A Qualitative Study of Child and Adolescent Mental Health during the COVID-19 Pandemic in Ireland

In the paper

“Throughout the interviews, we observed the stresses and strains placed on families in the COVID-19 crisis.”

In the paper

“Many parents argued that their children struggled the most with the lockdown measures.”

In the paper

“Children and adolescents experienced adverse mental health effects, including feelings of social isolation, depression, anxiety, and increases in maladaptive behaviour.”

In the paper

“A recurring theme was how the young people were missing out the most through the pandemic and that their life was changed for the worse.”

In the paper

“Children were socially withdrawn and socially isolated—and parents said that children felt it much more than adults due to their lack of fluidity with digital means of communication.”

In the paper

“Overall families described their children as anxious and high strung during the pandemic, and that this was facilitated by the media coverage of the pandemic and the lack of access to friends and family.”

In the paper

“Increased levels of anxiety and heightened fear were observed.”

In the paper

“A parent and teacher who works with a class of high- functioning adolescents on the ASD spectrum articulated that his students had a comprehensive understanding of the virus which provoked fear of COVID-19:”

In the paper

“While adolescents experienced similar negative mental health outcomes to younger children, their mental health experiences manifested differently.”

In the paper

“Families in this study also described increases in adolescent anxiety, depression, and despair.”

In the paper

“A parent of an ASD child with high needs discussed that his child’s anxiety manifested in relation to his attachment difficulties:”

In the paper

“At the same time, many mourned the cancellation of milestone events and were negatively affected by the loss of routine and guidance.”

In the paper

“Anxiety was a prominent theme among these children as all families articulated its presence in the household.”

In the paper

“The lack of freedom forced teenagers to be confined to their household, which provoked various challenges.”

In the paper

“The findings highlight the impact of severe restrictions on vulnerable populations' wellbeing and mental health outcomes, including children, adolescents, and those with Autism spectrum disorder (ASD).”

In the paper

“This study was conducted and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ).”

In the paper

“The analysis we employed followed the six steps outlined by Smith and Shinbourne [31]:”

What the sources say

• Not checked yetcites Smith and Shinbourne [31] Smith, J.A., and Shinebourne, P. (2012). Interpretative Phenomenological Analysis, American Psychological Association. source

In the paper

“A study in the United States (US) found that 13.2% of adolescents were receiving some form of mental health service from their school before the pandemic [24].”

What the sources say

• Not checked yetcites [24] Lipari, R.N., Hedden, S., Blau, G., and Rubenstein, L. (2016). Adolescent mental health service use and reasons for using services in specialty, educational, and general medical settings. The CBHSQ Report, Substance Abuse and Mental Health Services Administration US.

In the paper

“There have been increases in adolescent anxiety [9,10], which has been due in some part to pandemic related restrictions [11,12].”

What the sources say

• Not checked yetcites [9] Qi, 2020, Prevalence of anxiety and associated factors for Chinese adolescents during the COVID-19 outbreak, Psychiatry Clin. Neurosci. source
• Not checked yetcites [10] Smirni, P., Lavanco, G., and Smirni, D. (2020). Anxiety in Older Adolescents at the Time of COVID-19. J. Clin. Med., 9. source
• Not checked yetcites [11] Guessoum, 2020, Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown, Psychiatry Res. source
• Not checked yetcites [12] Kılınçel, Ş., Kılınçel, O., Muratdağı, G., Aydın, A., and Usta, M.B. (2020). Factors affecting the anxiety levels of adolescents in home-quarantine during COVID-19 pandemic in Turkey. Asia Pac. Psychiatry, e12406. source

In the paper

“The themes that emerged were then discussed and analysed together to determine the final themes.”

In the paper

“This study received ethical approval from The Social Research Ethics Subcommittee, Maynooth University (2407411).”

In the paper

“Research shows that depression, anxiety, and post-traumatic stress are the most common psychological reactions to the pandemic in adults [1];”

What the sources say

• Not checked yetcites [1] Brooks, S.K., Webster, R.K., Smith, L.E., Woodland, L., Wessely, S., Greenberg, N., and Rubin, G.J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet. source

In the paper

“Because they are in a critical period of development, with half of all mental health disordered developing before the age of 14 [15], children and adolescents must be provided with adequate supports.”

What the sources say

• Not checked yetcites [15] Escobar, D.F.S.S., Jesus, T.F., Noll, P.R.S., and Noll, M. (2020). Family and School Context: Effects on the Mental Health of Brazilian Students. Int. J. Environ. Res. Public Health, 17. source

In the paper

“Parental stress caused by the pandemic-related factors may have a more significant impact on younger children, which can result in behavioural problems and can have a substantial effect on children with developmental disabilities [20].”

What the sources say

• Not checked yetcites [20] Nearchou, F., Flinn, C., Niland, R., Subramaniam, S.S., and Hennessy, E. (2020). Exploring the impact of CoViD-19 on mental health outcomes in children and adolescents: A systematic review. Int. J. Environ. Res. Public Health, 17. source

In the paper

“Consent was achieved verbally through the recruitment phone call and during the interview.”

