By: Olivia Lounsbury, Patient Safety Movement Foundation
Those older than 65 and with long term conditions are, clinically speaking, more at risk for COVID-19 complications and poorer outcomes. Healthcare workers are inundated, stressed, and are lacking equipment. Healthcare system leaders are struggling to find appropriate supplies and are caught in the middle of staffing crises. Society is keeping a watchful eye on pregnant mothers. Essential workers are being appreciated, thanked and applauded in ways that have never been seen before. Our society is coming together to recognize and protect these populations and, while these efforts are exceptional and should receive recognition, we are seeing the same trends that we see in politics, elections, and economics: What about the young people?
In recent months, we are all trying to get used to a ‘new normal’ and for many, life has changed significantly. From working remotely with your pup as the only coworker, to washing your hands exponentially to the point of cracked and dried knuckles, everyone has been impacted by the COVID-19 pandemic. Historically, many of the behaviors we are now promoting, such as self-isolation and, frankly, public anxiety, have been quickly recognized as maladaptive behaviors that require intervention. While these precautions are essential to keep ourselves, and those around us, as safe as possible, the concern for mental health remains at the forefront. We start to show resilience and develop coping strategies during adolescence and as a young adult (ages 12-20), which are essential to emotional well-being throughout life. However, 75% of mental disorders start before age 18, and less than half of those young adults receive any mental health treatment for various reasons, including stigma, pride, lack of understanding, cost, lack of support, or accessibility (Office of Adolescent Health, 2017).
Therapy is one tool that is crucial to treatment and improved mental well-being. In the COVID-19 era, many parents have lost their jobs and subsequent work benefits. To be exact, as of April 2, 2020, 6.65 million Americans filed for weekly jobless claims. This is the highest recorded number in U.S. history, the second highest associated with the 1982 recession with 695,000 jobless claims (Hansen, 2020). Before COVID-19, 20% of adolescents had signs of a mental health issue. Since the inception of the COVID-19 crisis, consider how exacerbated this number has become when thousands of parents have potentially lost their benefits that provided mental health treatment for their children.
It is well-known that interaction with peers is fundamental to emotional regulation, development, identity, and conflict resolution (Smetana, 2011). Into a university setting, young adults are no longer under the supervision of a parent or guardian and are, essentially, behaviorally independent, living in a new place and possibly even financially independent. Interruption or turbulence during these already high stress environments and pivotal developmental periods can cause changes in behavior and coping skills and significant stress. All university students are now being forced to study from home and have hours more screen time (which is no doubt less interactive). Traditional college student jobs (you remember- restaurants, coffee shops, retail stores etc) were the first to be cut and often do not offer any compensation or protection package, as many consist of your hourly paycheck.
While the physical university setting provides some sort of uniformity in the resources available of the students, it is important to keep in mind that, in the transition to distance learning, the extensive variety in the socioeconomic backgrounds of the students can compromise equal access to resources, such as WiFi, and a quiet learning environment. Additionally, the transition back home may be a source of stress or contention for those living with a high-risk individual, such as a grandparent, those who look after younger siblings in their parallel move to online school, LGBTQ+ young adults who may have strained relationships with family members, those who have used substances or self-harmed in their home environment… While these are just a few examples of possible situations for young people as they shift from college campuses back home, it is clear that mental health outcomes can vary vastly due to the socioeconomic, familial, and emotional backgrounds for many students.
The lack of opportunity for financial stability, the interruption of pro-developmental social behavior, and the inherently malleable nature of teenage and young adult years can cause great frustration for this population of individuals when they feel as though they are not being heard. And, frankly, these young adults are often not represented or listened to when decisions, such as policies, are being made. It can be speculated that many of those who are breaking social distancing protocols are youth and while this behavior is inexcusable, more attention should be paid to the needs of this underrepresented and possibly vulnerable population.
