[[This post is largely part of Dr. Katelyn Jetelina’s (YLE) newsletter. To read in its entirety, she can be found on Facebook or on yourlocalepidemiologist.com]]

“Our Youth are Struggling with Mental Health… and COVID-19 is making it worse.”

On October 19, 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association issued a declaration that children’s mental health had become a “national emergency.” The U.S. Surgeon General followed on December 7 with his own 53-page advisory on the dire state of youth mental health. Mental health challenges are rising among kids, which seems to be due to a perfect storm of increasing mental health challenges before the pandemic and a highly disruptive pandemic.

***Before the pandemic***

Mental health challenges among children and youth are not new. Before COVID-19, pediatric mental health disorders were high: up to 20% of children and youth experience a mental health disorder in any given year, and the percentage has been increasing in recent years. The rate of suicides among 10-24 year-olds steadily rose between 2010 and 2018, and suicide was the second leading cause of death for the 10-24 year old age group in 2018.

***Immediately following stay-at-home orders***

Then COVID-19 hit. In-person school was closed, and children lost out on school-related activities and milestones. The isolation of remaining at home, concerns about the future, and potential economic strains on families contributed to declines in mental health. It’s clear from multiple studies that the first month or two of the pandemic significantly impacted mental health of kids.

At the beginning of the pandemic (April 2020), the proportion of pediatric emergency department visits for all mental health-related reasons increased 24-31% (depending on age). Then it stayed high for the rest of the year.

Specifically, research found the number of youth going to the ED for suicidal thoughts and behaviors increased from the start of the pandemic and remained higher than 2019. Overall, risk of presenting with suicide-related concerns was 133.5% higher among youth aged 5 to 12 years and 69.4% higher among youth aged 13 to 17 years, compared to 2019. Rates increased throughout the year for girls, specifically.

At the end of 2020, a national survey was conducted by the Jed Foundation to assess youth well-being during the pandemic. They found that 1 in 3 families reported their child’s emotional health was worse than before the onset of COVID-19. The most common challenges that children experienced were loneliness (23%) and anxiety (22%), followed by trouble concentrating (20%).

Then, in August 2021, JAMA pediatrics published an article that reviewed 29 studies with over 80,000 youth worldwide. They found that 25.2% of youth experienced depression, and 20.5% experienced anxiety during the pandemic worldwide, which is double that of pre-pandemic estimates (11.6% for depression pre-pandemic and 12.9% for anxiety pre-pandemic). Interestingly, the rates of depression and anxiety were higher later in the pandemic, particularly among older adolescents and girls. Also, interestingly, the rates of anxiety were highest among adolescents in Europe (34%) and North America (21%).

Most recently (August-September 2021), NPR, the Robert Wood Johnson Foundation, and Harvard polled parents to assess the impact of the Delta wave on children. They found that 36% of households with children struggled with stress, anxiety, depression, or sleeping difficulties. Additionally, over a third of families reported severe challenges in social support (like child care).

***Bottom line:***

Children had (and continue to have) a rough time during this pandemic. There’s a lot we can do on a national level, but also on an individual level to prioritize the needs of kids during this tough time.

Research: Dr. Katelyn Jetelina, Rebecca Molsberry, PhD candidate in mental health epidemiology, and Dr. Lisa Uebelacker

▪️▪️Hats off to you if you read that very condensed version! My open question to you is— how do you believe these mental health challenges our youth are facing should be properly addressed, by teachers, parents, and physicians? Both the AAP and many doctors monitoring this have made suggestions, but I think often we forget to ask real parents and people from other lines of profession their opinions on important matters like these.▪️▪️