In the paper

“increasing inequalities in parents' resources and shifting conditions of home environments may exacerbate disparities in opportunities for advantaged and disadvantaged youth [4].”

What the sources say

• Not checked yetcites [4] OECD (2020, November 25). OECD Policy Responses to Coronavirus (COVID-19): Combatting COVID-19’s Effect on Children. Available online: https://www.oecd.org/coronavirus/policy-responses/combatting-covid-19-s-effect-on-children-2e1f3b2f/.

In the paper

“Ireland has the fourth-highest suicide rate in Europe among young people [19].”

What the sources say

• Not checked yetcites [19] UNICEF (2017). Building the Future: Children and the Sustainable Development Goals in Rich Countries, UNICEF.

In the paper

“The extent of the impact will likely depend on factors like age, gender, socioeconomic indicators, and country of origin [13].”

What the sources say

• Not checked yetcites [13] Caffo, 2020, Debate: COVID-19 and psychological well-being of children and adolescents in Italy, Child Adolesc. Ment. Health source

In the paper

“Once interviews were transcribed, to ensure procedural consistency across interviews, all researchers initially separately coded the interviews.”

In the paper

“In line with the IPA approach, focuses on the subjective lived experiences of people [33], and, therefore, the researchers demonstrate reflexivity throughout the study [34].”

What the sources say

• Not checked yetcites [34] Corlett, S., and Mavin, S. (2020). Reflexivity and researcher positionality. The SAGE Handbook of Qualitative Business and Management Research Methods, SAGE.

In the paper

“Early research has indicated an increase in adverse mental health outcomes for young people. These include increased levels of depression and anxiety [9,10] as well as a greater likelihood of post-traumatic stress symptoms [14].”

What the sources say

• Not checked yetcites [9] Qi, 2020, Prevalence of anxiety and associated factors for Chinese adolescents during the COVID-19 outbreak, Psychiatry Clin. Neurosci. source
• Not checked yetcites [10] Smirni, P., Lavanco, G., and Smirni, D. (2020). Anxiety in Older Adolescents at the Time of COVID-19. J. Clin. Med., 9. source
• Not checked yetcites [14] De Miranda, D.M., Da Silva Athanasio, B., De Sena Oliveira, A.C., and Silva, A.C.S. (2020). How is COVID-19 pandemic impacting mental health of children and adolescents?. Int. J. Disaster Risk Reduct., 101845. source

In the paper

“Children and adolescents with pre-existing mental health conditions may be more susceptible to new mental health conditions during the pandemic [22].”

What the sources say

• Not checked yetcites [22] Chatterjee, 2020, Impact of COVID-19 pandemic on pre-existing mental health problems, Asian J. Psychiatry source

In the paper

“This approach benefits this research's quality, particularly concerning the data analysis as it buffers against personal experiences and biases impacting the research findings [35].”

What the sources say

• Not checked yetcites [35] Given, 2008, Diversity Issues, The Sage Encyclopedia of Qualitative Research Methods

In the paper

“The interviews were conducted by Amy McGrane, MSc, who was provided with interview training by the research's principal investigator, Katriona O'Sullivan.”

In the paper

“At the beginning of each interview, families were informed of their right to leave the research at any time without suffering any consequences.”

In the paper

“evidence suggests that young people are less likely to experience severe symptoms from contracting the disease [3]”

What the sources say

• Not checked yetcites [3] Verity, R., Okell, L.C., Dorigatti, I., Winskill, P., Whittaker, C., Imai, N., and Ferguson, N.M. (2020). Estimates of the severity of coronavirus disease 2019: A model-based analysis. Lancet Infect. Dis. source

In the paper

“the United Nations Sustainable Development Group (UNSDG) labels them a vulnerable group that is at-risk for becoming its biggest victims and for some, the impact will be lifelong [2].”

What the sources say

• Not checked yetcites [2] UNSDG (2020, November 25). Policy Brief: Education during COVID-19 and beyond. Available online: https://unsdg.un.org/resources/policy-brief-education-during-covid-19-and-beyond.

In the paper

“In Ireland, the landscape of youth mental health has deteriorated over recent years. There is a notable increase in anxiety and depression among young people and higher rates of self-harm [18].”

What the sources say

• Not checked yetcites [18] Dooley, B., O’Connor, C., Fitzgerald, A., and O’Reilly, A. (2019). My World Survey 2: The National Survey of Youth Mental Health, UCD.

In the paper

“Early evidence suggests that around 9 in 10 young people are screening with moderate-to-severe depression and 8 in 10 with moderate-to-severe anxiety, as a result of the crisis [30].”

What the sources say

• Not checked yetcites [30] Mental Health America (2020). COVID-19 and Mental Health, Mental Health America. Available online: https://mhanational.org/sites/default/files/Coronavirus%20Mental%20Health%20Presentation%207-1-2020.pdf.

In the paper

“Prolonged quarantine, fear of infections, boredom, insufficient personal space, and separation from classmates and teachers causes stress in children and adolescents [12].”

