While the COVID-19 pandemic has occurred in a series of waves, the heightened levels of depression and anxiety among children and youth seen at the start of the pandemic has remained consistent. This is one of many new preliminary findings from the ongoing COVID-19 mental health study led by The Hospital for Sick Children (SickKids). Taken together, the latest findings demonstrate a serious, sustained negative impact on the mental health of Ontario children, youth and their families.
New preliminary findings from the SickKids-led COVID-19 mental health study.
The study currently has over 2,700 participants ranging in age from two to 18 years old who live in Ontario. It is led by four research teams, each with their own areas of expertise in child and youth health. The research teams surveyed different participants at different time points to get a holistic understanding of how public health measures, including school closures, have impacted child and youth mental health and well-being.
Loss of in-person school had significant impact on child and youth mental health
The research team found mental health did not improve as the school year resumed, building on their previous findings that a majority of children and youth reported worsening mental health during the initial COVID-19 lockdowns. Over half of 758 children aged eight to 12 years old and 70 per cent of 520 adolescents reported clinically significant depressive symptoms during the second wave (February to March 2021).
Among 2,206 participants, the researchers found a strong association between time spent online learning and depression and anxiety in school-age children (six to 18 years old). The more time students spent online learning, the more symptoms of depression and anxiety they experienced.
Before the pandemic, 58 per cent of 1,261 participants surveyed participated in school sports and/or other extracurriculars, activities that are known to boost physical and mental health. During the pandemic, only 27 per cent participated in sports and 16 per cent in extracurriculars. Furthermore, losing in-school services, such as healthy eating programs, counselling and learning supports, resulted in worse mental health outcomes for children and youth.
School represents more than just academics for children and youth. For many, school and its in-person interactions and activities form the cornerstone of their lives.
“Our study found that despite periods of modified, in-person school, mental health measures did not improve significantly, including for those who attended school in person. This should serve as an urgent call to ensure that we do not replicate school as it was this past year, and get kids back to in-person learning, activities, and sports,” says Korczak.
Mental health impacted by inequities, increased screen time during COVID-19
The researchers found that families who were already vulnerable before the pandemic, for example those with lower household income and parental education rates, were disproportionately impacted by economic hardship as a result of the pandemic, such as job loss and food insecurity. These families experienced higher levels of both child and caregiver mental health symptoms and stress. For all families, caregiver mental health and family functioning were impacted by their children’s mental health difficulties and vice versa.
Increased time on screens had a wide-ranging impact on the mental health of children and youth as well. Across 1,494 participants of all ages, increased time spent watching TV, on digital media and video games was associated with more irritability, hyperactivity, inattention, depression and anxiety.
Tips to reduce screentime
Reducing screen time during COVID-19 can be challenging. Check out these harm reduction tips to promote healthy screen use.
In a separate but related study published in the Canadian Journal of Public Health on July 8, 2021, TARGet Kids! researchers found the public health measures implemented in Ontario between April 14 to July 15, 2020, were associated with a decrease in outdoor time and an increase in screen time among young children under 10 years of age. The study also found this association was stronger in females compared to males, and children aged five years old and above compared to children under the age of five.
“This study contributes to the growing evidence that the pandemic is associated with unhealthy movement behaviours among children,” says Dr. Catherine Birken, Principal Investigator of the TARGet Kids! study, co-investigator of the COVID-19 mental health study, Staff Paediatrician and Senior Scientist in the Child Health Evaluative Sciences program at SickKids. “We need to invest in safe outdoor opportunities in child-centred settings, such as schools and public parks. Furthermore, restarting camps, activities and sports will be crucial to support families in reducing screen time and promote children’s social and emotional development.”
The bottom line: Kids need school, friends and fun
The preliminary findings from the ongoing COVID-19 mental health study have not yet been peer-reviewed. The research team says that by sharing preliminary findings now, they hope to provide policy-makers, public health and others with the information they need when considering decisions that will impact children and youth in Ontario.
“Our data overwhelmingly points to the significant and sustained mental health effects that the public health mitigation strategies and school closures have had on children, youth and their families in Ontario,” says Korczak, who is also an Associate Scientist in the Neurosciences & Mental Health program at SickKids and an Associate Professor in the Department of Psychiatry at the University of Toronto. “Kids need school, they need their friends and they need to have fun. As our focus shifts to reopening society, we must have meaningful conversations about prioritizing the needs of children and youth.”
The ongoing COVID-19 mental health study is supported by the Canadian Institutes of Health Research (CIHR), Ontario Ministry of Health, the SickKids Centre for Brain and Mental Health, the Edwin Leong Centre for Healthy Kids, the Department of Psychiatry at the University of Toronto and SickKids Foundation. In-kind support was provided by the Ontario Brain Institute.
The TARGet Kids! study was supported by Canadian Institutes of Health Research (CIHR), Fast Funding for COVID-19 Science and SickKids Foundation. The research is an initiative of TARGet Kids!, a primary care research network co-led by SickKids and St. Michael’s Hospital/Unity Health Toronto.