ABSTRACT
The COVID-19 pandemic arrived with significant hardship. The secondary impacts of the pandemic and our response with respect to pediatric mental health has been a subject of significant discussion in the lay public, media, and decision-maker groups. The initiatives to control SARS-CoV-2 have become politicized. A narrative emerged early that strategies to mitigate the spread of the virus were harming children's mental health. Position statements from professional organizations in Canada have been used to support this claim. The aim of this commentary is to provide a reanalysis of some of the data and research methodology used to support these position statements. Some of the direct claims such as "online learning is harmful," should be supported by a strong evidence base with significant consensus that speaks directly to causality. We find that the quality of the studies and the heterogeneity of the results does not support the strength of the unequivocal claims made by these position statements. In a sample of the current literature examining the issue, we find that outcomes range from improvements to deteriorations. Earlier studies relying on cross-sectional surveys typically have shown stronger negative effects than longitudinal cohort studies, which often have also shown groups of children experiencing no changes to measured mental health characteristics or groups that have experienced improvements. We argue it is imperative that policymakers use the highest quality evidence in making the best decisions. We as professionals must avoid discussing only one side of heterogeneous evidence.
La pandémie de la COVID-19 est arrivée avec des difficultés importantes. Les effets secondaires de la pandémie et notre réponse à l'égard de la santé mentale pédiatrique ont constitué un sujet de discussion significatif dans le public profane, les médias et les groupes de décideurs. Les initiatives de contrôle du SRAS-CoV-2 sont devenues politisées. Une histoire a émergé tôt disant que les stratégies pour atténuer la propagation du virus nuisaient à la santé mentale des enfants. Des énoncés de position des organisations professionnelles du Canada ont été utilisés pour soutenir cette revendication. Le présent commentaire vise à offrir une ré-analyse de certaines données et méthodologies de recherche utilisées pour soutenir ces énoncés de position. Certaines revendications directes comme « l'apprentissage en ligne est nuisible ¼ devraient être appuyées par une forte base de données probantes et un consensus significatif qui s'adresse directement à la causalité. Nous croyons que la qualité des études et l'hétérogénéité des résultats ne soutiennent pas la force des revendications sans équivoque faites par ces énoncés de position. Dans un échantillon de la littérature actuelle qui examine la question, nous constatons que les résultats vont des améliorations aux détériorations. Des études précédentes s'appuyant sur des sondages transversaux ont typiquement montré des effets négatifs plus forts que les études de cohorte longitudinales, qui ont aussi souvent montré des groupes d'enfants qui ne connaissent aucun changement des caractéristiques mesurées de la santé mentale ou des groupes qui ont connu des améliorations. Nous défendons qu'il est impératif que les décideurs utilisent les données probantes de la plus grande qualité en prenant les meilleures décisions. Nous, comme professionnels, devons éviter de ne discuter que d'un côté des données probantes hétérogènes.
ABSTRACT
BACKGROUND: Understanding the psychosocial status of children and adolescents during the COVID-19 pandemic is vital to the appropriate and adequate allocation of social supports and mental health resources. This study evaluates the burden of mental health concerns and the impact of demographic factors while tracking mental health service recommendations to inform community service needs. METHODS: MyHEARTSMAP is a digital self-assessment mental health evaluation completed by children and their guardian throughout British Columbia between August 2020 to July 2021. Severity of mental health concerns was evaluated across psychiatric, social, functioning, and youth health domains. Proportional odds modelling evaluated the impact of demographic factors on severity. Recommendations for support services were provided based on the evaluation. RESULTS: We recruited 541 families who completed 424 psychosocial assessments on individual children. Some degree of difficulty across the psychiatric, social, or functional domains was reported for more than half of children and adolescents. Older youth and those not attending any formal school or education program were more likely to report greater psychiatric difficulty. Girls experienced greater social concerns, and children attending full-time school at-home were more likely to identify difficulty within the youth health domain but were not more likely to have psychiatric difficulties. Considerations to access community mental health service were triggered in the majority (74%) of cases. CONCLUSIONS: Psychosocial concerns are highly prevalent amongst children and adolescents during the COVID-19 pandemic. Based on identified needs of this cohort, additional community health supports are required, particularly for higher risk groups.