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

Research from across the UK and beyond

General children, young people and parent/carer COVID-19 research

Life on hold: Children's wellbeing and COVID-19

Source: The Children's Society
Date: July 2020

The Children's Society has published a report of findings from its annual UK household survey of over 2,000 parents and their children aged 10 to 17 carried out between 28 April and 8 June, and a further consultation with 150 children and young people between 21 April and 19 June on how they felt about lockdown. Key findings were:

• Children and young people report considerably lower levels of life satisfaction during lockdown compared to previous years - 18% of children and young people were dissatisfied with their lives overall, an increase from 10% to 13% over the last five years.  
• Lack of choice over their lives was also highlighted, with both young people and parents reporting unhappiness with the amount of choice they have. 
• As with other COVID-19 surveys, children reported that the aspects of coronavirus they struggled to cope most with were being unable to see friends (37%) and family (30%).
• Overall, 9 in 10 of all children (89%) said they were worried to some extent about coronavirus.
• Despite this, a majority of children (84%) said they had coped to some extent with the impact of the pandemic overall.  As with other surveys, girls reported coping less well than boys.
• The survey found evidence that children in poverty were more worried during lockdown. A higher proportion of young people in poverty stated they were 'very worried' about Coronavirus than those not in poverty (23% compared to 15%).
• Half of parents (50%) anticipate that coronavirus will harm their children's happiness over the coming year. 

Read the report: Life on hold: Children's wellbeing and COVID-19 (The Children's Society Annual Survey Report)

COVID-19 and Children's Play and Mobility

Source: International Play Association
Date: 24 Aug 2020

This international study uses a specially-created 'Child Lockdown Index' (CLI) to allow for meaningful comparisons between 25 countries on children's play.   The report asserts that the focus of research and policy during the pandemic has mostly focused on education but that the importance of play should not be underestimated, particularly outdoor play.  The CLI^[fn] for Scotland is 20 which is higher than some countries including Germany and Canada (11) but lower than others such as Spain and Italy (32).  This baseline measure will be used to help track the ongoing impact of the pandemic on children's lives.  The report calls for governments to consider how pandemic measures may restrict children's play opportunities.  It recommends the use of a risk-benefit assessment tool used by some play advocates.  The report states that it is important to acknowledge the sacrifices that children are being asked to make, and the potential consequences for their rights, health and well-being.

Read the report:  Play in Lockdown (International Play Association report)

Inquiry into the impact of COVID-19 on education and children's services

Source: Human Rights Watch 
Date: July 21, 2020

This Human Rights Watch report covers 3 areas: food insecurity, digital exclusion and the impact of the pandemic on disabled children (this is covered in the 'Children and Families impacted by Disabilities' section below).  The report covers a range of research undertaken and makes a number of recommendations, including the need for an emergency response plan in the event of future COVID-19 lockdowns, or other crises, that reflects a spectrum of no-, low-, and high-tech responses, and includes models for support for groups of children at risk of exclusion. 

• Food insecurity – Human Rights Watch research in May  found that some measures taken by devolved authorities in Scotland, Wales, and Northern Ireland produced more promising results than the free school meal replacement voucher system adopted in England and recommends the use of direct cash transfers and other non-voucher based systems.  The submission also recommends that NRPF (no recourse to public funds) restrictions on access to free school meals be lifted permanently.
• Digital exclusion – Human Rights Watch survey research and interviews with parents and school staff on the impact of lockdown on children's education found that the digital divide had an adverse effect on children's remote learning.  Teachers raised concerns about loss of contact with students from low-income families, minority ethnic backgrounds, traveller pupils, and those living in rural communities and significant loss of learning for these groups.  Families that struggle to afford devices and internet are forced to make hard choices, with many families only having one device. The digital divide also impeded teachers' ability to teach effectively (e.g. due to teacher's internet issues).  Finally, the submission raises concerns about the unprecedented amounts of children's personal data being gathered by online education platforms, potentially putting children's data protection and privacy rights at risk.

Read the report: Human Rights Watch Submission to the UK Parliament Education Committee: Inquiry into the impact of COVID-19 on education and children's services

Children's information sources and understanding of Coronavirus 

Source: Edge Hill University
Date: 30 Apr 2020

Edge Hill University is leading an international study^[fn] on where children (aged 7-12 years) get their information about coronavirus (COVID-19) and their understandings of the virus and current public health guidance for social distancing. The project aims to help work out the best way to give children news, important facts and safety tips about coronavirus.  Early findings are based on online child and parent surveys which was completed by 150 children and 200 parents.  A summary of the findings is presented below:

Access to information

• Most of the children who answered the survey do not get information from resources specifically developed for children.
• Children told us they are getting information about COVID-19 through their parents/carers or school.
• Children want information through their parents, teachers, and TV programmes like Newsround.
• Parents who answered the survey told us that providing information to their child was a "balancing act". They answered their children's questions, gave them just enough information so they didn't worry, but shielded them from "the worst of it".

Children's knowledge and understanding of COVID-19

• Children who answered the survey understand that washing their hands and social distancing are important.
• Children told us that they have unmet information needs, such as "people play it down and tell me it can't kill people, but people are dying each day".
• At the time of the survey (during lockdown), children had lots of questions in particular ones pertaining to return to school, cure for the virus, safety concerns and the COVID-19 death rate.

Read the news release: Children's Information about coronavirus (COVID-19) – Edge Hill University news story

Children ask scientists about coronavirus

Source: Children's Commissioner for England (but organised in partnership with all UK Children's Commissioners)
Date: 11 August 2020

Children from across the UK aged 7 to 19 asked SAGE scientists their questions about the coronavirus pandemic. This provides some insight into the areas of interest and concern that children in the UK have about coronavirus.  Their questions included topics about pets, face masks, school buses (risks of transmission), testing (what it's like to have a test), school uniforms, transmission rates (risk to children including BME children), symptoms, support bubbles, and the risk of a second wave.  The event was organised by the Children's Commissioner's Offices for England, Scotland, Northern Ireland and Wales.  

Listen to the Podcast: Children's Commissioner for England Podcast 'Children ask scientists about coronavirus' 

A key theme from a survey of more than 100 children and young people supported by Barnardo's and a further 150 children and young people across the UK was that children and young people felt that they were being ignored by decision makers during the pandemic. Recommendations to government include involving  children and young people in 'recovery planning' and giving them a role in relevant national decision making.

