key: cord-0761100-eddvhxko
authors: Solerdelcoll, Mireia; Arango, Celso; Sugranyes, Gisela
title: Calling for the integration of children's mental health and protection into COVID-19 responses
date: 2021-02-24
journal: Rev Psiquiatr Salud Ment
DOI: 10.1016/j.rpsm.2021.02.004
sha: d3530856b7bfbde56f0616e35c1a1b8c89911114
doc_id: 761100
cord_uid: eddvhxko

nan

of the potential negative consequences, deepening children's social, educational, and health inequalities.

Stressors such as family and friendship disruptions, frustration, lack of personal space, reduced psychosocial support, inadequate information, and family financial loss may have detrimental and enduring effects on the development and wellbeing of children and adolescents. Table 1 captures the specific psychosocial and mental health problems that may arise during the current crisis, and the potential ways they can lead to harmful consequences.

There is accumulating evidence on the impact of COVID-19 pandemic-related issues on children's mental health and well-being. Data from the first wave of COVID-19 in European countries showed that parents perceived a significant increase in their children's emotional, behavioral, and restless/attentional difficulties 8, 9 . Mental health problems appear to have decreased after the lockdown eased and through schools opened in September. However, when new restrictions were introduced, parental distress increased, with higher levels of stress, depression, and anxiety, particularly among low-income families and parents of children with special educational needs 8 .

Family environments marked by poverty or limited resources will bear the full brunt of COVID-19 and associated containment measures. High-stress home environments increase the likelihood of family conflicts, as well as emotional and behavioral problems, domestic abuse and violence 2 . The negative impact of loneliness and social isolation disproportionately affects children from disadvantaged backgrounds, thereby J o u r n a l P r e -p r o o f contributing to growing concerns that the COVID-19 pandemic will exacerbate existing health and social inequalities 4 .

Ideally, the integration of mental health concerns into COVID-19 care should be addressed through collaborative networks between child protection actors, pediatricians and mental health professionals, who should all be aware of mechanisms for preventing, identifying, and delivering psychosocial support to children and adolescents and their caregivers 4 . Table 1 lists the key strategies for providing psychosocial support to children that should be incorporated as part of the response to COVID-19.

A number of economic institutions worldwide have stated that the COVID-19 pandemic will increase poverty and global inequalities 4 . It is expected that the number of children at risk of family separation and in need of alternative care will increaseboth during the peak of the crisis and as a result of its long-term socio-economic impact on families' capacity to care. Positive parenting skills become even more important when children are confined at home. Furthermore, access to extended family, who before the pandemic often provided critical support to primary caregivers in the care of children, is likely to be limited during home-based quarantines due to restrictive confinement measures in elders and general limitations of movement. This change poses an addition challenge which may contribute to an increasing need for residential care settings in vulnerable children 10 .

In light of the growing economic crisis and the extensive psychological distress surrounding the COVID-19 pandemic, child psychosocial needs are increasing and require an immediate response from child protection and mental health services. The strategy must be inclusive of key risk groups such as children with disabilities. Governments and local authorities should offer continuing support to families and communities to prioritize keeping children safe in family environments. Enabling families to cope with this situation will require reducing stressors such as food and economic instability and increasing parenting capabilities, along with mental health support 10 . Such support can enhance family resilience and help minimize the need for residential care.

We suggest that an inter-agency collaboration between child protection, education, and mental health services should be adopted in the design and development of programs targeting the specific challenges related to the COVID-19 pandemic.

Finally, we call on governments, health institutions, and non-governmental organizations to include and prioritize the needs of children and young people in any discussion or implementation of COVID-19 responses. If children's needs are not appropriately addressed, the mental health consequences for a generation of children could far exceed the immediate health and economic impact of the COVID-19 pandemic, leaving longterm social and economic consequences.

Guidance Note : Protection of Children During Infectious. Alliance Child Prot Humanit Action

Children of the Recession: The impact of the economic crisis on child well-being in rich countries. Innocenti Rep Card no 12

The effects of poverty on children

Policy brief: the impact of COVID-19 on children

Psychiatry in the aftermath of COVID-19

Pandemics and violence against women and children. Cent Glob Dev Work Pap

The effects of social deprivation on adolescent development and mental health

How did the mental health of children and adolescents change during early lockdown during the COVID-19 pandemic in the UK?

Immediate Psychological Effects of COVID-19 Quarantine in Youth from Italy and Spain

A wake-up call: COVID-19 and its impact on children's health and wellbeing