During the COVID-19 pandemic, children have experienced major disruptions as a result of public health safety measures, including school closures, social isolation, financial hardships, and gaps in health care access. Many parents have reported poor mental health outcomes in their children throughout the pandemic – in May 2020, shortly after the pandemic began, 29% said their child’s mental or emotional health was already harmed; more recent research from October 2020 showed that 31% of parents said their child’s mental or emotional health was worse than before the pandemic. Some children have also exhibited increased irritability, clinginess, and fear, and have had issues with sleeping and poor appetite. As mental health issues become more pronounced among children, access to care issues may also be increasing. These access issues may exacerbate existing mental health issues among children.
Even before the pandemic, many children in the United States were living with mental health disorders. On average, in the years 2018 and 2019, among children ages 3-17, 8% (5.2 million) had anxiety disorder, 4% (2.3 million) had depressive disorder, and 9% (5.3 million) had attention deficit disorder or attention deficit/hyperactivity disorder (ADD/ADHD) (Figure 1). Other mental health disorders among children and adolescents include obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders. Adolescents in particular have seen increases in poor mental health outcomes in recent years, such as persistent feelings of sadness or hopelessness and suicidal thoughts. Many mental health conditions develop by adolescence and, if unaddressed, can persist into adulthood and limit quality of life.
This brief explores factors contributing to poor mental health and substance use outcomes among children during the pandemic, highlighting groups of children who are particularly at risk and barriers to accessing child and adolescent mental health care. Although data on child and adolescent mental health have historically been limited, where possible, we draw upon data from the National Survey of Children’s Health, the Youth Risk Behavior Surveillance System, and the National Survey on Drug Use and Health, in addition to surveys conducted during the pandemic. Key takeaways include:
- Several pandemic-related factors may negatively impact children’s mental health. Social distancing and stay-at-home orders could lead to loneliness and isolation among children – known risk factors for poor mental health. Income insecurity and poor mental health experienced by parents during the pandemic may also adversely affect children’s mental health and may be associated with a possible rise in child abuse.
- Adolescents, young children, LGBTQ youth, and children of color may be particularly vulnerable to negative mental health consequences of the pandemic. During the pandemic, more than 25% of high school students reported worsened emotional and cognitive health; and more than 20% of parents with children ages 5-12 reported their children experienced worsened mental or emotional health. A survey of LGBTQ youth found that many LGBTQ adolescent respondents (ages 13-17) reported symptoms of anxiety (73%) and depression (67%) and serious thoughts of suicide (48%) during the pandemic. Although data is limited on children of color, research suggests that even before the pandemic they had higher rates of mental illness, but were less likely to access care.
- Prior to the pandemic, many children with mental health needs were not receiving care; and it is possible that access to mental health services has since worsened. Data shows that there have been large declines in pediatric mental health care utilization since the pandemic began. Access to mental health care via telehealth has increased, however, access via schools – a commonly utilized site of care for children and adolescents – may have decreased due to school closures.
- Several bills that include funding related to children’s mental health have been introduced during the pandemic. The recently passed American Rescue Plan Act allocates funding for pediatric mental health care access and youth suicide prevention. The American Jobs Plan and American Families Plan propose additional funding for services to benefit children, including upgraded schools and nutrition programs.
Population: Youth
Links to resources:
- Read the full issue brief Mental Health and Substance Use Considerations Among Children During the COVID-19 Pandemic from Kaiser Family Foundation.
- Learn more about the Kaiser Family Foundation.
- Read the full analysis Children, Coronavirus, and the Digital Divide: Native American, Black, and Hispanic Students at Greater Educational Risk During Pandemic on the Population Reference Bureau website.
- Learn more about the Population Reference Bureau.
Date: 2021