Read the news release: Young people call on government to prioritise mental health in UK's coronavirus recovery (Barnardo's news story)

Find out more about Barnardo's Big Conversation Campaign

Mental health and wellbeing

Emerging Evidence: Coronavirus and children and young people's mental health (Issue 3)

Source: Evidence Based Practice Unit (EBPU)
Date: 26 Aug 2020

In its third publication, the EBPU continues to review the international evidence base in order to address three core questions: what the mental health challenges are for children and young people, what they are for disproportionately affected groups and what might help children and young people to manage those challenges.  A summary of the key points from its most recent publication (which captures research identified between 25th

May and 14th June 2020) is provided below:

Key mental health challenges for children and young people during the pandemic:

• Mental health difficulties such as anxiety and depression have markedly increased.
• Feelings of panic, stress, fear and fatigue amid uncertainty and a lack of control among young people are also widespread, which has contributed to growing stress and anxiety.
• Concerns about returning to schools and colleges are also common.
• Family dynamics, learning and education, financial stressors, social isolation and loneliness are all stressors contributing to poor mental health during the pandemic
• For some, the pandemic has had positive mental health impacts due to a sense of support and potentially reduced stressors, such as social pressures at school.

Key mental health challenges for disproportionately affected groups:

• Children and young people with pre-existing health and education needs, such as anxiety, ADHD, and SEN are experiencing an increase in symptoms and compromised access to support.
• Children and young people with pre-existing social care needs, such as young people experiencing homelessness, children in care, young carers, and young people experiencing poverty are, on the whole, struggling more due to reduced support systems and further financial impacts of the pandemic.
• BME children and young people are disproportionately affected by the coronavirus as they and their parents and carers are both more likely to be key workers, and more likely to work in shut-down sectors. They therefore have greater likelihood of exposure to the virus while also being more likely to experience loss of household income. As a result, the mental health impact for these young people is exacerbated.

Helping children and young people to manage these challenges:

• Parents and carers play a key role in helping children and young people to manage their stress during the pandemic and to develop healthy habits such as good sleeping habits, play, and exercise, to promote positive mental health.
• Given the likely extended period of social distancing, professionals supporting young people should continue to be receptive to the needs of young people and continue to adapt their ways of working to include digital and remote services.
• Education professionals need to be sensitive to the mental health needs of young people during lockdown and offer support, but also plan additional support and ways of working as many prepare to transition back to schools and colleges.
• Financial and logistical support for new and existing local systems from health, education and social support agencies can help improve the support available for all young people .
• Multisector and collaborative working is particularly crucial at this time, to provide a joined-up response to supporting young people.

Read the report: Emerging Evidence: Coronavirus and children and young people's mental health Issue 3 (Evidence Based Practice Unit)   

Read Issues 1 and 2 from the Evidence Based Practice Unit

Impact on young people with mental health needs

Source: Young Minds
Date: Summer 2020

Young Minds has published findings of their second UK survey of 2,036 young people aged 13-25 which was conducted between 5 June and 6 July, 3 months after the first survey.  This included 1,081 young people who had accessed some form of mental health support in the first three months of the year.  

• More than 3 in 5 respondents (83%) in both surveys reported that their mental health has worsened due to the coronavirus.  The data suggests that mental health has deteriorated over time as the number of young people saying that it is 'much worse' has increased since the first survey (40% compared to 32%).
• The impact on mental health was usually related to an increase in loneliness and anxiety (87% of respondents agreed that they had felt lonely or isolated during the lockdown period).  Those with eating disorders and a history of self-harm reported an increase in these behaviours.  
• A number of LGBTQ+ respondents said their dysphoria had got worse or that they felt that they were not able to be their real selves at home.
• Helpful coping mechanisms included connecting with friends, writing a diary, exercise, spending time with family and watching TV or reading.
• Access to support appears to have become more difficult for some. Responses to this survey suggest that almost a third (31%) of young people who were receiving some form of mental health support immediately before the pandemic are no longer able to access the support they need (5% more than the previous survey).
• As reported in previous briefings, this survey showed that many young people lack access to technology to access remote services, are concerned about privacy or simply do not feel safe opening up online.
• Overall, there appears to be a persistent stigma around mental health. Half of respondents (50%) did not feel confident about talking to someone about their mental health if they needed to.
• Young people, although looking forward to returning to school/work/university and some kind of 'normality', expressed various concerns including exam pressure, adjusting to social distancing, loss of friendships and the virus itself.
• The report warns of a surge in demand and the need for services to be scaled up, better coordinated and a greater emphasis placed on early intervention. It also emphasises the importance of ensuring the full involvement of young people in the renewal process. 
• Young people want more focus on wellbeing in schools and for schools to have realistic expectations about what students can achieve following the lockdown.

A number of recommendations are made including funding for mental health services in education settings, a transition period in education settings which make allowances for the effects of lockdown, face-to-face MH support to resume as quickly as possible, and a wellbeing campaign co-produced by young people.

Read the report: Coronavirus: Impact on young people with mental health needs (Young Minds report)

Young People's Mental Health during the COVID-19 Pandemic

Source: NIHR School for Public Health Research
Date: August 2020

Findings from an longitudinal public health research project led by the University of Bristol that explores social media use and adolescent mental health and wellbeing have been published.  The study was completed by 1,047 students aged 13-14 across 17 schools in the South West of England.  The online survey was completed in April and compared to findings from a pre-pandemic survey in 2019.  Key findings include:

• Overall there were reductions in anxiety and rises in wellbeing but no large changes in depression in the majority of students.
• We saw larger improvements in mental health and wellbeing for students who had poor mental health and wellbeing before lockdown.
• Students with low school, peer and family connectedness pre-pandemic, saw the biggest improvements in mental health and wellbeing during lockdown. Improvements in mental health and wellbeing may be due to the removal of stressors within the school environment, such as pressure of academic work, and challenging peer relationships.
• Survey results showed reduced anxiety and improved well-being coincided with significantly greater usage of social media among girls. 
• The biggest increase in social media usage was seen during the week, when more than half of girls (55%) reported spending in excess of three hours daily on social media during lockdown.
• Students receiving free school meals showed a reduction in anxiety and depression and an increase in wellbeing during lockdown. This group did not report higher COVID-19 worry during lockdown than students who did not receive free school meals. 
• Students from BME groups did not report poorer mental health or wellbeing at either time point compared to white students, and did not report higher COVID-19 worry during lockdown compared to white students. BME students showed a reduction in anxiety during lockdown but showed no change in levels of depression or wellbeing.

