The stress, fear, and anxiety that has been created and continually multiplied by the COVID-19 pandemic is impacting all of us, but it may be hitting teenagers especially hard. Many adolescents’ physical health, social life, and mental well-being are being impacted by the pandemic. With the cancellation of school, postponement of extra-curricular events, and closure of public spaces like gyms and playgrounds, teens have lost many of the places they used to frequent for socialization, exercise, and relaxation. In addition to losing physical access to these locations, adolescents have also lost consistent in-person access to the friends and adult support they interacted with in these places. Losing these positive interactions with others outside of the home may be harmful to the health of teens in a multitude of ways. It is well-recognized that the adolescent brain is still developing in the teenage years, so a sudden shift in the schedule and routine they have become accustom to over their childhood has the potential to cause negative trends in teens’ physical and mental health.
Schools offer many services to their students beyond just education, such as nutrition and a place for safe exercise. One extremely important service offered at school to students is health care, which is especially crucial to students who don’t have access to health care otherwise. Prior to the pandemic in the Philadelphia School District, hearing and vision screenings were offered to students at different grade levels along with tracking of general vital signs like weight and height and routine checks for scoliosis [1]. While these screenings done by the school nurse weren’t a replacement for regular checkups with a primary care practitioner, they played an important role in keeping students healthy and able to focus on learning, which should be their primary concern at school during their adolescent years. With school moving to a digital platform, access to a school nurse and to some of these important health screenings have been lost.
just over 1/3 of them [school-aged students] were receiving the entirety of their mental health care at school [2]
In addition to providing physical health screenings for many students, schools also serve as a location where adults can identify and address mental health problems in teens. A study from 2019 found that of school aged students who were accessing mental health care, 58% of them were receiving at least some, if not all, of that treatment at their educational institution, and just over 1/3 of them were receiving the entirety of their mental health care at school [2]. Physical school closures will likely be extremely disruptive to the latter group’s mental health care, as those students may be left with nowhere to turn for their mental health concerns. Additionally, educators and other adults working in schools often play a role in recognizing the signs and symptoms of mental health disorders in teenagers. In the virtual school environment, the screen-based interactions between educators and students are more distanced, so important signs that would have been noticed in the in-person environment may be missed. With screens replacing face-to-face interactions, students may be unwilling or unable to share details of their lives that they’d more willingly share in person. With school closures around the country and here in Philadelphia, students are losing access to an extremely important part of their healthcare during a time when mental health concerns in teens are potentially exacerbated due to stressors of the pandemic.
Fortunately, not all students will struggle with their mental health during this time; however, it is important to continually check on adolescents, whether they had prior mental health diagnoses or not. Many teenagers, regardless of whether or not they had prior health concerns, are experiencing feelings of loneliness and an increased sense of isolation from friends and peers. One study found that 79% of girls are feeling lonelier and more isolated since the onset of the pandemic [3]. Moreover, teens are vulnerable to development of symptoms of anxiety or depression during times of social isolation, and during this time of extreme social isolation in combination with a complete change in routine, there is a very high risk for development of these symptoms in teens.
One of the most important things we can do during this time is check in with the adolescents we know to see how they’re feeling and use this time to validate their feelings.
Students have not only lost an avenue for treatment, many of them have also lost their primary stress-relief opportunities that they would have used as coping mechanisms for increasingly stressful situations, such as playing sports with friends and other after-school activities. The loss of these stress regulation opportunities may lead students in the direction of bad coping mechanisms, as opposed to good ones they may have pursued prior to the pandemic. These increased levels of stress only serve to exacerbate the feelings of anxiety students are experiencing. If the symptoms aren’t caught and addressed early, they could lead to worsened and more damaging symptoms down the road. In a study of the mental health repercussions of the SARS-1 and H1N1 pandemics, 30% of school-aged children who were isolated or quarantined met the criteria for a diagnosis of PTSD based on symptoms reported by their parents [4]. That fact is extremely concerning considering schools have already been closed much longer than they were in either of the previously mentioned pandemics, and students have been isolated for a longer period of time.
As a society, we must provide support to our teens to attempt to combat the potentially devastating consequences of the COVID-19 pandemic. One of the most important things we can do during this time is check in with the adolescents we know to see how they’re feeling and use this time to validate their feelings. We, as trusted adults, can encourage those who are struggling to seek help if they have the means, especially considering that tele-mental health care has become increasingly available during this time (although this may not be an option for everyone).
We don’t know what the long-term impacts of the COVID-19 pandemic will be on adolescents and school-aged children for quite a long time, but it’s important to recognize that the current conditions that these children are living through may have lasting effects on their health in order to support them in as much of a capacity as we can.
Disclaimer: The opinions expressed in this article are my own and do not represent the opinions of any organization with which I am affiliated.
References:
Mandated Health Screenings: The School District of Philadelphia. https://www.philasd.org/studenthealth/student-health/mandated-screenings/. Accessed October 13, 2020.
Ali, M., et al. Utilization of Mental Health Services in Educational Setting by Adolescents in the United States. J Sch Health. 2019 May; 89(5): 393-401. Published May, 2019. Accessed October 13, 2020.
Research Brief: Findings from 1,273 Girls on School, Technology, Relationships, & Stress Since COVID-19. The Rox Institute for Research and Training. https://rulingourexperiences.com/covid19?campaign_id. Published June, 2020. Accessed October 13, 2020.
Sprang, G. & Silman, M. Posttraummatic stress disorder in parents and youth after health-related disasters. Disaster Med Public Health Prep. 2013 February; 7(1): 105-110. doi: 10.1017/dmp.2013.22