The pandemic and the ‘crisis’ in children’s and young people’s mental health: what’s new?

Most days, I’ve seen newspaper and social media headlines about the impact of the pandemic on children and young people and arguments about how to make amends. Much of it is about how to help with an academic ‘catch-up’, with periodic reminders (usually initiated by the footballer Marcus Rashford) of the impact of the pandemic on families living in poverty and a last-minute rush to ensure that children can eat in the school holidays.  A ‘crisis’ in young peoples’ mental health is also talked about, often evidenced by an increase in diagnosable disorders. Data about increased demand for children and young peoples’ mental health services are part of a difficult and worrying story, and children and young people need access to services that can help them to back to safety and health. But the way that the ‘mental health crisis’ story is often told is frustrating for practitioners like me who work outside of acute medical services. It is a story of diagnosis and treatment, floating free of the context in which the difficulties arrived.  In our current context of prolonged uncertainty, it’s not a coincidence that some children and young people are feeling distressed and behaving in ways that are detrimental to their wellbeing. An assessment of a ‘disorder’ nor treatment to relieve symptoms will not, in isolation, take away this distress. Children and young people, just like the adults in their lives, need time, space, and support to process the fears that are fuelling their ‘symptoms’.

As the mother of three teenaged children, a counsellor in a high school and in my own practice at the time the first lockdown was announced, and a school governor, I’ve seen from various angles the impact of the pandemic on children and young people.  The cancellation of exams, proms and the celebrations that mark the transition from one stage of school life/childhood/adolescence to another was met last year with everything from relief to grief. When school went online (for those who could get access), then opened again with new rules and little of the informal socialising and downtime that makes school more than a place to acquire qualifications, young people were put in a constant state of vigilance. The periods of isolation that for many punctuated the autumn term before school closed again in January has taken away the comfortably boring predictability of the academic year. Many first-year university students, excited to be starting newly independent lives, contracted the virus within days of their arrival in student accommodation, before they’d established supporting relationships. Most have been taught exclusively online and many are studying back in the childhood bedrooms they moved on from only at the end of last summer. For many young people in work or looking for jobs, the future looks as uncertain as the present feels. The children and young people I have contact with have demonstrated their strength and resilience in many ways; recently, I’m noticing different ways in which they are shutting down. Some are withdrawing (engaging less with online school, not having even the ‘allowed’ amount of contact with others outside the household) while others are drawn to more overtly self-destructive ways of coping with or numbing their distress.

When the first lockdown was announced last March, despite the shock and the fear, I had hope for change. Early conversations amongst therapists, teachers and others working with children and young people challenged the idea that post-pandemic life would be a return to normal; that the shock had woken us up to the needs that were already evident. As the ‘crisis’ was not an event in the past (like a terror attack) or something that was happening just to ‘other people’ (patients, clients, pupils, offspring) but to us too, conversations about support for children and young people started from shared connection. Being in the same storm (albeit a different boat) meant that the focus was less on treatment and management than understanding and relating. After nearly a year, it seems that the shared discomfort has become less tolerable. The experience of being in the same storm is perhaps too overwhelming to stay with for long.  Fellow feeling has turned, perhaps, to helplessness. In therapy, as in other ‘helping’ professions, feelings of helplessness can turn into a rush to solve and fix, to ‘do to’ rather than ‘be with’, as we turn away from reminders of our own vulnerability.

As I write, days before the announcement of the UK government’s roadmap’ (to where?)  I feel there’s a collective holding of breath.  While I am hopeful that vaccines will loosen the grip of the virus, I have lowered my expectations about profound changes in our approach to the teaching and nurturing of children and young people. I am not hearing much in terms of fundamental changes that will mean that children can develop the emotional and psychological resources to develop adaptive resilience (approaches to life that help them) rather than maladaptive coping skills (beliefs and behaviours that hurt them). My loss of optimism stems not from a belief that all children and young people have been traumatised by the way we’re living (though many will have, because of the way they were living before the pandemic). Rather, I am disappointed that opportunities to reset our approaches to working with children and young people may be missed in the rush to a return to normal. For so many, normal wasn’t that great to start with and for them and those whose lives were okay we need to pay close attention to the legacy of the last year as we move on.

In my work, I don’t ask ‘what’s wrong with you?’. With adults, children, and young people I get curious about what has happened to you and how you’ve adapted to those experiences and encourage you to do the same. Some of what’s happened to you this past year has also, in some way, happened to me. Let’s start there, where we meet, and carry on working from there ‘once this is over’.

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