Exploring the experiences and impact of Covid-19 on Children and Young People’s mental health and wellbeing in England (2020)

By Lauren Cross, Research Assistant and Tamsin Ford, Professor of Child and Adolescent Psychiatry in the Department of Psychiatry (University of Cambridge). They both work within Child and Adolescent Resilience and Mental Health project within the department.

What are the implications for the second national lockdown?

As we reacclimatise ourselves to a second lockdown it is important to reflect on what we have already learned and, crucially, what we still need to know about children and young people’s experiences of Covid-19 and its potential impact on mental health and wellbeing.  

Covid-19 and restrictions put in place have radically altered children and young people’s daily lives, with school closures, disruption to peer, family and community networks, economic insecurity, and heightened health anxieties. Mental health and wellbeing is an area of key concern, with some emerging evidence to suggest mental health is deteriorating – and young people appear to be a particularly vulnerable group (see Pierce et al., 2020).

What have we learned so far?

Despite mental health of children and young people identified as a priority there are surprisingly few studies of sufficient quality (those with data collection both before and during Covid-19) to reflect on. The recently published findings from the Mental Health of Children and Young People Surveys, however, are able to provide some important information and insights into children and young people’s experiences of Covid-19.

The Mental Health of Children and Young People Surveys (MHCYP Surveys):

The MHCYP Surveys explore prevalence of probable mental disorder on a representative sample of children and young people from England. In this context ‘probable mental disorder’ means those who would likely be diagnosed as having a mental health disorder by a clinician if they were to present to mental health services.

An initial survey was conducted in 2017. The same group of participants were then followed-up in 2020 with some additional questions exploring the experiences of family life, education and services, and worries and anxieties during the COVID-19 pandemic (June, 2020). This allows us to compare results from both time points, and establish how mental health has changed over time.

How has mental health changed in 2020? 

The 2020 follow-up of the MHCYP Surveys revealed that rates of probable mental disorders have increased since 2017. In 2020, one in six (16.0%) children aged 5-16 years were identified as having a probable mental disorder, increasing from one in nine (10.8%) in 2017. Whilst it is not possible to conclude that this deterioration in mental health is directly caused by experiences and restrictions associated with Covid-19, it is clear that the mental health of children and young people is worsening- and Covid-19 is most likely playing a part.

This means it is essential that mental health and wellbeing remains a priority during this current lockdown period.

Background characteristics appeared to be important with the likelihood of probable mental disorder increasing with age, and young women aged 17-22 in particular appeared to be a more vulnerable group (with more than 1 in 4 identified as having a probable mental disorder in 2020). A number of environmental factors were also associated with the increased likelihood of a probable mental disorder including individuals reporting they were more likely to be living in a household that had fallen behind with payments, less regular support from school or college, and witnessing an argument between adults within their household.

However, perhaps of greatest concern, is that the survey data revealed those with a probable mental disorder are a uniquely vulnerable as their lockdown experience is more likely to be characterised by greater challenge. For example, children and young people with a probable mental disorder were more likely to say that lockdown had made their life worse (54.1% of 11 to 16 year olds, and 59.0% of 17 to 22 year olds), than those unlikely to have a mental disorder (39.2% and 37.3% respectively). Therefore, it is essential that necessary safeguards and support are accessible during this time.

Where do we go from here?

This existing research provides essential information regarding national trends. However it is limited, in the way that all large-scale quantitative surveys are, in terms of the detail it can provide. In order to truly capture and understand experiences of Covid-19 restrictions and associated impact on mental health we need to look in a little more depth.

Our project intends to conduct qualitative interviews with a smaller group of children and young people (aged 14-22) and their parents (children aged 5-18) who completed the MHCYP Surveys 2020 follow-up. We will purposively select individuals who reported life had got better, and those who said life got worse during lockdown. Having both of these groups will enable us to unpack a range of lockdown experiences. We will explore some key themes identified as important in the national survey including school closures, being at home, and where appropriate the impact of reduced access to mental health services.