Editorial: Effects of the COVID-19 pandemic on child and adolescent mental health

How to Link Assessment and Suitable Interventions for Adolescents: Relationships among Mental Health, Friendships, Demographic Indicators and Well-Being at School

BACKGROUND

Over the last 10 years, a noticeable deterioration in mental health has affected adolescents' lives.

METHODS

This study was conducted in 12 secondary schools and 14 high schools located in different cities across Lithuania from October to December 2023. The survey included students aged 12 to 17 years. The adolescents filled out a questionnaire about the need for outside help, friendships, and well-being at school and the Strengths and Difficulties Questionnaire. The goal of our study was to analyze the risk factors that influence adolescents' psycho-emotional state.

RESULTS

A total of 4124 students were involved in this study, with a mean age of 14.48 ± 1.15 years. The sample consisted of 50.9% males and 49.1% females. The boys showed a statistically significantly lower total difficulty score on the Strength and Difficulties Questionnaire (SDQ TDS) and internalizing score (IS) than the girls (12.45 ± 5.39 vs. 14.93 ± 5.76; 5.39 ± 3.30 vs. 7.49 ± 3.64, p < 0.001). Also, the SDQ TDS, IS, and externalizing score (ES) were statistically significantly lower in the group of adolescents who lived with both parents (13.50 ± 5.69 vs. 14.76 ± 5.72; 6.32 ± 3.61 vs. 6.98 ± 3.65; 7.18 ± 3.23 vs. 7.78 ± 3.35, p < 0.001). Linear regression analysis of the SDQ TDS (R2 = 0.406) indicated a significant impact on the feeling of safety at schools (β = -0.173, p < 0.001) and loneliness (β = 0.314, p < 0.001). Linear regression of the SDQ IS (R2 = 0.469) showed that there was a significant predictor effect of bullying (β = 0.170, p < 0.001) and loneliness (β = 0.345, p < 0.001). However, the linear regression of the SDQ ES (R2 = 0.256) showed that there was a significant predictor effect of the feeling of teacher care (β = -0.163, p < 0.001) and loneliness (β = 0.166, p < 0.001). We determined that gender (OR = 2.30) and loneliness (OR = 1.77) were the most significant factors associated with adolescents seeking help.

CONCLUSIONS

It is crucial to determine specific risk factors and particular groups of teenagers who need psycho-emotional support the most. The findings of this study may offer valuable insights for advancing additional prevention or support programs aimed at adolescents within higher-risk groups.

A Mixed Methods Exploration of Young Women's Agency and Mental Health during COVID-19 in Low-Income Communities in Mumbai, India

INTRODUCTION

Adolescent girls and young women (AGYW) in India face additional health inequities compared to their male peers, as gender norms constrain agency for prevention and self-care. The onset of the COVID-19 pandemic and associated lockdowns deepened health inequities and often worsened mental health, but the impacts on agency are unclear. This exploratory sequential mixed methods paper examined mental health and COVID-19 elements that exacerbated or mitigated adverse consequences for AGYW in low-income communities in Mumbai.

METHODS

We conducted semi-structured interviews with AGYW (aged 15-25 years; N = 60) and adults (parents, healthcare providers, community-based organization representative; N = 30). We administered a structured survey to AGYW (N = 150) to assess health concerns, depression and anxiety symptoms (using the PHQ-8 and GAD-7 scales), and experiences during COVID-19. We analyzed qualitative data using the constant comparative approach in Atlas.ti, and quantitative data using R and SPSS.

RESULTS

Qualitative data revealed that AGYW faced stressors and had limited agency during lockdowns due to limited access to education, financial insecurity, and community violence. Quantitative data indicated that limited agency in the context of COVID-19 was significantly associated with depression and anxiety. Financial resources to address COVID-19 created new employment and leadership opportunities for AGYW to become COVID educators and preschool teachers; participation in these opportunities was associated with less anxiety.

DISCUSSION

Pandemic stress was difficult for low-income AGYW in Mumbai. Mitigating programs for COVID-19 control helped address acute needs and enable capabilities. Exploring similar themes among a broader population of youth can help design strategies and opportunities for young people in low-income communities during health emergencies.

