From the very first waves of school closures and lockdowns in 2020, the pandemic significantly damaged children’s mental health in ways teachers are still coping with and researchers are still struggling to understand.
A new analysis of research across 11 countries including the United States in the journal JAMA Pediatrics finds widespread anxiety and depression among those 19 and younger in the earliest days of the pandemic, exacerbated by greater screen time and less physical activity, and coupled with fewer adult supports to ensure children stayed out of dangerous situations.
Researchers studied the effects of school closures from February through July 2020, across 36 studies including nearly 80,000 children and adolescents and more than 18,000 parents in 11 countries. Across the studies:
- Eighteen percent to as much as 60 percent of children and adolescents across the board had strong “distress,” especially symptoms of anxiety and depression, which affected more than 1 in 4 adolescents in some countries.
- Research also showed a rise in screen time and social media use, while some studies found a decline in physical activity—both trends which have been linked to greater risk of depression among children.
- Child protection referrals also dropped, with the decline ranging from 27 percent to nearly 40 percent across countries and studies. The data showed much of this decline came from a lack of school referrals, suggesting that because students were in less day-to-day contact with educators and other adults, signs of abuse or neglect were more likely to go unnoticed.
- However, studies found no significant connection between school closures and suicide among young people, at least in the first months of the pandemic.
Health care clinicians led by Dr. Danielle Dooley reported in a commentary on the JAMA analysis that they are already seeing symptoms related to the disruptions, including disengaging from school, unhealthy weight gain, and delays in immunization and other healthy behaviors.
“These immediate, visible consequences of school closures are harbingers of long-term outcomes, including decreased life expectancy for U.S. schoolchildren,” the doctors wrote.. “Children are resilient, but this resiliency requires individual support, systemic scaffolding, societal investment, and scientific research into the short-, medium-, and long-term impacts of the pandemic on children.”
The JAMA analysis looked at school closures ranging from a few weeks to three months. Researchers cautioned that as schools generally closed or moved to online learning in response to broader community lockdowns and other quarantine measures, the data couldn’t tease out whether mental health problems arose from the pandemic as a whole or school closures in particular. The analysis also did not look at differences in experiences for students of various races, though the few studies of students of different income levels showed students in poverty had higher rates of anxiety.
The study could not determine how to balance students’ risk of mental and emotional harm from school closures with the risks of physical illness and spread from allowing students and staff to gather in person. However, a December report from the U.S. Surgeon General suggested that many students’ mental health problems have begun to recede in the year since the majority returned to in-person learning.
The JAMA researchers found children and adolescents were more likely than adults to be completely isolated from others their age during the first waves of the pandemic; adults were more likely to see each other online or through in-person social distancing, but children didn’t have much access to peers outside of school.
“We are regularly hearing from teachers who feel overwhelmed by the pandemic challenges and the increase in the number of students experiencing learning, behavior, and emotional problems,” said Howard Adelman, psychology professor and codirector of the Center for Mental Health in Schools at the University of California, Los Angeles, who was not involved with the JAMA study. But he cautioned, “Without transforming student-learning supports, just adding more mental health staff in schools will contribute to the ongoing fragmentation and marginalization of efforts to cope with the increased number of learning, behavior, and emotional problems schools are confronting.”
Many schools structure their academic, social-emotional, and mental health supports using processes such as multi-tiered systems of support or Positive Behavioral Interventions and Supports, but Adelman said the approaches tend to be too limited to deal with the complex and widespread mental health problems schools have faced during the pandemic.
“Given the relatively small pool of resources available to so many schools and the range of students in need,” he said, “this is a critical time for schools to rethink how they are addressing barriers to learning and teaching and improve their approach to reengaging disconnected students and their families.”