After the formal presentations, the speakers came together to answer questions posed by the audience.
Low income families
Many people living on very low incomes have been reporting particularly high levels of difficulty. It is of course a variable picture; some low-income families who were furloughed appreciated the time they had together, whereas for others the situation has been much more challenging. So, while it is difficult to draw clear conclusions, the data gives reasons for concern. From the UCL social study with adults, two of the major factors associated with better wellbeing during the pandemic were the ability to access the outdoor environment and staying active – both of which are much easier if the family has a garden.
The identification of the drivers of mental issues is really key. Before the pandemic, poverty was already highlighted as one of the major drivers. Unless new policies are implemented, then the problem will remain and continue to cause significant emotional, social and psychological distress, with subsequent mental health problems.
Did social media reinforce anxieties and mental health problems or did it provide relief? Questions about social media are always present, especially in discussions about young people. Obviously, people have concerns about the impact of social media on young people’s mental health. In one study, it was clear that those of secondary school age were well-connected with their peers. The vast majority had regular contact with friends, via texting on phones and video calls, through online gaming: in fact, in all sorts of ways. That was not true for primary school children where only a very small number had any interaction with their peers outside the home.
It was suggested that may be connected to transition points for young people at secondary school as they move from dependence upon the family to interdependence with their community – friends, essentially. Digital engagement has been a huge benefit for that this group. On the other hand, lack of play and interaction has been detrimental for children of primary school age.
Studies examining anxiety in children have found that common anxiety problems have an early onset. Half of all lifetime anxiety disorders will start by the age of 11. So they need to be identified early, with effective interventions. Families in need of help can often experience a series of barriers in accessing support: there are problems about the identification of the problems themselves and what support could be effective. There are also issues about knowing where to obtain help and then actually accessing it when they try.
By carrying out screening in schools, though, many of those barriers could be bypassed and those children who could benefit from support could receive it early. It is important to make sure that people get support based on expert evidence. Where there are problems which are causing interference in people’s lives, identification needs to be rapid and help provided quickly. In addition, there need to be specialist services that can be called upon when problems need further intervention.
One of the speakers recalled their own experience in an inner-city school. This initially had a dedicated team for safeguarding and mental health issues. Yet very quickly, this moved to a whole school approach where all staff were available and trained to support this activity. It was a recognition that background and upbringing had as much influence as anything from a medical perspective.
Outside the school
Some in the audience suggested that more time in a family setting might have helped people through the pandemic. The speakers saw a mixed picture. Some studies showed an improvement in mental health for a number of people, starting from an initial low level. There were certainly some families where life became easier for the young people when they were not in the school setting. They could learn in a different way at their own pace, the social pressures that they had felt before no longer being there. So it was positive in some ways but it was the absence of stress that led to the improvement.
In terms of general wellbeing, many families spoke about the opportunity to spend more time together: that can create stresses too but, in many cases, benefits and positive experiences as well. There were also opportunities just to spend a bit more time doing things people wanted to do: a break from the rapid pace of life that people experience otherwise. It will be important to learn from these findings and make the make the most of them going forwards.
There was a call for more investment in mental health research. The country is spending very little on research into what is today a chronic problem. There is also a question of the proportion of existing funding that is directed towards the characterisation and measuring of mental health, as opposed to research into the prevention and intervention processes that are required. If the country can spend billions of pounds on testing and tracing in the current health threat, could it not spend the same amount on health and wellbeing opportunities that will have greater long term impact? A national set of indicators could provide a substantive measure of the wellbeing of future generations.
Investment in mental health and wellbeing for children and young people must cover a range of activities, from promotion, to prevention, to intervention – and none of these things can be done in isolation. However, the pandemic has provided an opportunity to accelerate scientific learning and discovery. In the mental health area, there have been large trials using digital tools which has enabled access to parents much more easily and flexibly, in ways that better suit their lifestyles.
Research priorities for the COVID-19 pandemic: a call for action for mental health science – Academy of Medical Sciences and MQ Mental Health Research (April 2020)
Paper in Lancet Psychiatry on the research needed in mental health science (April 2020)
Covid-19 Mental Health and Wellbeing Surveillance Reports – Public Health England
Mental Health Winter Plan 2020-21 – Department of Health and Social Care
Young people’s mental health during the Covid-19 pandemic: what do we know so far? - Blog by Steven Bright and Dr Katherine Young.
Mental Health of children during lockdown – Podcast with Professor Louise Arsenault, Professor of Developmental Psychology, Kings College London.
Mental health of children and young people – Podcast with Kate Day, Managing Director, KRD Training
Effect of lockdown on mental health of children and young people – Podcast with Monika Jephcott, Chief Executive of Play Therapy UK
Mental health – a personal perspective – Podcast with Flo Sharman