The influence of COVID-19 on intertemporal choices in the health and economy domains

Background

With the spread of COVID-19, concerns regarding its adverse effects have arisen. Based on affect regulation theory and construal level theory, this study explored how COVID-19 affects intertemporal choice in the health and economy domains, self-other differences for intertemporal choice were also inspected. The study examined whether psychological safety can moderate the relationship between COVID-19 and intertemporal choice.

Methods

A 2 (COVID-19 status: pre-COVID-19, during-COVID-19) × 2 (decision maker role: decision for self, decision for others) × 2 (domain: health, economy) three-factor hybrid experiment was employed.

Results

(1) Individuals in during-COVID-19 condition preferred more immediate options. (2) Delayed options were preferred more in the health domain. Preference for immediate money options enhanced during than before COVID-19. However, COVID-19 status did not affect choices related to health. (3) Delayed options were preferred more when making intertemporal choices for others than for oneself under the pre-COVID-19 condition. Self-other differences for intertemporal choice disappeared during COVID-19. (4) Psychological safety moderated the effect of COVID-19 on intertemporal choice.

Conclusions

During COVID-19, individuals' impulsive preference of intertemporal choice increased. COVID-19 affected intertemporal choice regarding economy and the self-other differences for intertemporal choice. Psychological safety could buffer the effect of COVID-19 on intertemporal choice.

Value

This study can provide empirical evidence to affect regulation theory and level of explanation theory as well as guide individuals in making scientific decisions in health and economic domains under public health emergencies.

Indonesian COVID-19 lesson: A mixed-methods study on adolescent health status and health services during pandemic

TOPIC

The COVID-19 pandemic affected adolescents' physical and psychological health. There must be specific services to cater to the needs of adolescents during COVID-19 in Indonesia. Lessons learned from previous pandemics will be beneficial for nurses and other health professionals to prepare services for future pandemics.

PURPOSE

This mixed-method study aimed to examine 459 Indonesian adolescents' health, literacy, preventive measures, and preferred health services during the COVID-19 pandemic. This study also examines sociodemographics, respondent characteristics, health information sources, and media choices.

RESULTS

A total of 47.5% of adolescents knew about COVID-19, 26.8% experienced physical health changes, and 61.7% considered wearing masks. Adolescent health information came from teachers (26.6%) and the Internet (32.9%). Psychological changes showed 67.8% irritation. Indonesians preferred online counseling (53.8%) and WhatsApp (45.8%) for pandemic health services. COVID-19 literacy did not affect physical or mental health (p > 0.05).

CONCLUSIONS

Most adolescents reported mental and physical health changes during COVID-19. Our data suggest that adolescents' strong COVID-19 knowledge did not prevent anxiety and other psychological difficulties. The longitudinal studies could be utilized if pandemic demands social and physical distance. The government, as well as nurses, might utilize WhatsApp-based remote online treatment for health services.

Factors associated with depression, anxiety, and satisfaction with life among Malaysian parental caregivers of adolescent psychiatric patients: A cross-sectional study

Depression and anxiety are prevalent mental health issues worldwide, especially among parental caregivers. By expanding the family stress model, this cross-sectional study investigated the relevant factors associated with depressive symptoms, anxiety symptoms, and satisfaction with life among Malaysian parental caregivers of adolescent psychiatric patients. Data were collected through questionnaires (N = 207) across five major public hospitals through convenience sampling. Participants answered questionnaires measuring financial strain, caregiver burden, relationship quality, belief in mental illness, perceived COVID-19 stress, satisfaction with health services, depressive symptoms, anxiety symptoms and life satisfaction. Findings revealed that relationship quality among spouses, COVID-19 stress and caregiver burden were significantly correlated with anxiety symptoms, depressive symptoms and satisfaction with life. The multiple regression model also suggested that depressive symptoms (β = .613, p < .001), anxiety symptoms (β= .657, p < .001) and relationship quality among spouses (β = .264, p < .001) were the most influential predictors of anxiety symptoms, depressive symptoms and satisfaction with life respectively. By addressing the mental health needs of parental caregivers, this study can contribute to improving the overall quality of care and support provided to adolescent patients and their caregivers in Malaysia and beyond.

