Almost 200,000 research studies on mental health impacts were carried out during the pandemic, but only 35 included children and young people, creating “a huge data gap”.
A British Medical Journal (BMJ) article written by Cambridge Children’s Mental Health Research Lead, Professor Tamsin Ford, says better evidence on how children’s mental health is affected by health shocks is essential to inform policy responses.
Tamsin Ford, Professor of Child and Adolescent Psychiatry at the University of Cambridge, co-authored the BMJ article with 17-year-old Ann Sabu from Cambridge Children’s Hospital Young Adult Forum. Professor Ford described children as a “precious resource” but that they repeatedly “drop down the agenda”.
Big decisions were made about children and young people during the pandemic, but they were barely involved, said Professor Ford. One of the article’s key messages is that their interests and voices must be represented and respected in prioritisation of research questions to tackle the wide evidence gap.
The impact on children should be front and centre of pretty much every policy decision - but it's really not. During Covid the interests of children and young people were not at the table.
Professor Tamsin Ford
While Professor Ford said an emergency situation might make it difficult to bring children and young people on board, we should still try. If this is really not possible, the professionals who work with them could take part in panel discussions “so children’s interests are not secondary to adults’ interests.”
The peer review article drew on multiple sources, including a survey shared with Cambridge Children’s Network and third sector organisations. Young people and parents of young children responded with a bleak picture of social isolation, loneliness, reduced confidence and a lack of typical age-appropriate experiences.
Luke Webber, 16, filled in the survey, sharing his own experiences with Professor Ford and her team. He was diagnosed with a brain tumour in the summer of 2020. Restrictions on hospital visitors and school closures meant his younger brother Ryan had to stay at home with his grandparents, unable to visit Luke, see his mum and dad, or talk about the situation face to face with his friends at school. This went on for months. Dad Peter said: “I think if Ryan had been at school or been around people, then he would have been able to forget a lot of the struggles going on at home.”
Peter said what he found most upsetting was that Luke and Ryan, now 16 and 14, didn’t experience a normal journey in hospital, which really affected the mental health of both his sons.
There were no therapy dogs coming in for games, no being in the communal areas. Neither of them got to experience any of that for the whole time. It’s just like this big black hole that Luke and Ryan were in, separate from each other.
Peter Webber, Luke and Ryan's dad
Additionally, the BMJ article described how experiences diverged, with well resourced families adjusting and enjoying additional time with each other, while children in abusive households and young carers faced escalating isolation and challenge, posing an extra threat to their mental wellbeing.
Ann, now 18, found her experience of lockdown to be largely positive, but when schools reopened she noticed some of her peers struggling with anxiety. She is calling for better access to mental health support for children and more research as to why some struggled during the pandemic, while others did not.
Going back to school was never the same because you had the one-way system, you had to wear masks, you had to sanitise all the time. It felt very controlling. It felt like Covid took away from our school experience because there were so many regulations and rules that were put in place.
Ann Sabu, Cambridge Children's Hospital young ambassador
With hindsight, Professor Ford says schools should have been the last organisations to close and the first to reopen. She said responses to future health shocks must be based on sound evidence, as robust as that carried out for adults, ensuring children’s mental health is protected and promoted.
A child who cannot function for several months pays a developmental price in terms of skills and educational development, which adults do not. Similarly, there can be no health without mental health: prevention and containment of communicable diseases must not neglect mental health, nor widen inequalities.
Professor Tamsin Ford
- Neither seen nor heard: the evidence gap on the effect of covid-19 on mental health in Children (opens in a new tab)”, by Tamsin Ford, Tamsin Newlove-Delgado, Ann Kannuralil Sabu, and Abigail Russell is published in the British Medical Journal.