What the sources say

• Not checked yetcites [12] Kılınçel, Ş., Kılınçel, O., Muratdağı, G., Aydın, A., and Usta, M.B. (2020). Factors affecting the anxiety levels of adolescents in home-quarantine during COVID-19 pandemic in Turkey. Asia Pac. Psychiatry, e12406. source

In the paper

“There is an increased risk of developing psychiatric disorders, such as depression and anxiety during these formable years with half of all mental health disordered developing before the age of 14 [15].”

What the sources say

• Not checked yetcites [15] Escobar, D.F.S.S., Jesus, T.F., Noll, P.R.S., and Noll, M. (2020). Family and School Context: Effects on the Mental Health of Brazilian Students. Int. J. Environ. Res. Public Health, 17. source

In the paper

“Increases in parental stress during quarantine is associated with their children's negative emotions and behaviour; the more stressed a child's parent is, the more stressed the child themselves are [26].”

What the sources say

• Not checked yetcites [26] Orgilés, M., Morales, A., Delvecchio, E., Mazzeschi, C., and Espada, J.P. (2020). Immediate Psychological Effects of the COVID-19 Quarantine in Youth from Italy and Spain. Front. Psychol., 1–13. source

In the paper

“With schools closed and the decrease in services offered by them, home-schooling stresses may be acting to exacerbate the long-term psychological impacts on young people; young people’s experience in this study point towards this.”

In the paper

“In the United States, epidemiological data indicated that 35% of adolescents who used mental health services between 2012 and 2015 availed their school’s mental health services [10].”

What the sources say

• Not checked yetcites [10] Smirni, P., Lavanco, G., and Smirni, D. (2020). Anxiety in Older Adolescents at the Time of COVID-19. J. Clin. Med., 9. source

In the paper

“These parental mental health difficulties may lead to negative parenting behaviours related to nurturing and monitoring, decreased attention to a child's needs and more significant dysfunction within the home [27,28].”

What the sources say

• Not checked yetcites [27] Elgar, 2007, Maternal and paternal depressive symptoms and child maladjustment: The mediating role of parental behavior, J. Abnorm. Child Psychol. source
• Not checked yetcites [28] Wilson, 2020, Effects of paternal depression on fathers’ parenting behaviors: A meta-analytic review, Clin. Psychol. Rev. source

In the paper

“Increased family stress exacerbated by home-schooling and reduced psychological supports through school means that young people might be more vulnerable [29].”

What the sources say

• Not checked yetcites [29] Bubb, 2020, Learning from the COVID-19 home-schooling experience: Listening to pupils, parents/carers and teachers, Improv. Sch. source

In the paper

“Additionally, social interactions with peers contribute to adolescents’ social health, creating a sense of belonging and reducing feelings of burdensomeness on others. These factors are essential for interpersonal needs [38].”

What the sources say

• Not checked yetcites [38] Oosterhoff, 2020, Adolescents’ Motivations to Engage in Social Distancing During the COVID-19 Pandemic: Associations with Mental and Social Health, J. Adolesc. Health Off. Publ. Soc. Adolesc. Med. source

In the paper

“Mental health problems emerge in early childhood, with almost half of the acute mental illnesses occurring by the age of 14, and 75 per cent manifest by the mid-20s [4].”

What the sources say

• Not checked yetcites [4] OECD (2020, November 25). OECD Policy Responses to Coronavirus (COVID-19): Combatting COVID-19’s Effect on Children. Available online: https://www.oecd.org/coronavirus/policy-responses/combatting-covid-19-s-effect-on-children-2e1f3b2f/.

In the paper

“For adolescents, this risk is complicated by how hormonal and neurobiological changes correspond to increased emotional reactivity and continual development of stress regulation and coping strategies [38].”

What the sources say

• Not checked yetcites [38] Oosterhoff, 2020, Adolescents’ Motivations to Engage in Social Distancing During the COVID-19 Pandemic: Associations with Mental and Social Health, J. Adolesc. Health Off. Publ. Soc. Adolesc. Med. source

In the paper

“These results highlight children’s mental and emotional vulnerability during this pandemic, especially those with developmental disabilities.”

In the paper

“The lack of freedom forced upon young people through the national restrictions provoked various challenges; with the closure of schools and home-quarantine increasing anxiety and loneliness among adolescents and increasing negative behaviour in younger children.”

In the paper

“A second limitation is the use of the remote interview technique. Though this was an essential tool because of COVID-19, this technique limits nonverbal communication between the interviewer and interviewee and nonverbal communication can provide important insights into the interview.”

In the paper

“Previous research shows that these children are at increased risk as the pandemic dissipates and that they require specific interventions to minimise having disproportionate consequences on their psychosocial and emotional wellbeing [41].”

What the sources say

• Not checked yetcites [41] Aishworiya, R., and Kang, Y.Q. (2020). Including Children with Developmental Disabilities in the Equation During this COVID-19 Pandemic. J. Autism Dev. Disord., 1–4. source