Relationship Between Childhood Trauma and Nonsuicidal Self-Injury Among Adolescents with Depressive Disorder: Mediated by Negative Life Events and Coping Style

Purpose

Nonsuicidal self-injury (NSSI) is related to childhood trauma, negative life events, and coping style, but the interaction among these factors and the mechanism by which they interact in adolescents with depressive disorder remain unclear. This paper explores how these factors interact to influence NSSI and provides evidence to develop prevention efforts and interventions for adolescents with depressive disorder with NSSI.

Patients and Methods

A cross-sectional design and convenient sampling method were used in this study. The Childhood Trauma Questionnaire, Adolescent Self-Rating Life Events Checklist, Trait Coping Style Questionnaire, and Adolescent Nonsuicidal Self-injury Assessment Questionnaire were completed by 540 adolescents with depressive disorder. Descriptive analysis, chi-square tests, t-tests, Pearson correlations, and serial mediation analyses were used in the data analysis.

Results

A total of 398 (79.442%) adolescents with depressive disorders reported experiences of NSSI. The results of serial mediation analyses determined that childhood trauma has a direct (estimate = 0.209, 95% CI: 0.063, 0.334) and indirect (estimate = 0.271, 95% CI: 0.199, 0.371) impact on NSSI. The indirect impact of childhood trauma on NSSI through negative life events alone (estimate = 0.096, 95% CI: 0.007, 0.169), coping styles alone (estimate = 0.088, 95% CI: 0.034, 0.183), and negative life events on coping styles (estimate = 0.086, 95% CI: 0.042, 0.162) was significant.

Conclusion

This study demonstrates that screening for childhood trauma should be considered when preventing and treating NSSI behavior in adolescents with depressive disorder. Managing negative life events and coping style may mitigate the negative impact of childhood trauma on NSSI behavior in adolescents with depressive disorder.

Peer Connectedness and Social Technology Use During COVID-19 Lockdown

During the COVID-19 pandemic lockdown, adolescents relied on social technology for social connection. Although some research suggests small, negative effects for quantity of social technology use on adolescent mental health, the quality of the interaction may be more important. We conducted a daily diary study in a risk-enriched sample of girls under COVID-19 lockdown to investigate associations between daily social technology use, peer closeness, and emotional health. For 10 days, 93 girls (ages 12-17) completed an online daily diary (88% compliance) assessing positive affect, symptoms of anxiety and depression, peer closeness, and daily time texting, video-chatting and using social media. Multilevel fixed effects models with Bayesian estimation were conducted. At the within-person level, more daily time texting or video-chatting with peers was associated with feeling closer to peers that day, which was associated with more positive affect and fewer depressive and anxiety symptoms that day. At the between-person level, more time video-chatting with peers across the 10 days was indirectly associated with higher average positive affect during lockdown and less depression seven-months later, via higher mean closeness with peers. Social media use was not associated with emotional health at the within- or between-person levels. Messaging and video-chatting technologies are important tools for maintaining peer connectedness during social isolation, with beneficial effects on emotional health.

A mixed-method study on adolescents' well-being during the COVID-19 syndemic emergency

In this study, we set out to investigate adolescents' levels of perceived well-being and to map how they went about caring for their well-being during the COVID-19 syndemic. Participants were 229 Italian adolescent high school students (48.9% males, mean age = 16.64). The research design was based on an exploratory, parallel, mixed-method approach. A multi-method, student-centered, computer-assisted, semi-structured online interview was used as the data gathering tool, including both a standardized quantitative questionnaire on perceived well-being and an open-ended question about how adolescents were taking charge of their well-being during the COVID-19 health emergency. Main findings reveal general low levels of perceived well-being during the syndemic, especially in girls and in older adolescents. Higher levels of well-being are associated with more affiliative strategies (we-ness/togetherness) whereas low levels of well-being are linked with more individualistic strategies (I-ness/separatedness) in facing the health emergency. These findings identify access to social support as a strategy for coping with situational stress and raise reflection on the importance of balancing the need for physical distancing to protect from infection, and the need for social closeness to maintain good mental health.

