Emerging Findings Reveal the Pandemic's Impact on Youth

In the news this past week, the pandemic’s effect on young people has been a hot topic. Here’s a roundup of what we’ve learned about minors and mental health this past week, along with what you can do about it.

As a society, we’re just beginning to realize how a global pandemic can impact individual people’s internal worlds and experiences. Mental health in America was a prevalent issue before Covid-19, but it’s become more of a talking point than we ever thought possible. Which is fortunate, because we’re likely to continue needing to talk about it for the rest of our lives.

As deeply as the global pandemic impacted adults and society at large, it’s also had a severe and rippling effect on the mental health of children. There are hidden costs of the pandemic that we haven’t even begun to grapple with, let alone address on a systemic level. Here’s what we’ve learned.

The World Before the Pandemic

Even before Covid-19 and its effects rippled through our lives, a concerning number of young people were already living with mental health issues. These ranged from feeling helpless, anxious, and depressed to suicidal ideation. At this point, mental health issues were the leading cause of disability and poor life outcomes in young people. Up to 20% of American children ages 3-17 had a mental, emotional, developmental, or behavioral disorder. 

And rates of mental illness in children and teens have increased in the past decade. Rates of childhood mental health concerns and suicide rose steadily between 2010 and 2020. By 2018, suicide was the second-leading cause of death in people ages 10 to 24 – a stark mental health statistic if there ever was one. From 2009 to 2019, the percentage of high school students who reported feeling sad or hopeless increased by a staggering 40% -- again, this was before the pandemic hit.

But this worsened during the pandemic. In the past several years, we’ve seen dramatic increases in emergency healthcare needs to treat mental health emergencies across the board. 

What Happened to Youth During the Pandemic?

The pandemic disrupted people’s lives and exacerbated issues that were already facing a lot of American youth. One consistent phenomenon was that the most vulnerable people were hit the hardest during the pandemic. This was true for kids and teens as well. And the list of risk factors is so long that in some zip codes around the country, it could very well be challenging to find an example of a child who hasn’t been affected by:

• Disabilities
• Racial and ethnic minorities
• LGBTQ+ issues
• Low-income people
• Remote or rural areas
• Immigrant households
• Involved with child welfare
• Juvenile justice or carceral systems
• Unhoused or housing insecurity
• Food insecurity
• In dangerous or abusive situations
• Socially isolated

How Can One Event Have Such a Lasting Impact?

One of the clearest examples of the pandemic’s ripple effects can be seen by examining the consequences of social distancing and isolation. This may seem like ancient history by now, but 2020 saw us grapple with the destabilization of huge swaths of our daily lives, such as:

• Daily routines
• Social support systems
• Welfare programs
• Education
• The food system (remember in 2020 when your grocery store’s shelves were practically empty for a while?)

Mental health care was also hard to access for a while, with many appointments being canceled or delayed as providers scrambled to keep up with increased demand, new virtual appointment formats, and their own personal stressors and burnout.

We also can’t talk about the pandemic’s effects on children without mentioning the fact that over 214,000 American children have lost a parent to Covid so far. Losing a parent can have severe, long-lasting effects on a child’s mental health for the rest of their life. This is a hidden cost of the pandemic we haven’t even begun to grapple with, let alone address on a systemic level.

A Critical Time for Development

All these changes and challenges came at difficult times for adults, but during critical developmental periods for children and teens. Young people also don’t have the same coping skills and emotional regulation capabilities as the average adult. And with isolation measures and social distancing, young people couldn’t all access the same support and resources they once relied on. This would have been particularly true for children who didn’t get all their needs fulfilled by their immediate family members and people in their household.

We’re just now starting to grapple with what this means. In December of last year, the US Surgeon General even issued an advisory on what they called the “youth mental health crisis,” which their statement said was “further exposed by the COVID-19 pandemic.”

The pandemic set off what experts have called a “perfect storm” of mental health factors that will impact our country for years to come. While many experts and studies are examining the impacts of the pandemic from the lens of the immediate aftermath, we’re likely to see ripple effects of the pandemic for the rest of our lives, if not in the next generation’s lives as well.

What Does This Mean for the Country's Mental Health in the Future?

Interestingly enough, this week also brought a fresh report out of Brazil about what the effects of childhood trauma look like. This was published in The Lancet Psychiatry as the Pelotas Birth Cohort Study.

Findings suggest that children exposed to life-threatening or horrifying events are almost twice as likely to develop psychiatric disorders as their peers. Some qualifying traumatic events, as named in the study, included:

• Seeing someone die
• Suffering a serious injury
• Experiencing sexual violence

And these events could have lasting effects on children who experienced them firsthand or who saw them happening to other people, including loved ones. Affected children were more susceptible to developing:

• Anxiety
• Mood disorders
• ADHD
• Hyperactivity disorders
• Conduct and oppositional disorders

The study specifically identified ages 6-11 as crucial years for this. Children who experienced traumatic events during that age period were between 50% and 100% more likely to develop psychiatric conditions than their non-traumatized peers.

In Brazil (where the study was conducted and the sample chosen), this is related to a considerable, long-term mental health issue among the child population. Obviously, the US and Brazil are very different countries, but this can be useful information when examining the current state of affairs for American children – especially when you recall that the US is also facing a youth mental health problem.

