People, Research

Mental health assessments decreased during pandemic, study finds

September 09, 2021

The COVID-19 pandemic has significantly decreased mental health assessments among children and youth in Ontario, with the greatest decline among children from low-income neighbourhoods.

This is according to a study published in Traumatology from Education professor Shannon Stewart and co-authors: Aadhiya Vasudeva and Jocelyn Van Dyke, both master’s students from the Faculty of Education and professor Jeffrey Poss from the University of Waterloo.

“Social distancing, stay-at-home measures and school closures have impacted access to mental health services,” Stewart said. “The school is often a gatekeeper for early identification of mental health issues in children and youth, and when schools are closed, it is likely that many referrals to mental health agencies have not occurred because of the pandemic. Additionally, schools and agencies have had to drastically adapt their practices to virtual services.”

The study looked at more than 47,000 interRAI assessments to evaluate the impact of the current pandemic on mental health service needs and referrals of treatment-seeking children and youth. interRAI is a not-for-profit global network of researchers and clinicians that develop, evaluate and refine evidence-based standard care assessment tools for children, youth and adults. Researchers compared the pre-pandemic periods and compared them to the same annual pandemic period across 55 mental health service agencies across Ontario.

In addition, the study found mental health concerns changed during the pandemic. Referrals for anxiety, depression, self-harm, problematic videogaming, and Internet use increased while referrals related to hyperactivity/distractibility, risk of harm to others as well as aggressive and disruptive behaviour decreased.

Researchers also noted that bullying decreased while exposure to domestic violence increased during the pandemic, compared to pre-pandemic rates. While clinically referred children’s experiences of physical, sexual and emotional abuse and neglect remained the same, there was a significant increase in depression and self harm in girls during the pandemic.

“Almost 60 per cent of kids who come to mental health services have been traumatized and that's one key factor that is associated with mental health problems,” Stewart said. “We're seeing a disparity in access to mental health services, which can only increase the likelihood that these already vulnerable high-risk kids will have more difficulties later.”

Girls tend to internalize their behaviour or difficulties and present with anxiety and depression whereas boys tend to externalize their difficulties, acting out in more aggressive and defiant ways, which often get them into trouble, Stewart added. She said with school closures, reduced peer contact and social distancing, it is likely that these measures have had a differential impact on both referral patterns as well as service system access.

Stewart and her colleagues plan to follow-up with these children for at least five years to determine short and long-term impacts the pandemic has had on their learning and mental health.