These findings are clearly at odds with those of some other online surveys.  It is possible that this age group was less impacted than younger children who did not have access to social media, or older children who experienced disruptions to transitions or to exams.  The sample had lower proportions of some vulnerable groups than the pre-pandemic comparison survey (e.g. BAME students, students entitled to FSM and students with a long-term illness or disability).  A further reason may be that this is one of the few surveys that uses objective measures of mental wellbeing (WEMWBS) and is able to make pre-pandemic comparisons.  It points to the need for more longitudinal studies of this nature.

Read the report: Young People's Mental Health during the COVID-19 Pandemic Report (NIHR School for Public Health Research) 

Read the news story: New NIHR School for Public Health Research report shows young people's mental health improved during lockdown (news story)

Barnardo's research on the impact of lockdown on children and young people

Source: Barnardo's
Date: July 2020

Barnardo's has undertaken a wide range of research throughout the pandemic as part of its 'Big Conversation' campaign.  This has involved a YouGov online poll of over 4000 children and young people aged 8-24 in May/June, a survey of Barnardo's frontline workers in April, and in-depth qualitative research with Barnardo's service users in May/June which has included care leavers, children in care, young carers, young people with disabilities, young parents, refugees and young people with experience of sexual abuse.

A recent research report, co-produced with young people, has been published which pulls some of this research together.  The report includes a section on the mental health impacts on vulnerable children and young people (findings for specific groups are reported under the relevant section in this briefing).  The research found that some children and young people with pre-existing mental health conditions have had less or no support in lockdown.  Whilst some had accessed remote services, concerns were raised about difficulties in using this mode of service delivery when in crisis. The vulnerability and isolation of children and young people in inpatient mental health services was also highlighted, many of whom were unable to have visits during lockdown.

The report provides a 'what kept me well map' of what children and young people said had helped them cope during lockdown (See Annex 1).  Key things that helped included spending time with family, routine and structure, keeping in touch with friends, sleep, exercise and diet, and hobbies and leisure. 

Read the report: Mental Health and COVID-19: In Our Own Words (Barnardo's Report)

Findings from the Barnardos YouGov online poll (4,283 children and young people aged 8-24 carried out between 15 May and 2 June 2020) are briefly summarised below: 

• More than two-fifths (41%) of children and young people respondents said they were more lonely than before lockdown, more than a third said they were more worried (38%), more sad (37%) or more stressed (34%). A third also said they had more trouble sleeping, which could have a knock on effect on school work, behavioural issues and family life.
• Boredom (51%), worry (28%) and feeling trapped (26%) were the top three emotions experienced by children and young people in lockdown.  
• Friendship issues were widely reported - around two thirds (68%) of children and young people said not seeing their friends had been one of the three most difficult things about lockdown. Nearly a quarter (74%) said they found it harder to maintain their friendships during lockdown and nearly half (47%) thought they would still be more isolated from their friends once things had started to return to normal.  

Results from a quarterly survey of Barnardo's frontline workers in April (over 1000 responded) reports that more than two-thirds (69%) of Barnardo's staff working directly with children and families say they're supporting people with an increase in mental health issues due to the COVID-19 crisis. Anxiety and disturbed sleep were the top two mental health difficulties reported by Barnardo's staff for the children and young people they work with.  The top three concerns of workers were reduced contact with services, children and young people experiencing boredom and impact on mental health.

Read the news release: Generation lockdown: a third of children and young people experience increased mental health difficulties (Barnardo's news release)

Child suicide data during lockdown

Source: National Child Mortality Database
Date: 09 July 2020

The National Child Mortality Database (NCMD) has published a report looking at child death by suicide in England during lockdown. Analysis of figures show that in 2020, during the 82 days before lockdown, there were 26 likely child suicides and a further 25 in the first 56 days of lockdown. The report notes that: there is a concerning signal that child suicide deaths may have increased during the first 56 days of lockdown.  In 12 of the 25 post-lockdown deaths, factors related to COVID-19 or lockdown were thought to have contributed to the deaths (restriction to education and other activities, disruption to care and support services, tensions at home and isolation appeared to be contributing).  However, it is important to note, as child suicides are rare, the analysis is based on small case numbers – meaning that it is not possible to reach definitive conclusions.

Read the report: Child suicide rates during the COVID-19 pandemic in England: real-time surveillance (report)

Disruptions experienced by young people aged 16-24 during first months of the COVID-19 lockdown

Source: University College London
Date: 13 July 2020

Researchers at University College London, Imperial College and the University of Sussex have published a report looking at the mental health consequences experienced by young people aged 16-24 in the UK during the first months of the coronavirus lockdown. Findings from an online survey of 1,507 respondents, 61% of whom reported previous mental health problems, carried out between 11 May and 29 June 2020 include: moderate to high symptoms of anxiety were reported in 70% of the participants with previous mental health problems and in 46% of those without previous mental health problems: 94% of the participants expected changes in their lives to some extent once the current crisis is over, of whom 6% expected a complete change in their lives with those who expected more changes in their lives experiencing higher levels of anxiety and depressive symptoms.
Read the report: Disruptions experienced by young people aged 16-24 during first months of the COVID-19 lockdown (UCL report)

The mental health emergency - How has the coronavirus pandemic impacted our mental health? 

Source: Mind
Date: 30 June 2020

Mind has published a report looking at the impact of the coronavirus on people's mental health across the UK. Evidence from more than 16,000 responses to surveys carried out in April and May has been used to draw up five tests which the UK Government must meet in order to protect and improve the country's mental health after coronavirus which includes support for children and young people. Recommendations include: implementing a comprehensive plan for supporting children and young people back into education, including those who have experienced trauma, loss and bereavement due to coronavirus and/or are at risk of school exclusion.
Read the report: Five tests for the UK Government Report (Mind)
The mental health emergency How has the coronavirus pandemic impacted our mental health? (Report by Mind)

How COVID-19 is affecting the mental health of children and young people

Source: ZenZone
Date: August

XenZone, which provides online mental health support in England (funded by the NHS), is a 'free, safe and anonymous' online mental service provider for children and young people.  'Kooth' has been publishing monthly data summaries derived from user data in England throughout lockdown.  The August data release is drawn from a sample size of over 50,000 unique users logging in during the period of 23/03/2020 - 20/07/2020 and 44,330 unique users last year over a similar period. Whilst the sample is very large, it is heavily biased towards children and young people with mental health concerns; it provides an indication rather than a standardised measure of mental health problems^[fn].  It is not clear what age of children and young people the data covers.  Some caution should be therefore be exercised when interpreting the findings.  The report focuses on nine major mental health issues where there has been a noticeable increase in prevalence compared to the same period last year:

• Demand for the online mental health service continues to rise
• The most common presenting issues are anxiety and stress, self-harm/suicidal thoughts and sadness.
• The largest increases (compared to data from the same period in 2020) are seen in sleep difficulties, body image concerns and eating difficulties.
• Other increases reported include mental health issues, loneliness, stress and anxiety, and anger issues.

