Colman Noctor: Covid casts a long shadow over children's mental health 

When restrictions on children were being considered during the pandemic, mental health experts warned about the longer-term impact of implementing these measures. 

Their concerns were often dismissed as “speculative” and paled compared to the “clear and present” danger of infection transmission. While these were crucial considerations at the time, the mental health needs of children were undervalued and under-represented. 

I am not surprised to hear parents say that the impact of some pandemic measures is now manifesting in the form of residual mental health issues.

I do not want to revisit the polarising discussions about mask-wearing for children and school closures, but I do not want to gloss over the experience of the past two years. 

Just because we have gotten through the pandemic restrictions does not automatically mean we have gotten over it. 

For example, when a coastguard helicopter lifts a person to safety and they are brought to shore, it would be easy to assume that all is well. However, while the risk to the person’s physical safety has been managed, the psychological impact of the experience has not even begun. 

In many cases, people will claim to be “fine” after a traumatic experience, but just when they think they might be “out of the woods”, the emotional impact of the event can emerge. 

Similarly, the eroding effect of social and emotional disruption on children is worth noting and deserves to be addressed rather than ignored.

Growing anxiety and depressive symptoms

In the A Lust for Life survey, 20% of parents reported noticeable depressive symptoms in their children. This increase is reflected in the stream of queries I receive from parents struggling to support an anxious child. Growing anxiety and depressive symptoms in children must be acknowledged and addressed before these experiences continue into adulthood.

Some 10% of parents in the survey reported that their child was experiencing suicidal thoughts, which points to a possible crisis and poses as much of a threat to the nation’s health as Covid-19 did. 

However, we will unlikely see anything similar to a response from the Government or the major decision-makers.

A worthy initiative is A Lust for Life’s schools’ programme, which aims to build resilience, increase wellbeing, and enhance the emotional literacy of third- to sixth-class pupils. 

It has already reached 44,000 pupils across Ireland and aims to reach every primary school pupil by 2024. But much more needs to be done, particularly for teenagers. 

The 13- to 17-year age group seems to be deeply affected by the events of the last two years, especially in the areas of socialisation and emotional maturity. 

Parents of young teenagers have contacted me in recent weeks saying their children have “checked out” socially and are spending most of their time alone.

The broad-ranging SPHE programmes in schools offer support for personal and social development, but this is limited to the classroom. What teens need are opportunities to socialise among themselves.

We repeatedly tell children, “if you are worried about something, talk to someone” but there is little value in promoting this narrative if there is no one to talk to. 

The waiting lists for Child and Adolescent Mental Health Services (Camhs) are far too long. There needs to be a creative approach to supporting children with mental health concerns beyond just Camhs. 

In other countries like Australia, there are primary care services in addition to psychiatry-led teams which offer a range of psychotherapeutic supports for children in mental distress. We need to learn from models such as these and avoid medicalising children’s emotional distress and offer talking therapies as an alternative to mental health services.

How to cope with life’s challenges

Many of the children described by the parents in the A Lust for Life survey will not need a Camhs clinic assessment; they may simply need support as they find ways to cope with life’s challenges. 

An adequately resourced community primary care service for children with the ability to access prompt mental health support would go a long way towards helping to manage waiting lists and unsuitable referrals.

I worked in Scotland in 2002 and the NHS Lothian service employed a primary mental health worker who visited schools and GP clinics with concerns regarding a child’s mental wellbeing. 

They carried out a screening assessment and directed the child towards the most appropriate social, education, or health service. 

This service worked well because a menu of non-clinical options existed in Scotland, which is not the case in many locations in Ireland.

As well as extending services and providing well-being programmes in schools, children need opportunities to make up for the social and emotional developmental steps missed during the pandemic. 

These gains in social and emotional momentum do not occur by completing a worksheet in an SPHE class — they happen in real life as teenagers spend time with their friends and peers. 

This informal, adult-free space will allow young people to practise social exercises and learn ways to develop emotionally.

The laboratory of life is an underestimated resource, and we need to tap into it. 

Many children and young people have lost the skills necessary to organise social events, and adults need to facilitate this and step back. 

Adult-led activities are not what children and younger teens need right now — they need opportunities to make up for lost ground. 

If we don’t listen and offer support, I have serious concerns about our children’s mental health in the coming years.