COVID-19 and Mental Health (CMH) Initiative: Research

Supporting Children and Adolescents’ Mental Health in the Context of Pandemic and Confinement: A Scoping Review of Interventions and Ethical Challenges

Key Messages

  • Children and adolescents living in a family that is economically affected by the pandemic are more vulnerable to having negative effects on their mental health.
  • The context of the pandemic and related confinement can increase maltreatment and interfamilial violence.
  • Equitable access to child and adolescent mental health care is an important ethical challenge.
  • Telehealth is the most widespread intervention put in place and the use of technology is the most widespread recommendation in order to offer remote services. However, technology-based services can be difficult to access for children living in families with a low socio-economic status. Privacy and confidentiality can be difficult to respect.
  • Preventative care is more limited due to the pandemic, which could be problematic if sustained over time.

Lay Summary

Overall, the pandemic and related confinement measures were found to have negative repercussions on children and adolescents’ mental health across age groups and contexts. These include increased stress, anxiety, and fear, as well as depressive symptoms and sleep/appetite disturbances. The pandemic is likely to have long-term negative effects on children and adolescents’ mental health. Groups that may be more vulnerable to detrimental mental health effects include: children and adolescents with a preexisting diagnosis of anxiety disorder, eating disorder or autism spectrum disorder (especially if co-morbid with attention-deficit/hyperactivity disorder); living in a family that is economically affected by the pandemic or that already faced economic hardships; and having parents who are distressed by the pandemic or who have preexisting mental health difficulties. Also, the context of the pandemic can increase child maltreatment and interfamilial violence.

A key ethical challenge that arises due to the pandemic is the equitable access to mental health care. Services have been significantly reduced, leading to fewer people receiving care. In-person care is reserved to the most extreme cases, with very little preventative care being offered. Another ethical challenge relates to families’ varying socio-economic status, which can be a limiting factor to accessing remote services such as telehealth (for ex. access to technology and good internet connection). It can also be more challenging for children living in families with a low socio-economic status to use telehealth in an environment that allows for privacy and confidentiality. These families are also more likely to receive mental health services exclusively from school settings, which have been cut with school closures. Patient engagement can be difficult to maintain, especially with younger children and children who have particular issues such as attention-deficit-hyperactivity disorder and autism spectrum disorder. As parents try to engage their child with the remote services, it can lead to tensions within the home environment. Assessing the family environment and benefits/limitations of the use of remote means is important.

Keywords

  • Mental Health; Interventions
  • Ethics
  • Children and adolescents
  • Telehealth
  • Inequities
  • Anxiety Disorders
  • Eating Disorders
  • Attention-Deficit/Hyperactivity Disorder
  • Autism Spectrum Disorder

Author(s)

  • Nominated Principal Applicant: Marjorie Montreuil, Assistant Professor, Ingram School of Nursing, McGill University
  • Aline Bogossian, Université de Montréal
  • Chantal Camden, Université de Sherbrooke
  • Christine Genest, Université de Montréal
  • Elsa Gilbert, Université du Québec à Rimouski
  • Geneviève Piché, Université du Québec en Outaouais
  • Jessica Rassy, Université de Sherbrooke

For more information, please contact: Marjorie Montreuil, marjorie.montreuil@mcgill.ca

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Population

Children, Youth and Families

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To ensure the rapid dissemination of this critical information, information is published in the language in which it was submitted. Please contact us for French or English translations.

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