Impact of School Closures on Mental Health during COVID-19

The Centers for Disease Control and Prevention (CDI) stated that Coronavirus disease 2019 (COVID-19) can affect children and young people directly and indirectly. Beyond getting sick, many young people’s social, emotional, and mental well-being has been impacted by the pandemic. Trauma faced is an important impact of school closures on mental health during COVID-19 and at this developmental stage can continue to affect them across their lifespan.

According to the National Alliance on Mental Illness (NAMI) California, the COVID-19 pandemic has presented many challenges to students, educators, and parents. Children already coping with mental health conditions have been especially vulnerable to the changes, and we are learning about the broad impacts on students as a result of schools being closed, physically distancing guidelines and isolation, and other unexpected changes to their lives.

Some of the challenges children and young people face during the COVID-19 pandemic relate to:

  • Changes in their routines (e.g., having to physically distance from family, friends, worship community)
  • Breaks in continuity of learning (e.g., virtual learning environments, technology access, and connectivity issues)
  • Breaks in continuity of health care (e.g., missed well-child and immunization visits, limited access to mental, speech, and occupational health services)
  • Missed significant life events (e.g., grief of missing celebrations, vacation plans, and/or milestone life events)
  • Lost security and safety (e.g., housing and food insecurity, increased exposure to violence and online harms, the threat of physical illness and uncertainty for the future)

 

Social Distancing Disruptions

The COVID-19 pandemic – and the social distancing measures that many countries have implemented – have caused disruptions to daily routines. As of April 8, 2020, schools have been suspended nationwide in 188 countries, according to UNESCO. Over 90% of enrolled learners (1.5 billion young people) worldwide are now out of education. The UNESCO Director-General Audrey Azoulay warned that “the global scale and speed of the current educational disruption is unparalleled”.

For children and adolescents with mental health needs, such closures mean a lack of access to the resources they usually have through schools. In a survey by the mental health charity YoungMinds, which included 2111 participants up to age 25 years with a mental illness history in the UK, 83% said the pandemic had made their conditions worse. 26% said they were unable to access mental health support; peer support groups and face-to-face services have been canceled, and support by phone or online can be challenging for some young people.

School routines are important coping mechanisms for young people with mental health issues. When schools are closed, they lose an anchor in life and their symptoms could relapse. “Going to school had been a struggle for some children with depression prior to the pandemic, but at least they had school routines to stick with”, said Zanonia Chiu, a registered clinical psychologist working with children and adolescents in Hong Kong, where schools have been closed since February 3, 2020. “Now that schools are closed, some lock themselves up inside their rooms for weeks, refusing to take showers, eat, or leave their beds.” For some children with depression, there will be considerable difficulties adjusting back to normal life when school resumes.

Special Education Needs

Children with special education needs, such as those with an autism spectrum disorder, are also at risk. They can become frustrated and short-tempered when their daily routines are disrupted, said psychiatrist Chi-Hung Au (University of Hong Kong, Hong Kong, China). He advised parents to create a schedule for their children to reduce anxiety induced by uncertainty. With speech therapy sessions and social skills groups suspended, he cautions that stopping therapy can stall progress, and children with special needs might miss their chance to develop essential skills. He points out that creative ways, such as online speech and social skills training, are needed to make up for the loss.

Many countries are postponing or canceling university entrance exams. Meanwhile, college and university students are stressed about dormitory evacuation and cancellation of anticipated events such as exchange studies and graduation ceremonies. Some lost their part-time jobs as local businesses closed. Students in their final years are anxious about the job market they are going to enter soon.

Social distancing measures can result in social isolation in an abusive home, with abuse likely exacerbated during this time of economic uncertainty and stress. According to Child and Adolescent Psychiatry and Mental Health (CAPMH), an online journal published by BioMed Central Ltd., the situation of the crisis produced by the Coronavirus (COVID-19) pandemic poses major challenges to societies all over the world. While efforts to contain the virus are vital to protect global health, these same efforts are exposing children and adolescents to an increased risk of family violence. This is not a surprise as increased rates of child abuse, neglect, and exploitation have also been reported during previous public health emergencies, such as the Ebola outbreak in West Africa from 2014 to 2016.

impact of school closures long-term mental effects

However, not much is known about the long-term mental health effects of large-scale disease outbreaks on children and adolescents. While there is some research on the psychological impact of severe acute respiratory syndrome (SARS) on patients and health-care workers, not much is known about the effects on ordinary citizens. Evidence is especially scarce in children and adolescents. This is an important gap for research. COVID-19 is much more widespread than SARS and other epidemics on a global scale. As the pandemic continues, it is important to support children and adolescents facing bereavement and issues related to parental unemployment or loss of household income. There is also a need to monitor young people’s mental health status over the long term, and to study how prolonged school closures, strict social distancing measures, and the pandemic itself affect the wellbeing of children and adolescents.

This article is provided by Dr. Ralph Kueche (Child Psychologist). Dr. Kuechle is a Child and Adolescent Clinical Psychologist who specializes in treating children and their families who may be struggling with mood and behavioral issues. Learn more about Dr. Kuechle.