Children's rights and restrictive measures during the COVID-19 pandemic: implications for politicians, mental health experts and society

Development will (try to) find its way: a qualitative study of Chilean adolescent mental health during and after lockdown

BACKGROUND

The COVID-19 pandemic has had a well-evidenced impact on adolescents, who are especially sensitive to pandemic disruptions given the critical role of socialization in their development. In Chile too, evidence shows increases in mental health complaints among adolescents over the lockdown period. Our study aimed at exploring the experiences of Chilean adolescents regarding their mental health during the lockdown and school closure (March 2020-December 2021), and during the return to on-site education (2022) as informed by adolescents and school staff, with a focus on family, school, and social sources of risk and support for adolescents' wellbeing during these periods.

METHODS

Using a qualitative approach, we conducted semi-structured interviews with 19 adolescents and 16 staff members from schools in an urban area of Chile.

RESULTS

Through thematic analysis, we generated five themes: [1] Adolescents in a mental health crisis, comprising a range of distressing experiences and mental health problems. This crisis was fueled by alterations in the functioning of adolescents' systems: [2] Broken support systems (peers and school); [3] The school agenda must go on, reflecting schools' strict compliance with the educational curriculum; and [4] Blurred boundaries between home and school life and within the family. Finally [5], Development will (try to) find its way describes how most participants experienced a bouncing back to wellbeing in the course of the school year upon return, and how some developmental milestones took place despite the abnormal conditions, providing evidence for resilience amid pandemic adversity.

CONCLUSIONS

The findings give insight into how the exchanges between the adolescent and the social systems they are embedded in were interfered. The results help us understand the challenges for mental health during and after the pandemic, and highlight adolescents' capacity to thrive as normality was restored. The results also underscore the importance of upholding stability across adolescents' systems and routines, in order to mitigate impacts on wellbeing amid abnormal circumstances. The findings are relevant for development-informed initiatives in policy design in the aftermath of the pandemic and in future crisis management responses.

"The Walls Had Been Built": A Qualitative Study of Canadian Adolescent Perspectives on Mental Health During the COVID-19 Pandemic

Public health measures (PHMs) implemented during the COVID-19 pandemic introduced sudden changes to adolescents' everyday routines and required adolescents to repeatedly adapt their routines at a critical developmental stage. While meant to protect physical health, the PHMs destabilized mental health. Using a youth-engaged approach and interpretive description, this study explored adolescents' perspectives on their mental health in relation to the COVID-19 pandemic-related PHMs in Canada from March 2020 to the time of data collection in March 2022. Four Youth Research Collaborators contributed an adolescent lens to informing study activities, and a total of 33 high-school aged adolescents ages 14 to 19 completed individual interviews. Findings suggest an overarching concept of a "timeline" through which adolescents described their experiences. Most adolescents described their mental health as worsening during the initial lockdown, although some adolescents experienced positive mental health outcomes. Several adolescents felt their mental health had not recovered after the PHMs were fully lifted. This study contributes young Canadians' unique voices to the literature on the pandemic-related PHMs and adolescent mental health. It is essential that the impacts of the pandemic on adolescent mental health continue to be a focus of research and programming to better understand and address its ongoing effects.

How the COVID-19 pandemic and related school closures reduce physical activity among children and adolescents in the WHO European Region: a systematic review and meta-analysis

BACKGROUND

Emerging research suggests that physical activity among children and adolescents decreased during the COVID-19 pandemic. However, a differentiated overview of European youth is lacking. In particular, no systematic analysis has been conducted to date on the impact of heterogeneous pandemic restrictions and school closures within European countries, and with regard to potentially vulnerable groups.

METHODS

We searched seven databases and included studies for children and adolescents (≤ 19 years) of the WHO European Region that compared physical activity during the COVID-19 pandemic with a pre-pandemic baseline using validated measurement instruments. We used the Oxford Stringency Index and School Closure Index as indicators of restriction stringency. Screening for eligibility, data extraction, assessment of the study risk of bias (using the 'Risk of Bias in Non-randomized Studies - of Exposure' [ROBINS-E]) and certainty grading of evidence (using the GRADE approach), were all done in duplicate. Unpublished data was requested from study authors. Data were pooled in random effects models. An a priori protocol was published, reporting is carried out in accordance with the 'Preferred Reporting Items for Systematic Review and Meta-Analyses' (PRISMA) statement.

RESULTS

Of 14,897 non-duplicate records, 26 publications (n = 15,038 pre-pandemic, n = 13,041 during pandemic) met full inclusion criteria. Comparison before and during the COVID-19 pandemic revealed a significant reduction in total physical activity (standardized mean difference [SMD], -0.57 [95%CI, -0.95; -0.20]) and moderate-to-vigorous physical activity (SMD, -0.43 [95% CI, -0.75; -0.10]), corresponding to a decrease of 12 min per day (a 20% reduction of the WHO recommendation). A decrease in sporting activity was also recorded. Subgroup analyses suggested that middle childhood (aged 8-12) and adolescents were particularly affected by the decline. School closures were associated with a reduction in physical activity. The certainty of evidence for all outcomes was low.

CONCLUSIONS

A sharp decline in all forms of physical activity was recorded among European children and adolescents during the COVID-19 pandemic. This decline was higher during periods of school closure and mainly affected younger schoolchildren and adolescents. Immediate action by policy-makers and practitioners, as well as evidence-based public health strategies, are imperative in reversing this trend.

TRIAL REGISTRATION

PROSPERO: CRD42023395871.

On return to school: disorder symptoms, stress at home and evaluations of school COVID-19 measures

Background: Social restrictions during the COVID-19 pandemic had a major impact on the mental health of children. Yet, analyses on the mental health of younger children in the later course of the pandemic are scarce. The present study assessed 8- to 11-year-olds' internalising disorder symptoms during the last three weeks, from the third week of February through to the first week of March, of the 2021 national lockdown.Method: One hundred and forty-five pupils, including a subset of keyworkers' children who had face-toface schooling, completed the validated Revised Child Anxiety and Depression scales, items on COVID-related stress at home, and evaluations of home-learning and school's measures for reopening.Results: Symptoms increased with age in months and/or number of siblings. Girls reported more symptoms and home stress than boys did. Pupils who had face-to-face schooling were more satisfied with school measures and less satisfied with home learning compared with those who only had home learning. Hierarchical regression analyses corroborated the contributions of sociodemographic characteristics and found that home stress and school measures evaluations were associated most with major depression, generalised anxiety, and social phobia.Conclusion: Findings can contribute to mental health practice by promoting school communications and family and educator awareness of stressors, vulnerabilities and symptoms to boost pupils' readiness for school returns.