Read the briefing:  ZenZone Week 30 Briefing: How COVID-19 is Affecting The Mental Health of Children and Young People

Poor mental health in lockdown most common among young women

Source: UCL Centre for Longitudinal Studies
Date: 7 Aug 2020

This study based on national representative longitudinal data (survey in May of over 18,000 people aged 19, 30, 50 and 62) found that poor mental health in lockdown was most common among the 19-year-olds surveyed (the youngest cohort in the sample). Among 19-year-olds, just over one third of women and just under one quarter of men had symptoms of depression during lockdown in May, and 45% of women and 42% of men had felt lonely during this time. 

Read the briefing: Mental health during lockdown: evidence from four generations (UCL Briefing)

Physical health and wellbeing

The latest report from the ONS on shielding households in England estimates that 328,000 clinically extremely vulnerable (CEV) people (15%) live in a household with children aged under 16 years.

Read the report:  ONS Report: Coronavirus and shielding of clinically extremely vulnerable people in England: 9 July to 16 July 2020

An evidence review produced by the Youth Sport Trust in June highlighted a number of findings relating to physical activity during lockdown:

• Parents reported that around a third of children were doing less physical activity than usual (30% are doing more) and only one fifth were getting their recommended daily allowance of 60 active minutes. Nearly one in ten children were getting no physical activity.
• Parents are valuing the time they are spending on activity with their children, believing that sports and fitness are bringing families together: 53% of parents were doing more physical activity with their children than they did prior to lockdown and 61% felt that keeping fit was helping maintain their family's physical and mental well-being.^[fn]

Read the review: The Impact of COVID-19 Restrictions on Children and Young People (Youth Sport Trust Review)

Coronavirus: children and young people's health

Source:  BMJ
Date: 06 August 2020

An article in the British Medical Journal (BMJ) discusses the impact of lockdown on children and young people's health. Findings from a snapshot survey of more than 4,000 paediatricians across the UK and Ireland at the end of April 2020 show a range of impacts of lockdown on health services:

• Delayed presentations - 32% of 752 emergency department paediatricians had witnessed delayed presentations. The most common delayed presentation was diabetes, followed by sepsis and new cancer diagnoses.  The article states that there were also nine deaths, resulting mainly from sepsis and malignancy, where delayed presentation was considered by the reporting paediatrician to be a significant contributing factor – higher than the total number of childhood COVID-19 deaths reported over the same period in England. The reasons for the delayed presentations included parents strictly adhering to the "Stay at Home" messaging by the government, as well as parental concerns about getting infected by COVID-19 in hospital and not wanting to disturb doctors during the pandemic.
• Reduction in immunisations -The lockdown also resulted in declining childhood immunisation rates (although there are signs this is now returning to normal), especially for the measles-mumps-rubella (MMR) vaccine at one year of age, raising concerns of future outbreaks. 
• Reduction in child protection referrals - Community paediatricians raised concerns about the lack of referrals for child protection assessment at a time when many parents struggle to cope with staying at home, particularly the most disadvantaged families. 

Read the article: Lockdown measures reduced the risk of covid-19, but had unintended consequences for children (British Medical Journal)

Education, learning and employment

Parents and their children's concerns about attending school

Source: Oxford University
Date: 29 July 2020

The Co-SPACE (Oxford University) Study has published its latest (5^th) supplementary report^[fn] from the COVID-19: Supporting Parents, Adolescents and Children in Epidemics (CO-SPACE)  study which covers parent and child concerns about returning to school.  This monthly UK-wide survey is completed by parents of children aged 4-16 and young people aged 11-16.  The report provides cross-sectional data from approximately 1,602 parents/ carers who answered questions about concerns around children and young people attending school during the COVID-19 pandemic between 06/07/2020 and 27/07/2020.  Key findings are:

• Parents of children with SEN/ND are particularly uncomfortable about their children attending school, as are parents who do not work, and those with lower incomes (<£16,000)
• Particular concerns for parents of children with SEN/ND and parents on low incomes are that their child will not get the emotional, behavioural and educational support that they need, or that they will struggle with the workload.
• The most common concerns among parents/carers are the practicalities of their child being in/not in school, that their child will struggle with the workload, and the lack of educational support.
• Only a minority of children and young people are perceived by their parents/carers to not feel comfortable attending school.  No differences by gender or ethnicity were observed (although this may be due to the small number of BME families).  
• That said, a higher proportion of parents/carers of children with SEN/ND (18% compared to 4.2% of parents with non-SEN children), pre-existing mental health difficulty and parents on low incomes reported that their children are not comfortable about attending school.  Concerns related to things being uncertain or different, the transition to a new school/class/group and problems with paying attention in class.
• Both primary and secondary school aged children appear to be concerned about things being different or uncertain (e.g. not being able to be with friends). Secondary school aged children appear to be more concerned about academic pressures.

Preparing for September: challenges and opportunities for SEN students

Source: TES
Date: 20 August 2020

A TES survey of SEN community members (294 respondents) found that a majority (59%) of students adapted well or extremely well to the changes resulting from coronavirus.  The second biggest challenge (after social distancing) was reported as supporting children's social, emotional and mental health, followed by pupils adjusting to routine changes and children's anxiety about returning to school.  Read the headline findings from the TES survey.

The Barnardo's research highlights the likelihood that some children and young people with SEN will have struggled with the change in routine and loss of services due to lockdown.  The report notes that services, in particular education providers, have a major role in identifying and supporting children and young people, many of whom will be needing support as lockdown further eases.

