ALTHOUGH the COVID-19 pandemic has been challenging for all Australians, children and young people have been particularly impacted (here, and here). School closures, stay-at-home orders, the cessation of community and sporting activities, and other social distancing measures have created unprecedented challenges for young people. The implications of these challenges for young people’s short and longer term health and wellbeing are still unfolding.
During Victoria’s second lockdown, we invited young people (aged 14–17 years) participating in the Mothers’ and Young People’s Study to complete an online survey. This lockdown lasted over 100 days and included statewide shutdown of non-essential services, school closures, stay-at-home orders, restricted travel (5 km) and night curfew (8 pm) for people living in Melbourne. The survey asked about young people’s experiences of school, remote learning, family relationships, friendships and daily activities during the pandemic.
The results of our survey are concerning. Almost two out of every five (38%) young people reported clinically significant depressive symptoms, one in five (20%) reported clinically significant anxiety symptoms, and one in five (21%) reported frequent thoughts of suicide. Thoughts of suicide were also most common in those experiencing clinically significant depressive symptoms, with nearly half (46%) of all young people experiencing depressive symptoms also reporting frequent suicidal ideation. The prevalence of mental health symptoms and suicidal ideation among young people was approximately double pre-pandemic estimates for Australia and other high income countries (here, and here).
Remote learning contributed to young people’s distress, with three in four reporting that they felt overwhelmed and/or that they needed more support from teachers. Four in five thought that the pandemic had a negative impact on their school performance.
Young people taking part in our survey reported feeling hopeless and uncertain about their futures, and openly shared their thoughts and feelings:
I had trouble feeling like anything was worth doing when I could just let the heavy feeling set in instead and lay in bed for hours instead of working. Why bother with repetitive useless schoolwork when everything is falling apart outside and there’s nothing you can do but watch anyway? Why even bother?
I was really happy before because I have all these dreams and all these plans for my future, and now I get sad thinking about them. I am fighting with my family so much more but no one seems to want to talk about it.
While around one in three young people experiencing depressive or anxiety symptoms had spoken to a psychologist or school counsellor in the previous 3 months, two in three had not accessed professional support. Barriers to access included: long waiting times, lack of private space at home to talk to a psychologist or counsellor via telehealth, and other fears and worries about the process of talking to a health professional about mental health.
I don’t feel comfortable talking about my problems in my house, so I have stopped seeing my therapist.
I wanted to see my school counsellor, but she was all booked out, so I have had to wait.
Despite evidence of increased uptake of telephone support lines during the pandemic, only around one in 10 young people experiencing frequent thoughts of suicide or depressive symptoms had accessed a telephone helpline for support.
Although the peak of the pandemic seems to have passed in Australia, its impact on young people’s mental health and family relationships is likely to continue. Our findings highlight both the pressures on Australian families, and the need for greater investment in accessible, affordable and flexible mental health care options for young people.
It is also important to recognise the strain which the pandemic has placed on families. Two-thirds of young people taking part in our survey reported increased family conflict, and three-quarters reported increased stress at home. Young people experiencing difficulties within family relationships were more likely to report clinically significant depressive and anxiety symptoms.
As this comment from a young person taking part in our study illustrates, there is a need to think about approaches which support whole families, not just individuals.
There are lots of arguments and this makes me feel really stressed and frustrated. I have found that it is easier to avoid my family, so I don’t make anything worse by getting upset. My mum is finding it hard to deal with everyone fighting and gets angry really easily.
Finally, while the pandemic created challenges for young people and families, many young people in our survey noted positive outcomes of the pandemic. Most young people reported doing more activities as a family and having more quality time together. Nine out of 10 young people thought that people were looking out for each other more. Young people who reported spending more quality time together as a family, staying connected to friends and engaging in regular exercise were less likely to report mental health difficulties.
Looking forward, some of the mental health difficulties experienced by young people could be mitigated by stronger policy responses and more targeted investment in the health and wellbeing of young people and their families. Schools are a critical source of information and support for parents and young people. It is important that schools and young people are adequately supported to create and share resources with families, and to prioritise support for young people’s social and emotional wellbeing. In particular, it is important that schools are adequately resourced to promote social connections and a sense of belonging in the school environment and to raise awareness of common mental health difficulties and avenues for seeking support. It is also important for young people to have options for seeking support outside the school and home environment.
The Royal Commission into Victoria’s Mental Health System recommends the major expansion of publicly funded area level youth mental health and wellbeing services to overcome barriers currently limiting young people’s access to mental health care. These barriers are well documented in the Commission’s five-volume report. They include:
- a focus on crisis response at the expense of primary mental health care;
- long waiting times to access counselling and other psychological services;
- out-of-pocket costs for Medicare funded GP and mental health care services; and
- language and cultural barriers that further limit access for young people of migrant, refugee and Indigenous backgrounds.
The Commission’s focus on systems change and expansion of age-appropriate and tailored models of community based mental health care provides a blueprint for transformational change that would go a long way to improving young people’s access to support at a critical life stage, with long term benefits for mental health and wellbeing across the life course.
Further information: The Mothers’ and Young People’s Study is a longitudinal study investigating the health and wellbeing of over of 1500 first-time mothers and their first-born children. The study has been continuously supported by the National Health and Medical Research Council since 2002. We will shortly be commencing follow-up of mothers and young people in the cohort as the young people reach 18 years of age. For more information about the study and to access our Policy Briefs which informed this article please, see https://www.strongerfutures.org.au/mothers-and-young-peoples-study.
Dr Alison Fogarty is a psychologist and Research Fellow in the Intergenerational Health Group at the Murdoch Children’s Research Institute.
Professor Stephanie Brown is a social epidemiologist and Head of the Intergenerational Health Group at the Murdoch Children’s Research Institute.
If this article raised any issues for you, please reach out for support:
Kids Helpline: 1800 55 1800
Lifeline: 13 11 14
Beyond Blue Coronavirus Mental Wellbeing Support Service: 1800 512 348
Parentline: 1300 30 1300
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.