Most teenagers have fended off the physical effects of Covid-19 or avoided symptoms altogether. But there is growing evidence of the worrying toll the pandemic is taking on the mental health of children and adolescents in the UK.
One general practice doctor working in a coastal town near Bristol, in the west of England, said she began noticing this in October when an unusual number of young people began coming to her clinic with anxiety and depression.
“I have had a lot of primarily teenagers but also younger kids. A couple were self-harming. Some said they didn’t want to be here. It was really tough,” said the doctor who asked not to be named, adding that colleagues had told her they were experiencing a similar trend.
NHS data tells a similar story. In a recent 2020 follow-up to a nationwide study carried out in 2017, the health service found that one in six children between the ages of 5 and 16 were likely to have a mental illness, up from one in nine three years ago when the same sample of 3,500 young people was surveyed.
The research found this increased with age, with a marked and growing difference between the sexes. Some 27.2 per cent of women aged 17-22 were likely to have a mental illness compared to 13.3 per cent of young men.
Psychiatrists, psychotherapists and doctors operating in varied environments across the UK, all noted that the experience of lockdowns, school disruptions, and family life this year varied greatly and was not all bad. Some children had benefited from having more time at home with their parents.
But, said Ryan Lowe, speaking for the Association of Child Psychotherapists, 2020 was, on balance, bad in particular for adolescents. She said the exam grading fiasco last summer, being cut off from friends, and in cases overexposure to the darker influences of social media, inevitably took a toll.
“If you were to paint a picture of the perfect setting to grow up in, it would be the opposite of where we are now,” she said. “What you want to have is real certainty and hope in the future, stability while dealing with adolescence which is difficult at the best of times, and to have a really good social circle where you can learn about yourself independently of parents.”
A private practitioner working in London, Ms Lowe said the most distressing thing had been the number of young people presenting with serious enough conditions (either self-harming or at risk of suicide) that they needed to be referred to psychiatrists. Even those able to afford a private consultation were having to wait weeks for an appointment on account of the demand. Going through the NHS usually takes far longer.
“It used to be that around 10 per cent of clients referred to us saw psychiatrists and the rest were [treated with] psychotherapy. At the moment, around 40 per cent are needing to go to psychiatry, and I can’t keep up with those being referred to me,” she said. “It is heart breaking.”
Bernadka Dubicka, chair of the child and adolescent faculty at the Royal College of Psychiatrists, said that in Oldham, the Greater Manchester town where she practises, there had initially been a dramatic fall in the number of children turning up at hospital and at the Child and Adolescent Mental Health Service (CAMHS) during the first lockdown that began in March.
Parents may have been reticent about their children going to clinicians for fear they would be infected, she said. But this had translated later in the year into greater numbers of young people turning up with more serious conditions.
“Particularly with psychosis, the longer you leave it the more difficult it is to treat,” she said, adding that the virus had arrived at a time that young people were already increasingly anxious about issues such as climate change, recession and unemployment.
“We have a crisis on top of a pre-existing crisis. The level of uncertainty [in young people’s lives] is phenomenal in terms of what we have seen in our lifetimes,” she said.
YoungMinds, a charity working with young people, found that 39 per cent of those surveyed in the summer agreed that coronavirus had made their mental health worse and 41 per cent of them “much worse.” Often this was because of feelings of anxiety, isolation and a loss of “coping mechanisms” and motivation.
Peter Fonagy, a clinical psychoanalyst who heads the Anna Freud centre for research and treatment of children, praised teachers for having done a remarkable job in the circumstances but said they too had paid a price in terms of their mental health.
However, for young people, he said, the virus had created a “feeling that life is on hold.”
The Department of Health and Social Care said it had been an exceptionally difficult year but young people’s mental health services had stayed open throughout the pandemic.
“We are expanding and transforming services backed by an extra £2.3bn investment in mental health per year by 2023/24,” it said.