Coronavirus: children returning to schools in Wales

Source: Barnardo's
Date: 25 June 2020

Barnardo's Cymru and Action for Children Cymru have released figures which show that 85% of school staff in Wales fear that their pupils' mental health has been affected by lockdown during the coronavirus crisis. A joint briefing highlights learning from practitioners and partners in schools about the impact of the coronavirus crisis on the mental health and well-being of children and young people; what schools think they will need in terms of training and emotional support for school staff; and support from other sectors and organisations in addressing the needs of students and their families, particularly vulnerable children and young people.

Read the briefing: Lessons from Lockdown: supporting vulnerable children and young people returning to school and to learning (Barnardo's Wales)

New term, new challenges, new opportunities: putting children's mental health at the heart of education

Source: Barnardo's Northern Ireland
Date: 10 August 2020

Barnardo's Northern Ireland has published a report looking at teachers' views and experiences on the impact of lockdown, the return to school for pupils, and what help they will need to support the mental health and wellbeing of pupils. A survey of 167 education professionals across Northern Ireland found that nearly 90% of respondents thought that the pandemic was likely to have an impact on the mental health and wellbeing of pupils. Recommendations to government include: prioritising mental health and wellbeing in the recovery curriculum and increasing funding and investment in mental health and wellbeing services in schools.

Read the report: New term new challenges new opportunities: putting children's mental health at the heart of education (Barnardo's Northern Ireland report) 

Home schooling in Northern Ireland during the COVID-19 crisis: the experiences of parents and carers

Source:  Stranmillis University College
Date: May 2020

The results of an online survey on parents/carers' experiences of home-schooling during the lockdown in early May 2020, which received over 2000 responses from across Northern Ireland, have been published. The survey asked how parents/carers were approaching home-schooling, how schools were supporting them, and what could be done to better support their households.  The findings demonstrate varied family experiences of lockdown depending on parents' education and employment.  Key findings were:

• The area where children are most likely to have benefited is in their emotional well-being, where around 1 in 5 claim that there has been an improvement. By contrast, 3 in 5 claim that their child/ren's level of motivation to learn has become worse since home-schooling began.
• Parents/carers without a degree were more likely to report lower levels of confidence in managing home-education, and to report simply 'monitoring' their child's learning.
• Key workers were least likely to engage directly in their child/ren's home-schooling and were most likely to encourage their child/ren to learn independently as a result of having to work shifts outside the home.
• When asked for a single recommendation to improve home-schooling, parents/carers' most common call was more live interaction with teachers.
• Parent respondents reported that older children tend to prefer learning at school (and miss school more) while younger children are more likely to prefer the home environment.

Read the report: Home schooling in Northern Ireland during the COVID-19 crisis: the experiences of parents and carers (Stranmillis University College)

The Barnardo's research reported that young people entering education, employment and training are worried about disruptions to their employment and education.  Some young people are experiencing a decline in the progress of their work and education.  Other research has shown that young employees (aged 18-24) were the age group most likely to have lost their job or have been furloughed during the pandemic^[fn].  Addressing employment and financial security for young people will be vital for promoting mental health and wellbeing.

Impact on families

Parents report stronger relationships with their children during lockdown

Source: Understanding Society
Date: 23 July 2020

The coronavirus crisis has strengthened parent-child relationships, according to new data from the Understanding Society COVID-19 study.  

• About a quarter (26%) of parents reported that their relationship with their children had become better since the government's stay at home policy. Less than 5% reported it had become worse.  
• Mothers were more likely to report an improvement in their relationships than fathers. 
• Working from home may not be as bad for parent-child relationships as some have predicted. Nearly 40% of parents who reduced their hours to look after their children reported their relationships had become better, and only 6% said their relationships had become worse. 
• Parents who spend more time home schooling their children reported having a better relationship than those who spend no time with their children. 
• Disadvantaged parents, including lone and low-income parents, were slightly more likely to report their relationships had become worse, but about 1 in 4 reported it had become better. 

These results are based on parents surveyed in the Understanding Society May COVID-19 survey, a nationally representative study that collected data from 5,500 parents. Keep in mind that 97% of parents in Britain say that they have a close or very close relationship with their children.

Read the briefing: Understanding Society COVID-19 Survey: Briefing Note Wave 2: May 2020. Family Relationships. 

Also see Centre for Population Change - How has the COVID-19 crisis impacted parents' relationships with their children? 

Women, young people and parents of children under five worst-hit psychologically by lockdown

Source: Understanding Society
Date: 22 July 2020

Further evidence from the Understanding Society COVID surveys show that women, young people and parents of children under five have been hardest hit psychologically by the COVID-19 lockdown.  The survey which measures mental wellbeing using the General Health Questionnaire (GHQ measure) (which includes difficulties sleeping or concentrating, problems with decision-making or feeling overwhelmed) reported a 33% rise among women, 32% rise among parents with young children and 37% rise among young people aged 18 to 24, compared to pre-pandemic levels. 

Find out more about the Understanding Society findings on the mental health of parents of young children.

The UCL Covid Study is a panel study of the psychological and social experiences of adults in the UK during the pandemic. To date, over 70,000 people have participated in the study.  The study is not representative of the UK population, but it aims to have good representation across all major socio-demographic groups. Responses from Scotland make up approximately 6% of the sample; households with children make up just under a third of the sample.  A summary of relevant findings from the most recent briefing are provide below:

• Decreases in depression and anxiety have occurred across every subgroup. However, depression and anxiety are still highest in young adults, people living alone, people with lower household income, people living with children, and people living in urban areas.
• People with lower household income are becoming more worried about COVID-19 than people with higher household income, and they are more worried about finances, but less worried about unemployment. People living with children have worried more about all factors, but the differences on worries relating to COVID-19 and food access have diminished as lockdown has eased.
• Life satisfaction is similar to levels two weeks ago, but this remains substantially higher than when lockdown came in. Whilst it was lower amongst people with children during lockdown, this difference has disappeared as lockdown has eased. 
• Loneliness levels have stabilised in the past fortnight, but are noticeably lower than 21 weeks ago. Loneliness levels are still highest in younger adults, people living alone, people with lower household income, people living with children, people living in urban areas, and people with a diagnosed mental health condition.

