Impact of COVID-19 on poor mental health in children and young people ‘tip of the iceberg’ – UNICEF

NEW YORK/Albania 5 October 2021 – Children and young people could feel the impact of COVID-19 on their mental health and well-being for many years to come, UNICEF warned in its flagship report today.

According to The State of the World’s Children 2021; On My Mind: promoting, protecting and caring for children’s mental health – UNICEF’s most comprehensive look at the mental health of children, adolescents and caregivers in the 21st century – even before COVID-19, children and young people carried the burden of mental health conditions without significant investment in addressing them.

According to the latest available estimates, more than 1 in 7 adolescents aged 10–19 is estimated to live with a diagnosed mental disorder globally. Almost 46,000 adolescents die from suicide each year, among the top five causes of death for their age group. Meanwhile, wide gaps persist between mental health needs and mental health funding. The report finds that about 2 per cent of government health budgets are allocated to mental health spending globally.

There is a knowledge gap on the mental health status of the  children and adolescents  in Albania. According to “Health Behaviour in School Age Children survey” 2017-18 a considerable percentage of the school age children reported that they feel low or irritated at least once per month, they are nervous and report sleep disorders. The older children and girls report a higher level of mental health disorders.  Adolescents frequently report feeling nervous (18 per cent), irritable or bad tempered (20 per cent), and headaches and difficulties in getting to sleep (15 per cent each).

COVID-19 has highlighted mental wellbeing and health as an important and emerging risk faced by adolescents in Albania. When children experience strong, frequent, or prolonged adversity without adequate caregiver support this can have serious and enduring negative consequences on cognitive development and emotional regulation, potentially resulting in life-long impact on a child’s mental and physical health.

“It has been a long, long 18 months for all of us – especially children. With nationwide lockdowns and pandemic-related movement restrictions, children have spent indelible years of their lives away from family, friends, classrooms, play – key elements of childhood itself,” said UNICEF Executive Director Henrietta Fore. “The impact is significant, and it is just the tip of the iceberg. Even before the pandemic, far too many children were burdened under the weight of unaddressed mental health issues. Too little investment is being made by governments to address these critical needs. Not enough importance is being placed on the relationship between mental health and future life outcomes.”

Children’s mental health during COVID-19

Indeed, the pandemic has taken its toll. According to early findings from an international survey of children and adults in 21 countries conducted by UNICEF and Gallup – which is previewed in The State of the World’s Children 2021 – a median of 1 in 5 young people aged 15–24 surveyed said they often feel depressed or have little interest in doing things.

As COVID-19 heads into its third year, the impact on children and young people’s mental health and well-being continues to weigh heavily. According to the latest available data from UNICEF, globally, at least 1 in 7 children has been directly affected by lockdowns, while more than 1.6 billion children have suffered some loss of education. The disruption to routines, education, recreation, as well as concern for family income and health, is leaving many young people feeling afraid, angry, and concerned for their future. For example, an online survey in China in early 2020, cited in The State of the World’s Children, indicated that around a third of respondents reported feeling scared or anxious.

UNICEF in Albania  has been able to develop its response through engagement of additional work force -a team of professional psychologists for 24/7 provision of online psychological counseling for children, their parents and caregivers, especially those affected or at risk of  violence/Gender Based Violence and  frontline protection professionals through the existing platform www.nukjevetem.al  ; strengthening the existing operational capacities of child helpline ALO116 to address the limited functional capability of the helpline to operate in the situation of lockdown and also to deal with the increased number of calls from children; train staff of National Helpline and counselling platform NJV on handling the cases of violence/GBV risk mitigation and referrals for survivors, including for protection from sexual exploitation and abuse.  Also, on  how to provide adequate counselling and information to children young people and parents on COVID-19; adjust the current services to children in conflict or contact with the law to the situation of social distancing restrictions, with a view to ensure continuity of care and implementation of individual plans of treatment. 

UNICEF has supported capacity development of 160 health personnel in preventive maternal and child health services in 4 regions (Tirana, Elbasan, Korca, Vlora). A specific module on the parental wellbeing is part of the accredited training curricula of the home visiting personnel.  As a trusted professional, the home visiting health personnel  learns about the mental health needs of a pregnant woman, new mother, or father and provides advice and first-line listening support, as well as identifies those that need professional help and refers them to the appropriate services.

Cost to society

Diagnosed mental disorders, including ADHD, anxiety, autism, bipolar disorder, conduct disorder, depression, eating disorders, intellectual disability, and schizophrenia, can significantly harm children and young people’s health, education, life outcomes, and earning capacity.

While the impact on children’s lives is incalculable, a new analysis by the London School of Economics in the report indicates that lost contribution to economies due to mental disorders that lead to disability or death among young people is estimated at nearly $390 billion a year.

Protective factors

The report notes that a mix of genetics, experience and environmental factors from the earliest days, including parenting, schooling, quality of relationships, exposure to violence or abuse, discrimination, poverty, humanitarian crises, and health emergencies such as COVID-19, all shape and effect children’s mental health throughout their lifetime.

While protective factors, such as loving caregivers, safe school environments, and positive peer relationships can help reduce the risk of mental disorders, the report warns that significant barriers, including stigma and lack of funding, are preventing too many children from experiencing positive mental health or accessing the support they need.

The State of the World’s Children 2021 calls on governments, and public and private sector partners, to commit, communicate and act to promote mental health for all children, adolescents and caregivers, protect those in need of help, and care for the most vulnerable, including:

• Urgent investment in child and adolescent mental health across sectors, not just in health, to support a whole-of-society approach to prevention, promotion and care.
• Integrating and scaling up evidence-based interventions across health, education and social protection sectors - including parenting programmes that promote responsive, nurturing caregiving and support parent and caregiver mental health; and ensuring schools support mental health through quality services and positive relationships.
• Breaking the silence surrounding mental illness, through addressing stigma and promoting better understanding of mental health and taking seriously the experiences of children and young people.

“Mental health is a part of physical health - we cannot afford to continue to view it as otherwise,” said Fore. “For far too long, in rich and poor countries alike, we have seen too little understanding and too little investment in a critical element of maximizing every child’s potential. This needs to change.”