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The importance of good children’s mental health during COVID – 19

By Hannah Gilding

You may have seen the recently published survey results which have shown the detrimental impact of the Coronavirus pandemic on the mental health of children and young people. The children’s mental health charity Young Minds published results from data collected between 6th June 2020 and 5th July 2020 showing 80% of children and young people said the pandemic had worsened their mental health and 87% of respondents reported that they had felt isolated or lonely during the lockdown period. Barnardo’s also reported on a survey by YouGov showing that 41% of 8-24-year olds surveyed reported that they felt lonelier than before lockdown, 38% felt more worried, 37% said they felt sadder and 34% felt more stressed. These findings are very unsettling, especially for carers who may be concerned about the impact this time is having on the health of the children they care for. A further survey by Young Minds finds that 67% of parents and carer surveyed were concerned about the impact of the coronavirus on children’s mental health.

Although these findings are important, we need to be able to put them into a perspective that doesn’t increase fear and anxiety in parents and carers. To feel sad, lonely, anxious, or even bored does not substantiate a mental health illness. These are emotions, that as human beings we all feel and experience as both children and adults. Emotions related to Covid-19 have been triggered by an event; they are a response to something that is out of our control. Not only is facing a global pandemic anxiety-provoking, but the media has continued to provoke and increase fear in many of us.

This fear has unsurprisingly been felt by children. They may be picking up on the fear of adults, feeling anxious by the change to routines and the new rules we must live by. Dr Lucy Johnston, a Clinical Psychologist from Bristol, suggests it would in many ways be more concerning if children and young people did not have an emotional response to these changing and somewhat frightening events. Rather than diagnosing these emotions or becoming fearful of the concept of ‘mental health problems’, it is important that we can support children to manage their anxieties, as well as being mindful of our own.

The Transition back to School

Currently, the rules around schooling and education are constantly changing and children will be very uncertain of what this means. The school environment is likely to be very different from what children have experienced before, with new rules and routines to adjust too. This would be a lot for an adult mind to contemplate and the return to work for many of us is unsettling. We don’t know what to expect from the ‘new normal’ and how long these new ways of working will last. Children will have very similar fears and worries about returning to school, as well as some added stressors such as returning to their peer group and coping with their school workload.

The easing of lockdown for many people may bring positives, but for some, it signals a return to a previously stressful lifestyle. The beginning of lockdown saw fewer concerns for some carers and children. Families were able to create a ‘bubble’ around themselves to protect from the outside world. The stress of everyday life subsided and more time for play, relaxation and fun were provided. For many children, particularly those who have experienced trauma, the usual busyness of our pre-lockdown routines was stressful. With lockdown being eased, children are being removed from their comforting isolated bubble with family and are being faced with returning to pre-lockdown life, with added rules and anxieties to contend with. Young Minds reported that one of the main concerns for parents and carers was the transition back to ‘normality’ for the children they care for. As carers and teachers, it is important to consider what can be done to relieve these anxieties for children and to support them to manage these emotions to prepare for the transition back to school.

Advice for carers

Self-care

Many carers will have been home-schooling whilst schools have been closed in the UK. Carers have no longer been solely a parental figure for children, but also a schoolteacher. After spending the majority of time with a parent/carer for the past 5 months, a child may feel a large degree of separation anxiety at having to leave the carer and return to school. For some children, separation may have already been a challenge and for others, carers may notice a regression in a child’s behaviour at being separated from them. It is important that as the adult, you can be grounded and calm for the child. The child will be reassured by seeing that you are steady and supportive. If you are anxious, this will be reflected by the child. Consequently, it is important that you can manage your own emotions. This does not mean burying your feelings or presenting a stoic, ‘stiff upper lip’ response but engaging in your coping strategies and self-care, such as reconnecting with friends, exercise and breathing techniques. You could practice these with children and use it as an opportunity to model to children how they can manage their anxiety and fears. You must be able to help yourself feel calm about the circumstances surrounding Covid-19 and the return to school before you can do this for the child.