Read the briefing:  UCL Covid Study - Week 20-21 Psychological response, discrimination & community closeness

Sleepless in Lockdown: unpacking differences in sleep loss during the coronavirus pandemic in the UK

Source:  University of Southampton
Date: July 2020

The University of Southampton's research on sleep deprivation during the pandemic reports that women, particularly those with young children, key workers and BME groups are losing sleep.  This is thought to be due to rising stress levels due to anxieties about health, financial consequences, changes in social life and daily routine, all of which may affect sleep.  For women with children aged 0-4 years, a fifth (20%) suffered sleep loss over worry before the pandemic. This doubled to two fifths (40%) during the first four weeks of the lockdown. For women with school children aged 5 – 18, sleep loss also rose, from 22% to 38%. These findings are in-line with other research which suggests that there are consistent gender differences in the experiences and impact of the COVID-19 pandemic in the UK.

The research is based on representative UK data survey data from the Understanding Society COVID-19 Study collected during April 2020. It was then compared with survey data collected in 2018/19. The sample included 15,360 respondents aged 16 and above. 

Read the report: University of Southampton Report - Sleepless in Lockdown: unpacking differences in sleep loss during the coronavirus pandemic in the UK

Half of parents struggle to cope with impact of lockdown on children's behaviour

Source: Barnardo's
Date: 19 August 2020

Barnardo's have released findings from a YouGov poll of more than 1,000 British parents which found that 58% of parents have found it difficult to cope with their children at some point during lockdown. Almost a third (30%) report their children are often frustrated, with more than a quarter (28%) saying they get angry more easily and more than one-in-five (21%) saying they are sleeping less at times since lockdown began in March. The top three things that parents thought would help their child cope better during the lockdown were spending time with wider friends and family (42%), time to be outside in the fresh air away from the home (36%) and going back to school (33%).  A small but significant proportion (7%) said speaking to a professional children's support worker could help their child cope better.

Read the news story: Barnardo's - half of parents struggle to cope with impact of lockdown on children's behaviour (news story)

One in three parents 'out of their depth' as children struggle with pandemic fallout

Source: Action for Children
Date: 14 July 2020

Action for Children has released figures from a YouGov online survey of 2,001 parents of children aged 18 or under in Great Britain. The survey, carried out between 16–22 June 2020, found that; 36% of parents said that their children are feeling isolated and lonely; 43% of parents reported feeling anxious; and 33% said that they felt out of their depth when it came to supporting their children during the lockdown. Action for Children is warning that things are likely to get worse as the long term impacts of the pandemic become clearer. After seeing a surge of 415%  in the three months of lockdown to its digital parenting advice service, the charity is launching Parent Talk – a new national online service which connects mums and dads with trained parenting coaches.

Read the news release: Action for Children - One in three parents 'out of their depth' as children struggle with pandemic fallout (news release)

Mothers spend more time home schooling & playing with their children than fathers during lockdown

Source: UCL Institute of Education (Centre for Longitudinal Studies)
Date: July 2020

Initial findings from the COVID-19 Survey in Five National Longitudinal Studies (based on an online survey which ran 2 and 31 May 2020 issued to five nationally representative birth cohort studies) show previously reported gender differences in parental involvement in children's home learning, as well as developmental play activities.

• Home schooling - Among parents with school-aged children, 58% of parents reported doing some home schooling on a typical weekday during lockdown. This figure was higher for mothers (64%) than for fathers (49%), and for those with relatively higher levels of education - 63% for those with a degree or more, compared to 49% for those with lower levels of education.  Time spent on home learning varied by parent's gender, whether parents were working, and age of child.  No difference was found by lone parent status or parental education.  Parents spent more time helping with home learning than in interactive activities with their primary-aged children.  
• Play activities - Mothers of pre-school children spent on average 6.2 hours daily on interactive activities with children, compared to an average of 3 hours among fathers.  Mothers of primary-aged children also spent more time than fathers on these type of activities (3.4 hours compared to 1.8 hours).

Read the briefing: UCL Institute of Education Briefing - Parental involvement in home schooling and developmental play during lockdown

Low income families

Covid Realities Study

Source: The Nuffield Foundation
Date: 14 July 2020

Funded by the The Nuffield Foundation, the Universities of York and Birmingham in collaboration with the Child Poverty Action Group (CPAG) have published early findings from their research study (Covid Realities) on the impact of COVID-19 on low income families.  The qualitative research seeks to explore everyday life for low-income families during the pandemic via online diaries and virtual workshops. Preliminary findings indicate that some low income families have been left hungry, fearful, stigmatised and excluded. Recommendations include increasing child benefit by £10 per week and including the perspectives of people on a low income in policy decisions.  Other key findings were:

• The pandemic is causing additional and often extreme hardship in families' lives.
• Daily essentials became more costly and less available, sharply raising household costs. Food provision is sometimes insufficient, creating feelings of guilt for parents and carers.
• People's mental health is suffering from both new and compounded strains.  
• Financial, emotional, and social support are needed to navigate these additional barriers.
• The end of lockdown and the 'future' beyond looks highly uncertain for many.
• Future concerns centre on finding or retaining work, and on managing financial difficulties.
• The 'new normal' brings with it new costs that may heighten exclusion and inequalities.
• Policy responses have not firmly focused on the needs of families with dependent children.

Read the briefing:  Covid Realities Study - Exploratory Study Findings 

The Children's Society annual survey  found that children in poverty were more worried during lockdown. A higher proportion of young people in poverty stated they were 'very worried' about Coronavirus than those not in poverty (23% compared to 15%).

The Barnardo's research covered earlier reported concerns from frontline staff who are supporting someone in or at risk of being in poverty, were lack of access to food, finance and basic essential items. In their research, youth colleagues found that children and young people were anxious about finances for them and/or their families.

Homelessness

Hundreds of children lived in hotels during lockdown (England)

Source: Children's Commissioner for England
Date: 24 August 2020

The Children's Commissioner for England has published a report based on data from the 15 local authorities with the highest numbers of children living in B&B accommodation.  The analysis found that when lockdown began on 23 March there were 714 families housed in B&Bs across the 15 LAs surveyed.  Despite this number reducing during lockdown, the report states that across these 15 local authorities, 265 families with children were living in a B&B on 31 May and had been there for at least six weeks – despite council's being legally obliged to properly house families living in such accommodation during lockdown.  

• The children's commissioner for England estimates that across England as a whole some 400 and 760 families were living in B&Bs during lockdown.
• In some cases families were moved multiple times during lockdown with one family reported to have been moved 11 times.
• The children's commissioner for England has called on ministers to implement extra measures to protect children from homelessness including providing funding and support for local authorities to move children out of B&Bs in the event of local lockdowns and prioritise support for children facing homelessness through mental health services and those provided by health visitors, as well as extra support to help children impacted by homelessness readjust to return to school and catch up on lost learning.