Rural Children's Well-Being in the Context of the COVID-19 Pandemic: Perspectives from Children in the Midwestern United States

Children in rural areas are more likely to experience a variety of risk factors that increase their vulnerability to physical and mental health disparities. Bronfenbrenner's ecological model (1986) was used as a framework for understanding rural children's perceptions and well-being within multiple interactive contexts during the COVID-19 pandemic. This phenomenological study was designed to explore rural children's perceptions of their well-being and the impact of the COVID-19 pandemic on their contexts and well-being. This sub-study of the Children's Understandings of Well-Being project followed the standard qualitative interview protocol with additional prompts related to the pandemic. Rural children (age 8 to 18, N = 72) from the Midwestern United States participated from March 2020 to November 2021 via teleconferencing. Phenomenological analyses of transcripts focused on the essence of children's understanding of well-being and their perception of the impact of the pandemic on their contexts and well-being. Each transcript was coded by author 1 and verified by author 2, and discrepancies were identified, discussed, and resolved. The third author served as an external auditor to enhance trustworthiness. First-cycle coding focused on children's specific references to well-being experiences during COVID-19. Second-cycle selective coding focused on specific well-being experiences and contexts that were impacted by COVID-19. These codes were used to develop two broad themes, "Well This Kinda Stinks, But We Just Adapt" and "Safety Means Something Different to Me Now." The meaning of themes and subthemes are explored, with implications for researchers, practitioners, and policymakers.

Adolescent social emotional skills, resilience and behavioral problems during the COVID-19 pandemic: A longitudinal study in three European countries

Objectives

The consequences of long-lasting restrictions related to the COVID-19 pandemic have become a topical question in the latest research. The present study aims to analyze longitudinal changes in adolescents' social emotional skills, resilience, and behavioral problems. Moreover, the study addresses the impact of adolescents' social emotional learning on changes in their resilience and behavioral problems over the course of seven months of the pandemic.

Methods

The Time 1 (T1) and Time 2 (T2) measuring points were in October 2020 and May 2021, characterized by high mortality rates and strict restrictions in Europe. For all three countries combined, 512 questionnaires were answered by both adolescents (aged 11-13 and 14-16 years) and their parents. The SSIS-SEL and SDQ student self-report and parent forms were used to evaluate adolescents' social emotional skills and behavioral problems. The CD-RISC-10 scale was administered to adolescents to measure their self-reported resilience. Several multilevel models were fitted to investigate the changes in adolescents' social emotional skills, resilience, and behavioral problems, controlling for age and gender. Correlation analysis was carried out to investigate how changes in the adolescents' social emotional skills were associated with changes in their resilience and mental health adjustment.

Results

Comparing T1 and T2 evaluations, adolescents claim they have more behavioral problems, have less social emotional skills, and are less prosocial than perceived by their parents, and this result applies across all countries and age groups. Both informants agree that COVID-19 had a negative impact, reporting an increment in the mean internalizing and externalizing difficulties scores and reductions in social emotional skills, prosocial behavior, and resilience scores. However, these changes are not very conspicuous, and most of them are not significant. Correlation analysis shows that changes in adolescents' social emotional skills are negatively and significantly related to changes in internalized and externalized problems and positively and significantly related to changes in prosocial behavior and resilience. This implies that adolescents who experienced larger development in social emotional learning also experienced more increase in resilience and prosocial behavior and a decrease in difficulties.

Conclusion

Due to its longitudinal design, sample size, and multi-informant approach, this study adds to a deeper understanding of the pandemic's consequences on adolescents' mental health.

A scoping review of interventions using occupation to improve mental health or mental wellbeing in adolescent populations

Introduction

Occupation-based interventions could help to address a growing mental health crisis among young people and adolescents. To develop new interventions and avoid research waste, a review of the academic literature is needed that systematically identifies and describes interventions designed to improve the mental health and wellbeing of 11–25 year-olds.

Aim

The scoping review aims to systematically review the academic, literature to identify and describe key characteristics of intervention studies using occupation to improve adolescents’ and young people’s mental health and wellbeing, exploring the range of interventions, reviewing reporting quality and illuminating gaps for further research.

Method

An iteratively developed scoping review protocol informs a systematic database search and review of the literature. Core characteristics are extracted and described, using the TIDIER guidelines and the CASP assessment tool.

Results

Five occupational therapy-based interventions, and 69 other occupation-based studies representing a wide breadth of approaches, outcomes and settings were identified.

Conclusions

Robust development, testing and reporting of occupation-based and occupation-focused intervention studies to promote and support mental health and wellbeing in adolescents and young people are needed. Interventions should be co-designed, developmentally appropriate and scaffold development. However, better agreement is needed about core outcomes measurement in this area.

