The Mental Health of Young People and COVID

Playing catch-up or coordinated policy? How international institutions are responding to mental health risks for young people amidst COVID-19.

By Antony Maher | 27 July 2021

“With much of the world on pause, children and adolescents have been expected to move agilely between their analogue family lives and digital environments. Yet even children and adolescents who are emotionally and physically healthy and well cared for can experience the potentially deleterious repercussions of this rapid transition.”[1]

The transition could not have been more abrupt: attending school with classmates one week, socialising on recess and lunch breaks, to sitting in front of a laptop in a corner-come-office of a bedroom the next, staring at a screen-sharing teacher whose bewilderment at navigating virtual learning almost matches that of her students.

For those young people who have been able to access virtual education since the onset of the global COVID-19 pandemic in the early months of 2020, this reality is all too familiar.[2]

The COVID-19 pandemic has forced young people to respond to tremendous changes, often happening in rapid succession: physical distancing measures separating friends and families,[3] the closure of schools and roll-out of virtual learning,[4] and the cancellation of school graduation ceremonies,[5] to name just a few.

Recognising the rapidly changing landscape facing children, youth, and their families over the past year, this blog aims to provide an overview of recent high-level policy developments focused on the mental health of young people and COVID-19. What recent actions, if any, have been taken by leading institutions in global health? Is this question on the agenda of these institutions?

In this post, I focus on recent developments at the United Nations and its agencies. Read on to learn more.

Recent UN developments

At the level of UN agencies, several events and initiatives have taken place in recent months that address the mental health of young people and COVID-19, including through focusing on the determinants of mental health.[6]

First, the data-driven[7] repository of articles available through UNICEF is widely cited, with one recent headline stating in the strongest possible terms: “How the COVID-19 pandemic has scarred the world’s children”.[8]

According to UNICEF, at least 1 in 7 children and young people lived under stay-at-home policies for most of 2020. Echoing the multi-dimensional approach to mental health captured in The Lancet Commission on global mental health and sustainable development[9], the featured data understands the contributors to children’s mental health and well being in a broad sense, highlighting the impacts of pandemic-related changes in child poverty, access to education, refugee status, child marriages and malnutrition. UNICEF has also launched COVID-19 sections on existing digital platforms, such as the website “Voices for Youth”, which features stories, messages and works of art produced by young people.[10]

Second, the United Nations Office on Drugs and Crime (UNODC) also recently developed an initiative called “Listen First”,[11] branded as a media platform that highlights importance of actively listening to children in parenting effectively during COVID-19. While in existence prior to the pandemic, this platform was modified to respond to the unique challenges posed by COVID-19.

Reflecting on “Listen First”, Dr. Nick Banatvala, the Head of Secretariat, United Nations Inter-Agency Task Force on the Prevention and Control of Non-communicable Diseases, recently commented[12]: “The 'Listen First' campaign strengthens the argument that investing in the prevention and control of NCDs and mental health conditions yields excellent social and economic returns by tackling their shared risk factors such as substance use, including tobacco and alcohol use.”

Third, expanding into the education space, a further event includes the UNESCO High-Level Ministerial Meeting, “Prioritizing education recovery to avoid a generational catastrophe”, which took place on 29 March 2021 and explicitly focused on ensuring “learning continuity”[13] for the global student population. Several initiatives are highlighted in the conference report,[14] such as the provision of hotlines to provide psychological support in Armenia and allocating greater numbers of school counsellors in Japan.

Fourth, no shortage of UN-affiliated resources and toolkits have emerged that focus on young people’s mental health and COVID-19. Often with a service user focus, these include: the COVID-19 Coping Toolkit for Parents and Caregivers in Recovery[15] (UNODC); a story book entitled “My Hero is You”[16] and aimed at children ages 6-11, and its accompanying guide to facilitate conversations with children[17] (IASC); the “Helping Adolescents Thrive Toolkit”[18], aimed at the adolescent population (UNICEF/WHO); and a digital compendium of COVID-19 related partner resources on women's, children's and adolescents' health[19] (Partnership for Maternal, Newborn & Child Health, or PMNCH).

Future directions

As these events illustrate, several UN agencies have been active in this space in recent months. It is worth emphasising that these developments do not solely focus on mental health care, but rather on the broad contributors (and threats) to children’s mental health, ranging from education to parental substance use to social and economic stability.

While this recent surge in activity may be seen as an opportunity for action, it is unclear whether these developments are happening in a synergistic manner. For example, how does data from UNICEF inform decisions around UNODC’s “Listen First” campaign? If not, why not?

There are positive signs in this regard. In September 2020, the WHO and UNICEF committed to a 10-year Joint Programme on Mental Health and Psychosocial Well-being and Development of Children and Adolescents.[20] More recently, on 18 June 2021, the UN Inter-Agency Task Force on NCDs[21] held a webinar focused on recent actions related to mental health and COVID-19, and included in this call were representatives from UNICEF, UNHCR and WHO.

While this is evidence of UN agencies working together, it remains to be seen whether these actions will result in sustained and coordinated policy development. In particular, the longevity of child and youth mental health initiatives launched in response to COVID-19 is unclear. Fortunately one resource – the PMNCH Compendium of COVID-19 partner resources – pulls from multiple UN agencies, and was last updated on 19 July 2021 and current at the time of publishing this blog.

Further, from the perspective of knowledge translation, are the developments highlighted above reaching their intended audience(s)? As an example, clinicians in the mental health sector may not routinely think of UN agencies as “go-to” sources for readymade tools – such as the “My Hero is You” story book[22] – that can be distributed to young people and their families.#

Supported by the WHO Director General, a recent call to action advocating for a global summit on adolescent wellbeing in 2023 is perhaps the clearest indication[23] of an appetite for longer-term, coordinated action in areas such as the prevention of mental illness and promotion of wellness amongst young people. A major – and still unanswered – question relates to the provision of funding to spark and sustain these activities, particularly in light of data showing that only 0.1% of development assistance for health is dedicated to mental health promotion, protection and care.[24]

With thanks to Devi Sridhar, Genevie Fernandes, Alexey Kulikov and Nadia Putoud for input and revisions on the above.

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31445-8/fulltext

[2] https://www.nytimes.com/2021/02/26/podcasts/the-daily/texas-schools-reopening-covid.html

[3] https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html

[4] https://data.unicef.org/resources/remote-learning-reachability-factsheet/

[5] https://www.cbc.ca/news/canada/pandemic-gr12-students-yearend-1.6023562

[6] https://www.who.int/publications/i/item/9789241506809

[7] https://www.unicef.org/press-releases/least-1-7-children-and-young-people-has-lived-under-stay-home-policies-most-last

[8] https://www.unicef.org/coronavirus/COVID-19-pandemic-scarred-world-children

[9] https://www.thelancet.com/commissions/global-mental-health

[10] https://www.voicesofyouth.org/campaign/covid-19-and-youth-mental-health

[11] https://www.unodc.org/unodc/en/listen-first/parenting-under-covid-19.html