Read the report: Children's Commissioner for England report - No way out: Children stuck in B&Bs during lockdown

Care experienced and disadvantaged children and young people

Care Leavers in Lockdown 

Source: Barnardo's
Read the news story: Barnardo's news story - care leavers say they're struggling during lockdown (11 April 2020)

Barnardo's has published online video diaries of care leavers in lockdown. 

Other research by Barnardo's reported that care leavers reported lockdown was harder for them without the support of family, that they were facing issues with housing or finances, and that they were finding it difficult to access their usual support networks. 

Life Under Lockdown 

Source: Leicestershire Cares
Date: 19 May 2020

Leicestershire Cares ran a small rapid participatory assessment with 28 young people from across their youth projects on the impact of the pandemic, lockdown and social distancing restrictions on vulnerable young people in Leicester, Leicestershire and Rutland.  Key findings included:

• Social isolation was a key challenge for our participants, many of whom live alone and have had little contact with others for over eight weeks.
• Single young parents with small children were finding the lockdown particularly stressful and were struggling to manage their own health and wellbeing alongside that of their children.
• Some participants identified positive outcomes arising from the lockdown, including the opportunity to learn new skills, be creative and a newfound appreciation for their health, friends and family.
• Young people highlighted the immediate need for help with mental health and wellbeing, overcoming social isolation and staying safe as restrictions ease.  Future concerns included getting into work, continuing to buy essentials, having to use public transport, and overcoming the negative impact on their mental health.

Read the report: Leicestershire Cares – Life Under Lockdown report

Black and Minority Ethnic (BME) children, young people and families

Impact of Coronavirus on Roma Children

Source: University of Central Lancashire
Date: 29 June 2020

The University of Central Lancashire has published a policy paper looking at research on the impact of the coronavirus pandemic on Roma children and the barriers to their health and wellbeing. The paper reports on information from professionals working with young Roma, from 13 organisations in nine European countries including the UK. The findings show consistent patterns of challenging conditions experienced by some young Roma and their communities in relation to: Lack of Essentials for Basic Health and Income (including access to food and water, poor housing and reduced income/problems accessing government support); Wellbeing and Education (issues included isolation, lack of access to outdoor space impacting on mental wellbeing, digital exclusion); and Discrimination and Participation (including negative attitudes from the police, unemployment, and lack of information provision). The report includes a number of lessons learned and recommendations for policy makers.

Read the briefing: University of Central Lancashire - Roma children's participation: shaping responses to COVID-19 in the EU and Bulgaria (Report)

Read the news story: University of Central Lancashire - Roma children's participation: shaping responses to COVID-19 in the EU and Bulgaria (news story)

The Barnardo's research highlights the disproportionate impact of Coronavirus on BAME children and young people and raises concerns about continuing stigma and bullying against Chinese children and young people as they return to school, and the difficulties that children and young people face in accessing information, help and support.  The report also states that the pandemic will increase the number of BME young carers.

Young Carers

The Barnardo's research states that  the pandemic will increase the number of young carers, especially BME young carers, as parents, siblings and other relatives have been required to shield or have become ill from the virus. Lack of information (e.g. on whether a family member was on the 'vulnerable' list) was associated with increased uncertainty and anxiety for young carers. 

Children and families affected by disability

The Human Rights Watch report covered above reported on the impact of school closure on children with disabilities.  It that school closures had disproportionately negative consequences for children with disabilities.  The submission notes that children deemed to have "special educational needs" ("SEN") and children with intellectual or developmental disabilities were at an increased risk of missing out on education with a transition to remote learning.  Children with "SEN" are not getting the support they need which makes it much harder for them to access the relevant tools and engage in remote classes; this has meant that some of these children have not accessed any education since schools closed.  Families have struggled and there are great concerns that these children will fall behind.  Some children with disabilities and chronic health conditions are at risk of further exclusion from education if unable to return to in-person learning due to heightened medical risk and the need to shield. More guidance is needed for staff on how to support children when they do return to school e.g. regarding physical contact.  Other recommendations include access to remedial education programs and teaching support for those who have fallen behind.  

Read the report: Human Rights Watch Submission to the UK Parliament Education Committee: Inquiry into the impact of COVID-19 on education and children's services

Vulnerable Children

How safe are our children? An overview of data on adolescent abuse

Source: NSPCC
Date: August 2020

The report compiles and analyses child protection data from across the UK, and this year focuses on abuse perpetrated against adolescents. The report this year also includes an overview of emerging data on the impact of the coronavirus pandemic on the safety of children and young people in the UK (however, most of the official data used relates to 2018/19). The report found that rates of police recorded physical, sexual and online abuse offences against, rates of those in care, and rates of those subject to child protection measures, are all higher for adolescents that younger children. Many of the risk factors associated with abuse and neglect have been exacerbated by the coronavirus pandemic.  

• NSPCC helpline and Childline counselling sessions has seen an increase in the number and proportion of contacts and counselling sessions to our NSPCC helpline and Childline services about abuse and neglect, especially emotional abuse.  There has also been an increase in reports of sexual abuse within the family.
• Physical abuse - although there has been a drop in the overall number of children and young people attending accident and emergency departments, data from Great Ormond Street suggests a potential increase in the incidence of abusive head trauma (see below).
• Domestic abuse - Data from the charity Refuge and NSPCC helpline also suggests that children are increasingly being exposed to domestic abuse.
• Online abuse - Data compiled by Europol shows significant increases in activity relating to child sexual abuse and exploitation, including a rise in the number of referrals from the National Center for Missing and Exploited Children to Europol about child sexual abuse material.  There has also been an increase in calls to the Internet Watch Foundation about sexual abuse material.
• Abuse outside the home – There is some evidence that teenage girls feel less safe going out in public than before lockdown.  There is also research that suggests that lockdown has created new recruitment opportunities for gangs and a refocusing of recruitment of young people away from urban centres to local areas.^[fn]
• The impact of the pandemic on household finance and adult mental health (particularly woman and parents of young children) which has been widely reported may also impact negatively on children and young people.  That said, the number and proportion of contacts to the NSPCC helpline and Childline counselling sessions about parental mental health have remained low.
• Other issues reported include child mental health and wellbeing (including emerging data that suggests that child suicide deaths may have increased during lockdown, although it is too early to say whether this is a definite trend) and lack of face-to-face contact with services. There are increasing concerns about the child protection system's ability to cope with a potential influx of newly identified concerns.

