Coronavirus (COVID-19): impact on children, young people and families - evidence summary October 2020

11. Mental health and mental wellbeing

Public Health England COVID-19 Mental Health and Wellbeing surveillance report (England)

Date: 8 Sep 2020

Source: Public Health England

The publication draws together and compares data from various evidence sources relating to mental health and wellbeing. It presents 7 chapters which will be updated regularly, including one on the experiences of children and young people (aged 4-19). The key findings from that chapter are presented below and echo those of previous SG C&F briefings:

• There is growing indicative evidence that coronavirus COVID-19 and associated interventions have likely had an adverse effect on the mental health and wellbeing of children and young people.
• Loneliness has been a challenge for some children and young people, although some have reported benefits for their mental health and some studies show that children and young people report coping well. Experiences of loneliness appear to increase with age and is associated with increased anxiety. Whilst some children and young people have used social media to combat loneliness, some studies indicate a digital divide (e.g. for those living in 'low-income' areas) with some children and young people reporting not having access to or not using devices to communicate with friends.
• As reported in previous C&F briefings, key concerns for children and young people are worries about other people being at risk of COVID-19, education, and worries about future. There is also emerging evidence of disrupted sleep patterns for children and young people during the pandemic.
• Whilst some children and young people have experienced strains in family relationships during the pandemic, others have enjoyed more time with family/carers.
• While many children and young people have retained some access to mental health support during this period, a lack of access to mental health support has been associated with worse mental health and wellbeing for some children and young people.
• The latest evidence reviewed suggests that vulnerable children and other children and young people with challenging home environments, are more likely than others to have had experiences during the pandemic associated with a risk to mental health and wellbeing such as: loneliness, disruption to access to support, difficult relationships within the home, parental stress or poor mental health and a lack of access to the outside or natural environment.
• Emerging evidence on young people with existing mental health conditions suggests that the pandemic has negatively affected their mental health and wellbeing, but there are no robust comparisons.
• There is limited evidence available on the experiences of young people in low income areas – emerging evidence indicates a number of potential impacts, for example having less access to technology to stay in touch with friends.
• Access to support is widely reported as having reduced during the pandemic, whilst usage of online support is reported to have increased.
• The Xenzone Kooth service report relatively steady engagement with their online MH service across the pandemic period. Key presenting issues continue to be anxiety and relationship issues.
• The most recent data from Young Minds shows a continued trend of more parents seeking information and advice via email and online during the pandemic. They report that parents have been most likely to call about anxiety, anger, behaviour problems and self-harm.
• The chapter notes a number of evidence gaps which mirror those identified in SG C&F briefings. These include monitoring changes in children's mental health against a recent pre-COVID-19 baseline, representative evidence on the experiences and mental health of children and young people from particular sub-groups, access to or change in protective factors, and experiences of important pandemic related risk such as the experience of illness, bereavement or multiple parental stresses.

Back on Track: Supporting young people out of lockdown (England & Wales)

Source: YMCA England and Wales

Date: Aug 2020

The purpose of the 'Back on Track' research was to investigate young people's concerns as they move out of lockdown and return to education. The findings are based on a survey of approximately 1000 11-16 year olds living in England and Wales between 24-27 July. This was weighted by age, sex and region. Key findings are:

• The top three worries about coming out of lockdown all related to the virus itself. These were 'myself or my family catching coronavirus' (68%), maintaining social distancing at school (63%) and the future safety of the country (62%). Other concerns included having a safe environment to see friends, family employment and income, falling behind at school and anxiety about being in school.
• There were high levels of loneliness in young people during lockdown: nine-in-ten reported missing being face-to-face with people (92%), and three-quarters felt lonelier and more isolated during lockdown (77%).
• Three-quarters of young people (73%) tired of being online all the time (after 4 months of lockdown).
• Young people are struggling with school and their aspirations for the future are changing; 56% of respondents were worried about falling behind and 41% were worried about getting a job. A quarter agreed that the pandemic has affected their decisions on what they'll do when they finish school; a fifth agree that the pandemic has changed their career aspirations (21%).
• Over a third of respondents were worried about 'having enough money to live on' (37%); whilst a third disagreed with this statement (33%).
• More than two-fifths of young people reported that they were worried about their mental health or wellbeing as they come out of the COVID-19 lockdown (42%); 57% stated that their mental health had worsened during lockdown and 73% said that they felt more stressed during lockdown. That said, nearly half (49%) of respondents disagreed with the statement that 'I feel depressed or anxious' (28% agreed) and 57% stated that they were not that worried or not at all worried about their mental health or wellbeing.
• Returning to life beyond the home is promoting feelings of anxiety for some: 44% of respondents stated that they feel anxious about being in social spaces, and 36% feel scared of the outside world.
• Almost half of young people think involvement in online bullying has increased (48%), with just 6% thinking it has decreased (since schools closed).
• For many young people, the lockdown brought a chance to be with their family and practice self-care. Almost all respondents reported having enjoyed spending more time at home (93%), seeing more of their family (92%) and connecting with people online (90%). 82% of respondents have been able to take more time out to look after themselves, and 85% felt less school/exam pressure.
• That said, more than half of respondents (58%) feel that their relationship with their family has become more strained during lockdown. Local YMCAs have reported seeing a rise in the number of families struggling to cope living in cramped houses with limited digital access – often shared between siblings – and facing significant financial pressures.
• Top priorities for government (as chosen by young people survey respondents) were listening to what young people need, additional support to help people catch up with schoolwork, a safe space to meet friends, more support to help young people find jobs, and funding technology and internet access.

