockdown, parents are stepping in as teachers to supplement online schooling. Parents, while having to deal with their own hardships, economic or domestic, are also feeling burdened and burnt-out. And there’s a chain reaction at play here: distressed parents mean distressed children. It doesn’t help that the teacher-student relationship and the eyes-on attention children used to have at their disposal have also been untenable in the current situation. Ultimately, the experience of education is seemingly very chaotic for children.
Much of this has been attempted to be dealt with through the gradual lifting of the lockdown and the blended learning that filled the later months in 2020. However, concerns about long-term learning lag are very well-founded. This gets further exacerbated for vulnerable children, those from marginalised sections, those with special needs, and those living in unstable family contexts.
Exposure to the direct fear of the pandemic, loss & grief
Children are being asked to live in a less-than-optimal environment, with the many political and social stresses, and with the pandemic, the discomposing fear of contagion has been added to that list. The direct losses of the pandemic are not a rare anecdote anymore, either. At the time of writing this, the death tally due to coronavirus in the UK stood at 122,953 and the total number of cases at 4,182,009. With these numbers, it’s likely that several children have been personally impacted by this pandemic, albeit in varying degrees — losing an acquaintance, a beloved friend/relative or worse, an indispensable caregiver. Some may have experienced multiple losses, without a healthy grieving process due to lockdowns. For many, an illness in the family may have created severe hardships, what with the parents already stretched thin due to remote work and online school, and possibly financial strains.
Another potential impact of the pandemic is the children internalising the fears that they’re living with. They might live with obsessive habits or socialising fears for a long time, as often happens with traumatic experiences which take a long, long time to unlearn. For children who have essential workers in the family, the fears and paranoia could be scary and overwhelming. All of these experiences will have an impact on children’s coping abilities over time, even though children are known to be resilient.
Impact of loneliness and isolation on long-term mental health in the developmental years
As mentioned before, the impact of loneliness and isolation might be one of the most profound and problematic one for growing children and adolescents. Socialising, playing in groups, meeting friends — these are intrinsic elements of the growing years. They look forward to sports tournaments in schools, dances, graduations, or other social gatherings, all of which have been denied to them, albeit with good reason. To substitute these interactions, children seek some interaction through online modes. The increased use of technology comes with safeguarding and protection concerns of its own.
In another concern, children may also feel stressed about having rusty social skills, since they’ve been away for so long. When it’ll be time to reintegrate into the social fabric, it might again take some time to adjust and adapt. Dr Lucy Russell, a clinical psychologist based in High Wycombe, Buckinghamshire and founder of They Are The Future, shares what she thinks would be the two major long-term impacts, “One, a divide between children who had the resilience skills and emotional support to thrive during the pandemic (and who will have built their resilience skills yet further), and a large group of children whose mental health is in danger of being poor in the long term (into adulthood), without intensive therapeutic support. Isolation and lack of regular feelings of safety re-wire the brain to be in survival mode (fight, flight or freeze) much more of the time than is healthy.”
Living for too long in survival mode means that the children will require long-term therapeutic support to get out of the survival mode when the time comes. But the system seems ill-equipped to deal with this deluge, which is Russell’s second concern, “Mental health services (at least in the UK) were unable to meet the needs of children requiring therapeutic support before the pandemic. The pandemic has massively amplified this. So, I predict there will be a large group of children and young people who will not receive the psychological support they require, over the next few years. This means we may see children entering adolescence and adulthood in a state of surviving rather than thriving.”
Is it possible to pre-empt the negative consequences?
Short answer: Yes. With the awareness of these consequences, we are halfway there. But we need to take actionable, yet gentle steps.
Mundy wants the focus of the schools, in the post-pandemic time, to be on supporting the emotional wellbeing of children and on letting the children re-connect socially. She also suggests explaining to children what they’re feeling, like separation anxiety, through appropriate tools. This way, it'll be possible to have a healthy conversation with them, instead of talking down to them.
With the larger goal of supporting children, it is also important to ensure their parents are managing well. After all, they’re their immediate support system. Mundy agrees, “We also need to support parents manage their own mental health, and help them feel confident in supporting their children with their emotional worlds. What we know about resilience is that having supportive relationships is so important — we must work with their families too.”
Russell has some advice for the mental health professionals, and counsellors, "in the long run, we need a huge shift in our understanding of mental health. We need to move away from a medical model of mental health (which focuses on “fire-fighting” – treating a condition once it has been diagnosed) and move towards prevention, for example, a lifestyle medicine model. Many health professionals including Dr Rangan Chatterjee are heroically leading this movement. A focus on mental wellness through social connection and a healthy lifestyle will help future generations to thrive, not just survive. This approach also recognises that physical health and mental wellbeing are intimately linked.
In the meantime, it is important that children are given opportunities for interactive play, encouraged to engage in physical activities, allowed to co-create their online schedules with adults so they don’t lose their social developmental progress. On the flip side of all the negative consequences, there’s also a positive side-effect: people are talking about anxiety and mental health concerns far more openly now. So children who battled social anxiety and performance anxiety in the pre-pandemic time are now recipients of empathy.
As is clear, emphasis around the recovery strategy should be on a) fostering social connectedness to compensate for the lost socialisation, and b) a holistic framework for creating time and space for catching-up, whether on the intangible life/social skills or the tangible academic progress.