Behaviour

As the start of the new term approaches, you may notice a change in a child’s behaviour. Dysregulated behaviour can be extremely draining but it is important to try to remember that behaviour is a projection of how a child is feeling. Behaviour is a response to emotions that children are not yet capable of managing and can communicate underlying pain. Emotions, such as fear, can trigger a physiological response in children called the fight-or-flight response, which can increase blood flow around the body. It is important to regularly provide space for children for bursts of physical activity, to help them to calm their body. For example, encouraging a quick time challenge for how many star jumps they can do in two minutes, or how many laps of the garden can they run. Body calming activities can also be useful to alleviate these symptoms of fear. For children with sensory needs, items such as a weighted blanket can help them to feel contained and safe.

Conversation

Once a child is in a calm, regulated state, the focus should be on conversation. If you notice a change in a child’s behaviour, ask them about it. Help them to make connections between their feelings and behaviours. Listen to their fears and validate them; these changes can be scary and it’s okay to feel a bit frightened. Re-assure them that they are safe, and you are not going anywhere. You will be here when they get home from school and you will be thinking of them throughout the school day. Make yourself available to the child, so they have space where they can talk to you if they want too. Often, having sat down, focused conversations will be too much for a child. Spending time with them doing a different activity, such as going for a walk, baking, or making something creative, will provide a distractor from the conversation and may make it easier for a child to open up to you.

Routines

A large cause of anxiety is the unknown. It will be important to prepare the child for the new routine. Hopefully, you will have received communication from the school about the new school routines and timings. Talk this through with the child and map out exactly how their day will go. If they are particularly anxious, it may be useful to use a social story to explain the new routine. Write clear, succinct sentences and use simple language to explain what the changes will mean for the child, drawing pictures or sourcing clipart to show the transition visually. This may help to give the child a sense of control over knowing what to expect. They can begin to process how they may feel during the new routine and slowly prepare themselves for the changes. Try to keep to the home time routine as similar as possible to reduce the number of changes the child has to process.

You could rehearse the ‘goodbye’ routine for the morning and the ‘hello’ routine for after school. This could be something silly to give the child something to look forward to at the end of the day, such as a special handshake. Rehearsing could be a fun way to bring some humour to alleviate a child’s anxiety.

Positives

Alongside addressing the child’s fears and worries and validating their feelings, it will also be supportive to communicate the positives of this new transition. There may be aspects of school that your child used to enjoy, whether this is a favourite teacher, a friend, some of their lessons, or being able to get out of the house. Remind them of these important things, as often when we feel apprehensive, we can catastrophise and think of all the challenges, without acknowledging the positives. There may be things the child is proud of achieving over the lockdown period, such as something they have created or learnt. Remind them that they will be able to share this achievement with people at school and tell everyone about all the wonderful things they have done.

Transitional Objects

A good way to reassure a child that you will be thinking of them and to remind them of their safe place at home is to use transitional objects. Unfortunately, due to Covid-19, some toys and objects will not be able to be brought into the school. However, a child may be able to bring in something smaller and easier to clean, such as a small pebble, wrist band or a photo. If possible, liaise with the school to ask what could be brought in and explain how reassuring this could be for the child.

If no objects can be brought it, one idea is to draw a heart on the child’s hand and one on your hand. This could be described as a ‘hug button’ so when they are missing home or feeling scared, they can press this and know that you will be doing the same and thinking about them. It is one way for a child to feel connected to home when they are distanced from it.

To summarise

The coronavirus pandemic has been a scary time and it is not unusual to see a change in a child’s emotions and behaviours. Returning to school will be a big change in routine for children and may seem very frightening. They will need you to be calm and grounded and give them space to process the confusing feelings they have. Once you can reduce your anxieties, you can support the child with theirs. It may take time for the child to settle back into the school environment. Providing continual support and a grounded figure for the child will be the best help you can give.

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