Impact of the COVID-19 pandemic on mental health and family situation of clinically referred children and adolescents in Switzerland: results of a survey among mental health care professionals after 1 year of COVID-19

The aim of this study was to assess the impact of the COVID-19 pandemic on mental well-being of clinically referred children and adolescents and on their families from the perspective of mental health care professionals in Switzerland during the first year of the pandemic. Psychiatrists and psychologists for children and adolescents participated in an anonymous survey conducted online in April/May 2021. The survey was completed by 454 mental health care professionals, most of them working in outpatient clinics for child and adolescent psychiatry or in independent practices. Most participants indicated an important increase of referrals for depression (86.8% of respondents), anxiety disorders (81.5%), crisis interventions (76.2%), psychosomatic disorders (66.1%), suicidality (63.8%), and behavioral addictions, e.g., excessive gaming (64.6%). In contrast, referrals or treatment demands for disorders such as autism spectrum disorder or psychosis showed no substantial change or a slight decrease, respectively. According to 69% of respondents, patients experienced the highest psychological burden in January/February/March 2021. Family problems very frequently reported by mental health professionals were parents' worries about loneliness/isolation of the child (49%), child's education and academic future (33%), increased media use due to missing options of recreational activities (37.6%), as well as multiple stresses of mothers (36.3%). To conclude, the pandemic has substantially changed the pattern of disorders and the number of clinical referrals of children and adolescents with mental health problems, which has serious consequences for the treatment supply in Switzerland.

The role of family support and conflict in cyberbullying and subjective well-being among Chilean Adolescents during the Covid-19 period

Introduction

Life satisfaction plays a crucial role in integral development and mental health during childhood and adolescence. Recently, it has been shown that cyberbullying has severe consequences for the mental health and wellbeing of victims such as increased anxiety, depressive symptoms and even suicide risk. Although the role of the family in life satisfaction and cyberbullying behaviors has been studied, there is limited information on its impacts during the current pandemic period.

Objective

The aim of this study is to determine the role of family variables regarding students’ levels of life satisfaction and cyberbullying victimization during the pandemic period.

Method

Structural equation modeling was done using data from a cross-sectional study (n = 287; age ranged 14–18) conducted in six schools in Santiago, Chile during 2020.

Results

The tested model has a good fit and parsimonious adjustment. It explained 25.9% of the life satisfaction and 9% of the variance of cyberbullying victimization. Family support was positively associated with life satisfaction (p < 0.001) and negatively associated with cyberbullying victimization (p < 0.05). Likewise, family conflict was positively associated with levels of cyberbullying victimization (p < 0.05) and negatively associated with life satisfaction levels (p < 0.001). Finally, family visits were only positively associated with life satisfaction (p < 0.01).

Conclusions

Generating interventions on several levels focused on positive family bonds has become essential and urgent. This is especially important considering their protective impacts on cyberbullying victimization in promotion of adolescent well-being and quality of life.

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Level of family support decreased cyberbullying victimization and increased life satisfaction during the Pandemic.

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Level of family conflict increased the risk of cyberbullying victimization and decreased levels of life satisfaction.

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Interventions and policies are urgently needed to promote positive family bonds and work-life balance.

The Relationship Between Children's Problematic Internet-related Behaviors and Psychological Distress During the Onset of the COVID-19 Pandemic: A Longitudinal Study

BACKGROUND

The outbreak of the coronavirus disease 2019 (COVID-19) pandemic has generated negative effects on psychological well-being worldwide, including in schoolchildren. Government requirements to stay at home and avoid social and school settings may impact psychological well-being by modifying various behaviors such as problematic phone and Internet use, yet there is a paucity of research on this issue. This study examined whether the COVID-19 outbreak may have impacted problematic smartphone use (PSU), problematic gaming (PG), and psychological distress, specifically the pattern of relationships between PSU, PG, and psychological distress in schoolchildren.

METHODS

Longitudinal data on psychological distress, PSU, and PG were collected from 575 children in primary schools in 3 waves: Waves 1 and 2 were conducted before the COVID-19 outbreak and Wave 3 during the outbreak. Cross-lagged panel models were used to examine relationships between factors across the 3 waves.

