A British Medical Journal (BMJ) article written by Cambridge Children’s Hospital Mental Health Research Lead, Professor Tamsin Ford, says better evidence on how children’s mental health is affected by health shocks, like the Covid 19 pandemic, is essential to inform policy responses.
Professor Ford co-authored the BMJ article with 18-year-old Ann Sabu from the Cambridge Children’s Network. Ann and other young people are supporting the development of Cambridge Children’s Hospital, which will be a world first in fully integrating the treatment of mental and physical health under one roof. This is a partnership between Cambridge University Hospital NHS Foundation Trust, Cambridgeshire and Peterborough NHS Foundation Trust, and the University of Cambridge, where Tamsin Ford is Professor of Child and Adolescent Psychiatry.
Despite children being a “precious resource”, Professor Ford said they repeatedly “dropped down the agenda”. Big decisions were made about children and young people during the pandemic, but they were barely involved, she said. One of the article’s key messages is that their interests and voices must be represented and respected in the prioritisation of research questions to tackle the wide evidence gap.
Professor Ford said: “The impact on children should be front and centre of pretty much every policy decision - but it's really not. During Covid the interests of children and young people were not at the table.”
Efforts should be made to bring children and young people on board, even during an emergency situation like the Covid 19 pandemic, said Professor Ford. If this isn’t possible, she said professionals who work with children and young people should act as representatives.
The peer review article drew on multiple sources, including a survey shared with Cambridge Children’s Network and charities. Young people and parents of young children responded with a bleak picture of social isolation, loneliness, reduced confidence and a lack of typical age-appropriate experiences.
Luke Webber, 17, from Stevenage, shared his own experiences with Professor Ford and her team. He was diagnosed with a brain tumour in the summer of 2020. Restrictions on hospital visitors and school closures meant his younger brother Ryan had to stay at home with his grandparents, unable to visit Luke, see his mum and dad, or talk about the situation face to face with his friends at school. Peter Webber said both his sons suffered with their mental health.
Peter said: “There were no therapy dogs coming in for games, no being in the communal areas. Neither of them got to experience any of that for the whole time [Luke was in hospital]. It’s just like this big black hole that Luke and Ryan were in, separate from each other.”
Additionally, the BMJ article described how experiences diverged, with well-resourced families adjusting and enjoying additional time with each other, while children in abusive households and young carers faced escalating isolation and challenges, posing an extra threat to their mental wellbeing.
Co-author Ann Sabu from Cambridge, who is studying to be a doctor, found her experience of lockdown to be largely positive, but when schools reopened, she noticed some of her peers struggling with anxiety. She is calling for better access to mental health support for children and more research as to why some struggled during the pandemic, while others did not.
Ann said: “Going back to school was never the same because you had the one-way system, you had to wear masks, you had to sanitise all the time. It felt very controlling. It felt like Covid took away from our school experience because there were so many regulations and rules that were put in place.”
With hindsight, Professor Ford says schools should have been the last organisations to close and the first to reopen. She said responses to future health shocks must be based on sound evidence, as robust as that carried out for adults, ensuring children’s mental health is protected and promoted.
She said: “A child who cannot function for several months pays a developmental price in terms of skills and educational development, which adults do not. Similarly, there can be no health without mental health: prevention and containment of communicable diseases must not neglect mental health, nor widen inequalities.”
- “Neither seen nor heard: the evidence gap on the effect of covid-19 on mental health in Children”, by Tamsin Ford, Tamsin Newlove-Delgado, Ann Sabu, and Abigail Russell is published in the British Medical Journal.
Image: The front of Cambridge Children’s Hospital courtesy of Cambridge Children’s Hospital.