The simple acts of listening and understanding can be pivotal to improve someone’s well-being and can encourage reflection on their behaviors to promote the health of society as a whole. The Institute of Global Health Innovation, Imperial College London, set out to do just that, across the United Kingdom. The team launched CCopeY, a study around “Young People’s Mental Health and Their Coping Strategies During and After the COVID-19 Lockdown”.
As part of the background research to inform their study, the team evaluated results from two recent UK COVID-19 studies around mental health: YoungMinds survey (about young people with experience of mental health difficulties) and MQ: Transforming Mental Health and the Academy of Medical Sciences survey (about the mental health of people of all ages). Building on aforementioned concerns of young people, the team (including three young people) produced eleven research questions. After an online prioritization exercise with 78 young people, one research question was chosen and a survey was created (using various validated surveys). The aim of the study was to explore the mental health status in relation to the coping strategies, proactive or maladaptive, in 16-24 year olds since the COVID-19 pandemic lockdown. Although this project is specific to the UK, this is the first UK-wide survey for this age group that has also been co-produced with young people.
“From my own experience being in the 16-24 age group, I feel this study can help people feel less isolated in the sense that they can see they’re not the only one feeling this way. Even just filling out the survey can help in perhaps further identifying their own feelings.” Lizzy, young person involved in CCopeY research design and process
“I have really enjoyed working on this project so far – it will be interesting to see how the pandemic is affecting young people not just initially, but over a six-month period, potentially showing that a global crisis can affect an individual’s mental health even after the crisis has passed. I am also interested to see how mental health research evolves because of the pandemic – I feel that because this period will likely be the first time many have experienced mental health difficulties, this worldwide trauma has put mental health in the spotlight. I look forward to seeing how this impacts and improves our understanding of mental health globally.” Caroline, young person involved in CCopeY research design and process
Currently, the team has collected over 600 responses. The young co-researchers and researchers will soon be carrying out interviews with a random sample of survey respondents to explore the research question in more depth, building on the survey results.
“Because of COVID-19, all interverviews are being carried out online and we are ensuring we have appropriate safeguarding for our participants and researchers. As well as appropriate training for the co-researchers, we have clinicians and mental health first aiders as support” says Anna Lawrence-Jones, Patient and Public Involvement and Engagement Lead at the Institute of Global Health Innovation.
Although the team is in the midst of this study, the evidence provided could be incredibly valuable to understand the needs of a population that has been largely unexplored during the COVID-19 pandemic. The team hopes to use the results to inform policy and develop interventions to help young people. Patient Safety Movement Foundation will share the information from the Imperial project on our website as soon as it is publicly available.
CCopeY: Young people’s mental health and coping styles during and after COVID-19 lockdown. (n.d.). Retrieved from https://participate.mqmentalhealth.org/studies/ccopey-young-peoples-mental-health-and-coping-styles-during-and-after-covid-19-lockdown/
Hansen, S. (2020, April 3). Americans Have Lost 10 Million Jobs Because Of Coronavirus. Retrieved from https://www.forbes.com/sites/sarahhansen/2020/04/02/the-us-has-now-lost-nearly-10-million-jobs-because-of-coronavirus/#5052478c1b5c
MQ (2020). Survey results: Understanding people’s concerns about the mental health impacts of the COVID-19 pandemic. Retrieved from YoungMindsUk. (n.d.). Coronavirus having a major impact on young people with mental health needs – new survey. Retrieved from https://youngminds.org.uk/about-us/media-centre/press-releases/coronavirus-having-major-impact-on-young-people-with-mental-health-needs-new-survey/
Office of Adolescent Health. (2017, February 24). Mental Health in Adolescents. Retrieved from https://www.hhs.gov/ash/oah/adolescent-development/mental-health/index.html
Smetana, J. G. (2011). Adolescents, families, and social development: how teens construct their worlds. Chichester, West Sussex, U.K.: Wiley-Blackwell.
YoungMindsUk. (n.d.). Coronavirus having major impact on young people with mental health needs – new survey. Retrieved from https://youngminds.org.uk/about-us/media-centre/press-releases/coronavirus-having-major-impact-on-young-people-with-mental-health-needs-new-survey/