RESULTS

Cross-lagged models found that higher levels of PSU were not significantly related prospectively to greater psychological distress before the COVID-19 outbreak, but this prospective relationship became significant during the COVID-19 outbreak. Whereas PG was associated prospectively with psychological distress before the COVID-19 outbreak (ie, between Waves 1 and 2), this association became nonsignificant during the COVID-19 lockdown (ie, between Waves 2 and 3).

CONCLUSIONS

The COVID-19 outbreak has seemed to change prospective relationships between PSU and psychological distress and PG and psychological distress in schoolchildren. Future research should examine whether restrictions on or information provided to schoolchildren may exacerbate PSUs effects on psychological distress.

Problematic use of the internet during the COVID-19 pandemic: Good practices and mental health recommendations

With the onset of the COVID-19 pandemic and the accelerated spread of the SARS-CoV-2 virus came jurisdictional limitations on mobility of citizens and distinct alterations in their daily routines. Confined to their homes, many people increased their overall internet use, with problematic use of the internet (PUI) becoming a potential reason for increased mental health concerns. Our narrative review summarizes information on the extent of PUI during the pandemic, by focusing on three types: online gaming, gambling and pornography viewing. We conclude by providing guidance for mental health professionals and those affected by PUI (with an outline of immediate research priorities and best therapeutic approaches), as well as for the general public (with an overview of safe and preventative practices).

Impulsivity and Depressive Brooding in Internet Addiction: A Study With a Sample of Italian Adolescents During COVID-19 Lockdown

This contribution presents a study conducted on a sample of Italian adolescents (n = 411) in the period of the first COVID-19 lockdown. The study investigated the role and predictive weight of the impulsivity and depressive brooding variables on Internet addiction, using a hierarchical regression analysis. The participants were administered the Uso-Abuso e Dipendenza da Internet [Internet Use-Abuse and Addiction] (UADI-2), the Barratt Impulsiveness Scale-11 (BIS-11), and the Ruminative Response Scale (RRS). In terms of percentage distribution, 28% of the participants were in the full dependency range, while 34.7% demonstrated Internet abuse behavior. The results highlighted not only the predictive value of impulsiveness (β = 0.323) and ruminative thinking (β = 0.258), but also the role of gender (β = -0.205) on Internet addiction. Thus, male participants showed higher levels of Internet addiction, with higher scores on impulsiveness and brooding way of thinking. The study shows that the issue in question is significantly present among adolescents; in addition, not only targeted awareness programmes but also psycho-educational and clinical interventions to promote greater emotional and cognitive control would be necessary as a preventive and mitigating measure. Psychological interventions can help increase self-awareness, develop emotional regulation and impulse control, and correct maladaptive cognitions which in adolescents are mostly driven by a ruminative cognitive style.

Development of a Brief Group CBT Intervention to Reduce COVID-19 Related Distress Among School-Age Youth

School-aged youth have been significantly impacted by the COVID-19 pandemic. The effects of the pandemic will likely have long-standing effects on the well-being of youth, and access to mental health care is even more critical during this time. For the past 5 years, TRAILS (Transforming Research into Action to Improve the Lives of Students) has been working throughout the state to increase utilization of evidence-based mental health practices among K-12 school mental health professionals (SMHPs). By leveraging SMHPs who are widely accessible to students, TRAILS seeks to improve youth access to effective mental health care and reduce current mental health inequities. In March 2020, TRAILS responded to the COVID-19 pandemic by developing a group manual designed to be delivered virtually by SMHPs to help students develop effective coping skills to mitigate the impact of COVID-19. TRAILS focuses on promoting use of CBT and mindfulness, as these skills are ideally suited for school-based delivery, and thus the new manual, Coping with COVID-19 (CC-19), was grounded in these modalities. This article will describe the design, development, and deployment of the CC-19 program to address the mental health needs of students in the context of the pandemic. Early acceptability and penetration data will also be discussed.