Read the report: NSPCC Report - How safe are our children?

Rise in the incidence of abusive head trauma during the COVID-19 pandemic

Source: Archives of Disease in Childhood
Date: 02 July 2020

A letter published in the Archives of Disease in Childhood reports on an increase in the incidence of abusive head trauma (AHT) in infants at Great Ormond Street Hospital for Children during the coronavirus pandemic. Figures show that from March 23 to April 23 the hospital saw ten infants ranging in age from two weeks to 13 months diagnosed with AHT. In 2017, 2018 and 2019, the hospital reported an average of 0.67 such cases over the same time period each year. This represents a 15-fold increase during the pandemic compared with previous years.

Read the letter: Archives of Disease in Childhood letter - rise in the incidence of abusive head trauma during the COVID-19 pandemic

Supporting 'off-radar' children and young people who are at risk of violence/abuse in their household

Source: Kings College London
Date: 16 April 2020

Researchers from King's College London in collaboration with Survivors' Voices, the Violence Abuse and Mental Health Network, and The McPin Foundation is undertaking research to understand how best to identify and support 'off-radar' children and young people at risk of violence and abuse during the COVID-19 pandemic.

This survivor-led report contains possible actions to support children who are 'off-radar' (unknown to any statutory services) during and post pandemic 'lockdown' periods. This report documents the results of a survivor-led and rapid response qualitative online survey (the survey ran 30^th Mar to 1 Apr and received 43 responses) targeted at people who had experience of being abused as children whilst off radar, in order to identify practical actions that may help reach this population. This Part 1 Report is an initial collation and thematic analysis of the results of that survey which aims to inform possible actions.  It covers messaging and communication to children and young people at risk and suggestions for further research.

Read the report: Kings College London - supporting 'off-radar' children and young people who are at risk of violence/abuse in their household: Part 1 (interim report)

Harmful content and online safety - Report harmful content (RHC) has seen a 190% rise in cases during lockdown based on the same period in 2019.  These are partly attributed to the site being publicly available (it was piloted in 2019) but there also reports of an increase in online abuse/ harassment/ impersonation as part of a wider pattern of domestic violence over the last few months, and an increase in reports about text based child sexual abuse (CSA) content on independently owned sites.  

Read the article: UK Safer Internet Centre Helplines - Impact of COVID-19 Report

The Kooth mental health online service continues to publish data about young service users' experiences of abuse and neglect during lockdown in England. The mental health service is free and anonymous; data is based on what presenting issues are registered against a service user - typically during counselling but it could also be during any other interaction such as comments in a forum (which may be less reliable and lead to over-reporting). The June data release reports an increase in sexual abuse (up 46% from last year) (previous releases reported increases in other types of abuse – see C&F July briefing). 

Read the ZenZone (Kooth) Data Release June 11 2020 - Week 14: How COVID-19 is Affecting The Mental Health of Children and Young People.

Domestic abuse and family violence

The UCL Covid Study discussed earlier (see Impact on Families section) reports that domestic abuse ('being physically or psychologically abused') has remained relatively stable since the easing of lockdown.  However, it remains slightly higher in people living with children compared to those living with just other adults.

The impact of COVID-19 on domestic abuse survivors and the services supporting them

Source: Women's Aid
Date: 18 August 2020

Women's Aid has published a report on the impact of the coronavirus pandemic on adult and child survivors of domestic abuse and the services supporting them. The report includes a chapter on the impact of the pandemic on child survivors of domestic abuse. Findings include: 53% of respondents who were currently experiencing domestic abuse said their children had seen more abuse; and 38% said that their abuser had shown an increase in abusive behaviour towards the children.
Read the report: Women's Aid - A perfect storm: the impact of the COVID-19 pandemic on domestic abuse survivors and the services supporting them

The report is part of a wider survivor-led project by King's College London, Survivors' Voices, the Violence Abuse and Mental Health Network, and The McPin Foundation.  The project aims to understand how best to identify and support 'off-radar' children and young people during and after the COVID-19 pandemic.

Read more information about this new study on children and young people at risk of violence and abuse during COVID-19. 

Experiences of child and adolescent to parent violence in the COVID-19 pandemic 

Source: University of Oxford
Date: 19 August 2020

Researchers at the University of Oxford and the University of Manchester have published a report looking at families experiencing child and adolescent to parent violence (C/APV) during the coronavirus pandemic. Findings from an online survey of 104 parents who have experienced C/APV from their child aged 10-19 years and 47 practitioners who work with families experiencing C/APV include: 

• 70% of parents reported an increase in violent episodes during lockdown; 
• 69% of practitioners said they had seen an increase in referrals for families experiencing C/APV; and
• 64% of practitioners identified that the severity or incidence of violence had increased.

Read the report: University of Oxford report - Experiences of child and adolescent to parent violence in the COVID-19 pandemic 

Children involved with the Justice System

Risk of vulnerable children being excluded from school for behaviour resulting from being criminally exploited by gangs and drugs traffickers

Source: Just for Kids Law
Date: 26 Aug 2020

A report on how vulnerable children are excluded from school for behaviour resulting from being criminally exploited by gangs and drug traffickers highlights how the pandemic may have left some children at increased risk of exploitation.  Just for Kids highlights the risk of an increase in exclusions if children are not reintegrated and supported properly.  

Read the report: Just for Kids Law Report - Excluded, exploited, forgotten: Childhood criminal exploitation and school exclusions

Barnardo's research reported that practitioners working with children and young people with a parent in prison highlighted increasing mental health needs. The impact of COVID-19 is that social visits to prisons have stopped and children and young people are anxious about the safety of their parent.  There has also been a decline in community-based support as a result of COVID-19 (e.g.  pastoral care and prison-based family support services).

LGBTQ+ Children and Young People

The Barnardo's research cites evidence on difficulties experienced by LGBTQ+ children and young people in accessing mental and physical health support during lockdown, as well as informal support (e.g. from friends) outside their household.  That said, some participants reported the pandemic had helped them come to terms with their gender identity.

The NIHR research found that LGBTQ+ students and those with a health problem or disability had higher anxiety and depression, and lower levels of wellbeing pre-pandemic. Although anxiety reduced and wellbeing increased broadly across the sample there was not much change in these outcomes for this sub-group.