This is one of the first studies to demonstrate that trauma is linked to higher rates of an array of mental health problems in childhood. Previous studies looking at the impact of childhood trauma on mental health mostly focused on adults. But this study showed children could be negatively affected by trauma as young as age 6.

And the pandemic was just that – a collective trauma, especially for children who lost parents and loved ones. So, it stands to reason that we’re already going to be seeing some of the pandemic’s lasting effects on young people’s mental health, even if we think they’re too young to be affected by it or to “know the difference.”

How to Tell if a Child or Teen You Know is Struggling

Unfortunately, we simply don’t know what a world that didn’t go through the pandemic would have looked like. Parents, teens, and anyone who works with youth will tell you that one of the hardest parts of identifying mental health concerns in a young person is that there’s no control group. It can be hard to tell the difference between personality and a trauma response. But if a child was vulnerable or struggling before the pandemic, it’s likely they’re still struggling. If anything, they may be doing worse.

Parents, family members, and loved ones can watch out for:

• is your kid reaching typical developmental and emotional milestones?
• Are they participating in age-appropriate behavior?
• Are they able to participate in age-appropriate social events?
• Are they able to learn and employ healthy social skills?
• Are they able to learn age-appropriate coping skills when they encounter problems?
• Do they have an overall positive outlook on life and themselves?
• Are they doing well in school, both socially and academically?
• Are they able to form bonds and interact with their community?

Fears, sadness, and hopelessness are inevitable human emotions, and children are no exception. But if they’re persistent or extreme, that’s cause for concern. It could be a sign of anxiety, depression, or other underlying concerns.

Knowing the Signs

Another common issue is that mental health issues (including depression, anxiety, ADHD, eating disorders, etc.) manifest differently in children than in adults. For example, we expect depressed adults to just come off as quiet, withdrawn, or sad. But there are different things to look out for in young people, including:

• Age-inappropriate overreactions
• Behavioral problems
• Irritability
• Withdrawing from activities and hobbies they used to enjoy; kids have phases and may try new things and lose interest in others, but if that pattern seems abnormal or they lose interest in hobbies and don’t seem to replace that passion with something else, that can be a sign of depression
• Changes in diet or appearance
• Struggling with schoolwork
• overreacting to everyday events
• voicing persistent or recurring feelings of dread or unease

It’s often hard for parents and caretakers to tell when their kids are struggling mentally and emotionally. There are a handful of reasons for this.

• Kids tend to know more about current events/family problems than we think they do
• Children may interpret events or statements differently than we expect them to
• Children have rich internal lives their parents often aren’t aware of (especially as they get older)
• Adolescent mood swings and clashes with authority figures are often inevitable to some extent

Here’s how caretakers can hedge their bets and set themselves up for success in supporting youth:

Choose Your Messaging Carefully

When bringing up the subject of mental health with kids, try to exude a non-judgmental, open-minded attitude. Avoid making value judgments about their feelings and avoid using words like “crazy,” “unhinged,” or “ridiculous.” Try not to minimize their feelings by normalizing their struggles or referring to them as “part of growing up.” And keep in mind that just because you struggled with something as a child or teen doesn’t mean it’s necessarily normal.

Don’t Force the Issue

Don’t try to force them to open up. Be there for them, create a safe emotional space, and make sure they feel like they can talk to you. If you try to force intimacy, they may pull back more. Instead, focus on making sure they feel safe and heard. Then, trust that they’ll approach you when they need you.

Open Communication Channels

Be open to communicating over text, notes, or hand-written letters instead of face-to-face conversation, especially if that’s more your kid’s style. And remember, listening is just as important as talking.

Prioritize Self-Care

Take care of your own mental health. Caregivers’ mental health is really important for kids’ well-being and is often ignored. Chances are, if you’re struggling, your kid can tell.

Flex Your Support System

You’re not alone! If you’re concerned or not sure how your kid is doing, consider sensitively reaching out to:

• School counselors
• Coaches
• Teachers
• Trusted adults
• Your kid’s friends’ parents
• Therapists
• Your kid’s doctor

Let Them Know Therapy Is an Option

Talk to your kid about getting therapy if you think that’s necessary or would be helpful. You can let them know that you’d support them in pursuing mental health care if they think they’d benefit from that. This can open a dialogue without forcing the issue, and it also shows them therapy isn’t something to be embarrassed or scared of.

Offer to help them find a therapist and figure out copays and insurance costs for them. Do what you can to make sure therapy is a respite, not a stressor, for them. And remember that family therapy, group therapy, and individual therapy are all options – and they’re not mutually exclusive.

Keep Up With the Times

Actively try to break down the mental health stigma when you see it in your social spheres and family dialogue. Encourage a culture of openness, compassion, humanity, empathy, and curiosity – not judgment or rigidity. Gen Z is particularly well-informed about mental health and social issues, and Gen Alpha may well absorb that as well. You want to show them that you’re open to learning and aren’t clinging to outdated ideas about mental health. Don’t put the burden on them to educate you; it can make sparking an open dialogue challenging.

It's clear by now that we’re just beginning to see the pandemic’s ripple effects in our lives. Social science, psychiatry, and psychology scholars are sure to paint a clearer picture of what effects we can all expect to see moving forward.

This is daunting. There’s no way to sugarcoat that. But the good news is that this was a collective experience, which makes it easier to get support.