Sleep during COVID-19-related school lockdown, a longitudinal study among high school students

There has been great concern about the impact of coronavirus disease 2019 (COVID-19)-related school lockdown on adolescent health. The aim of the present study was to compare sleep patterns before and during COVID-19-related school lockdown, in a large sample of high school students. The present study is based a prospective, longitudinal survey on adolescent sleep health. Phase 1 was conducted in 2019, whereas phase 2 was conducted in 2020 (response rate 60.2%), during the last 10 days of a 60-day long school lockdown. Main outcomes comprised sleep parameters from the Munich ChronoType Questionnaire (MCTQ). A total of 2,022 students provided valid responses to MCTQ in both survey phases. Results showed later sleep timing on schooldays in 2020 compared to 2019 (36 min later bedtimes, Cohen's d = 0.56; 1:35 hr later rise times, Cohen's d = 1.44). Time spent in bed on schooldays increased from 8:20 to 9:19 hr (Cohen's d = 0.78), and sleep duration increased by 45 min (Cohen's d = 0.49). The proportion of adolescents obtaining the recommended ≥8 hr of sleep on schooldays increased from 13.4% (2019) to 37.5% during the lockdown. Social jetlag was reduced from 2:37 hr (2019) to 1:53 hr (2020, Cohen's d = 0.59). Results points to a potential advantageous effect of school lockdown in terms of increased school day sleep duration and reduced social jetlag. As sleep is important for mental and somatic health, it is conceivable that increased sleep duration offered some protection against harmful aspects of the COVID-19 pandemic and associated social restrictions. Future studies should address possible associations between sleep changes and health during COVID-19-related school lockdown.

Unaccompanied Minors in Greece and Italy: An Exploration of the Challenges for Social Work within Tighter Immigration and Resource Constraints in Pandemic Times

The number of unaccompanied minors (UAMs) arriving in the European Union (EU) has been increasing dramatically over recent years resulting in the formulation of EU policy directives around safeguarding and well-being. Notably, the majority of UAMs enter Europe irregularly through two main gateways to the European continent: via Italy, using the Central Mediterranean Sea route; or through Greece, transiting through the Eastern Mediterranean route from Turkey, mostly via sea. Profiles of UAMs travelling via the two different routes are significantly diverse, reflecting Italy’s and Greece’s geographical proximity to North Africa and the Middle East, respectively. Although Italy has witnessed a decline since 2018 (Todaro and Romano 2019), the two countries have faced a significant increase in UAMs, and this has required a considerable reorganisation of the reception systems and, more generally, of their welfare systems. However, difficulties in securing adequate reception for UAMs seeking protection have persisted in both countries. Through an analysis of the impact of the pandemic on the Italian and Greek reception systems and social interventions with UAMs, we utilised a multiple embedded case study approach within a comparative analysis, to identify key changes in the main services which should be guaranteed to minors—namely, hosting/housing, guardianship, foster care, family/relatives reunification, school integration, language, job training for care leaving, and preparation for leaving care after 18 years (Di Rosa 2017; Buchanan and Kallinikaki 2018; Barn et al. 2020). Against a background of critical reviews of the main issues related to policies and reported social work practice in a context of COVID-19 precarity, set within a wider EU framework, this paper contributes to the literature with an analysis of the current situation and the tightening of the conditions of reception, inclusion and integration that await UAMs in these gateway countries today. We conclude that with the suspension of key services and amenities, and with a practical halt to the due process of immigration and asylum, social workers are facing a difficult challenge to prevent the deterioration of UAMs’ mental health and well-being.

The impact of COVID-19 on the mental health of Canadian children and youth

Children and youth flourish in environments that are predictable, safe, and structured. The COVID-19 pandemic has disrupted these protective factors making it difficult for children and youth to adapt and thrive. Pandemic-related school closures, family stress, and trauma have led to increases in mental health problems in some children and youth, an area of health that was already in crisis well before COVID-19 was declared a global pandemic. Because mental health problems early in life are associated with significant impairment across family, social, and academic domains, immediate measures are needed to mitigate the potential for long-term sequalae. Now more than ever, Canada needs a national mental health strategy that is delivered in the context in which children and youth are most easily accessible—schools. This strategy should provide coordinated care across sectors in a stepped care framework and across a full continuum of mental health supports spanning promotion, prevention, early intervention, and treatment. In parallel, we must invest in a comprehensive population-based follow-up of Statistics Canada’s Canadian Health Survey on Children and Youth so that accurate information about how the pandemic is affecting all Canadian children and youth can be obtained. It is time the Canadian government prioritizes the mental health of children and youth in its management of the pandemic and beyond.