COVID-19 and Mental Health Concerns in Children


Ensuring a healthy future for our children is every parent’s concern. Recently, behavioral health professionals have reported increasing numbers of children visiting emergency rooms with mental health concerns. “Behavioral health has become the epidemic within the pandemic,” says Leigh Youmans, who leads work on this issue at the Massachusetts Health and Hospital Association (MHA). A recent study in the Journal of the American Medical Association (JAMA) Pediatrics indicates that, globally, 1 in 4 children are experiencing symptoms of depression and 1 in 5 children reported increased anxiety since the start of the COVID-19 epidemic. These statistics are concerning and impact the future health of our children.

School Closures and Remote Schooling

Initially, concerns about the spread of the COVID-19 virus resulted in school closures throughout the world. Educators scrambled to cobble together an online curriculum and to meet the needs of students who were isolated at home. Students with mental health needs could not access the services they would usually have at school, such as school counselors and accommodations that assist them in the school environment. Students could not see their friends and engage in extracurricular activities. As the days dragged on, 83% of students with mental health concerns reported that the pandemic worsened their symptoms.

Disruption of Family Systems and Routines

While teachers were scrambling to put together an online curriculum and learning to navigate a digital delivery system, parents and families were adapting to having school-age children home for the day. Parents and children had to develop new routines. For many families, this involved parents working from home. For other families, this involved a parent quitting their job to stay home with the children. Many parents lost their jobs or had their incomes cut, causing significant financial stress for the family. Children expressed fears that they would contract COVID-19 or that a family member would become sick and die. With 756,000 COVID-19 deaths and counting in the United States, many children and their families are grieving the loss of close relatives. Children who live in homes where a parent may have a mental health or substance use disorder are especially at risk, as they cannot leave the home or access outside support.

Lack of Access to Services

The pandemic also challenged the ability of mental health agencies to provide care. Many agencies shut down during the initial phases of the pandemic, and their providers began working from home. Children were required to see their providers via telemedicine instead of face-to-face. Scheduling appointments and managing medications became increasingly challenging for families. Agencies struggled to provide care and transition to a telemedicine model. Preventive care fell to the wayside, resulting in children not being seen until they were in crisis. Inpatient psychiatric units cut capacity or temporarily closed while they figured out how to manage patient care in a pandemic.

How to Support Children

Children need extra support now. Talk with your children about how they’re feeling. Talk with them about their fears that loved ones might contract COVID-19 and about their sadness when a loved one passes away. Work with other families to establish mutual support and to provide opportunities for children to socialize and engage in activities. Kimberly Hoagwood, Ph.D., and Kelly Kelleher, MD, have proposed a Marshall Plan for addressing children’s mental health after COVID-19. They suggest moving away from a “brick and mortar” approach to a community-based, more flexible method of providing services. This would include an increased reliance on telemedicine and alternative methods of service delivery.

We need to focus on the mental health needs of our children to ensure a healthy future. Now is the time to rethink how we provide care and to new models of service delivery.


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