EIF poll shows parents' concerns about pupils' mental wellbeing and support for schools to do more (England)

Source: Early Intervention Foundation

Date: Sep 2020

A survey of over 600 parents, conducted by Ipsos MORI for has underlined ongoing concerns about children's mental health and wellbeing as they return to school.

• Half of parents surveyed said they had concerns about their children's mental wellbeing as they were returning to school or entering reception, including one in six who said they were very concerned.
• Reasons given for parental concern about mental wellbeing included children needing to adjust to changes in the school environment, to focus on school work, to reintegrate socially with other pupils and teachers, and manage infection anxiety.
• Lower-income parents, in particular, are more likely than better-off parents to be concerned about their children's mental wellbeing as they return to school. In the survey, 58% of those earning up to £20,000 were concerned, compared with 44% of those earning over £55,000.
• Parents want schools to provide mental wellbeing support - seven in 10 parents supported schools doing more to provide help on mental wellbeing.
• This research underlines the importance of prioritising children's social and emotional wellbeing in any recovery plans (alongside educational attainment), particularly those children from low income or disadvantaged backgrounds. The crucial role of mental wellbeing in learning and the widening attainment gap because of lost learning during lockdown also underlines this.

Children and Young People's Mental Health Coalition Annual Report (UK)

Source: CYPMHC

Date: 28 Sep 2020

This report from a coalition of children's charities calls on the UK Government to put mental health first for children and young people and stop school exclusions this year. The report raises concerns about the growing levels of poverty and inequality and their impact on infant, children and young people's mental health. The report explores the impact so far of the COVID-19 pandemic on children's mental health and finds that the pandemic has heightened inequalities that were already there. The report emphasises the links between traumatic experiences that some children may have experienced during the pandemic (including neglect, abuse and bereavement) and behaviour. Gaps in digital access are highlighted in relation to accessing online mental health services. It calls for a moratorium on school exclusions over the next academic year so that pupils have the time to adapt to changes and for a trauma-informed approach to addressing behaviour problems in schools.

Bereavement (UK)

Barnardo's has raised concerns about the impact of bereavement and loss. Before COVID-19, statistics showed 1 in 29 5-16 year olds had been bereaved of a parent or sibling^[12]. Although data is not yet available to show how much this number has increased due to the pandemic, given the number of COVID-19 deaths in the UK, it is likely that many children and young people will be experiencing bereavement.

Some communities will be especially impacted by grief and bereavement, especially those at higher risk of becoming seriously ill or dying from the virus, such as Black, Asian and Minority Ethnic (BAME) communities or those living in areas of high deprivation.

Barnardo's recommends ensuring schools are places of safety, offer a nurturing learning environment, and are linked to specialist services that can support children and young people through this difficult time will be critical.

Further analysis of data from recently published Scottish research on adult wellbeing^[13] during lockdown shows that nearly one in ten households in Scotland with children (8%) had suffered a COVID-19-related bereavement at the time of the survey (Apr/May). This was previously reported in the SG C&F July (internal) briefing and is very similar to that reported in the Children's Society annual survey.

Co-SPACE Survey Report 05: Changes in children and young people's mental health symptoms during lockdown and patterns associated with key demographic factors

Source: Oxford University

Date: 11 Sep 2020

The latest report from the Co-SPACE team covers parent reporting of child mental health^[14] over a one-month period in lockdown (baseline and one month follow up). This is not a nationally representative sample. Parents/carers who completed the one month follow up survey were more likely than those who did not to be female, have a higher than average household income, be a parent of a primary school aged child and to have reported that their child had fewer behavioural difficulties at baseline than those who did not complete the follow up survey. The findings are based on longitudinal data from 2,729 parents/carers who took part in both surveys.

• In primary school aged children, there were mean increases in emotional, behavioural and restlessness/inattention difficulties. The proportion of children likely to have significant difficulties (i.e., meet diagnostic criteria for a clinical diagnosis) in these 3 areas also increased, by up to 35%.
• In young people of secondary school age, there was a reduction in emotional difficulties, no change in behavioural difficulties and a slight increase in restlessness/inattention. The proportion of young people within this age range likely to have significant emotional difficulties did not change but did increase for difficulties with behaviour and restlessness/inattention. As respondents were more likely to have primary school aged children, however, this finding should be interpreted with some caution.
• For children and young people from low income households, emotional and attention difficulties (and behaviour difficulties for primary school aged children) were consistently elevated compared to those from higher income households, with around two and a half times as many children experiencing significant problems in low income households.
• There were similar levels of emotional, behavioural and restless/attention difficulties for children and young people from single and multiple adult households, but primary school aged children from single adult households were reported as having more emotional difficulties than those from multiple adult households throughout lockdown.

Children's views on well-being and what makes a happy life, UK: 2020 (UK-wide)

Source: Office for National Statistics

Date: 02 October 2020

The Office for National Statistics (ONS) has published analysis of UK children's perspectives on their well-being and what makes a happy life. Whilst this research does not address the coronavirus pandemic directly, it can help inform recovery approaches aimed at improving children's wellbeing. Ten focus groups with 48 children and young people aged between 10 and 15 carried out between September 2019 and February 2020 (before lockdown), including focus groups held in Scotland. Feeling loved and having positive, supportive relationships are the top priorities for children to have a happy life. Children also see feeling safe as an essential element of their happiness, alongside personal expression, school experiences and family finances. Key factors for future happiness and wellbeing included peace, child empowerment and having a say in decisions that affect them, and addressing climate change.