COVID-19: Two-thirds of B.C. youth now struggle with mental health

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Two-thirds of children and youth in British Columbia are struggling with mild to moderate mental health challenges during the pandemic, up from one third before the arrival of COVID-19, says new research from B.C. Children’s Hospital.

“This information is going to be very useful for what they call the shadow pandemic, or what’s going to fall out of the pandemic for years to come. It will tell us what kind of resources are needed and where geographically,” said study lead Dr. Quynh Doan, a pediatrician at the hospital and a UBC professor.

“Everybody’s realizing that there’s going to be a huge mental health cost to this pandemic.”

Preliminary results from Doan’s Child and Youth Mental Health During a Pandemic study found two thirds of participants reported mood issues, anxiety and suicidal ideation, deemed by researchers to be of mild to moderate concern. This compares to a study done two years ago, which found one third of youth at B.C. Children’s Hospital for non-mental-health issues experienced these psychiatric challenges.

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This increase happened during the pandemic, but Doan has not completed the analysis yet to explain why: because of school shutting down last spring, or the restrictions that curtailed social activity, or financial hardship due to a parent losing a job?

“I think it’s because of the whole thing — the uncertainty, the change in their lives, the worry that they might get (COVID), that someone in their family might get it,” she said.

Improving mental health services was a big focus in Tuesday’s provincial budget, but experts worry the new investments are insufficient given the increase in diagnoses, will do little to reduce burgeoning caseloads in the provincial Child and Youth Mental Health system, and are not equitably distributed across the province.

“Many of the mental health challenges children experience are preventable, all are treatable,” said Jennifer Charlesworth, B.C.’s Representative for Children and Youth. “We weren’t meeting the needs prior to the pandemic. And so we have to ramp up our capacity during and post pandemic.”

So far, 350 families have participated in Doan’s study and she hopes to grow that number by June, especially in the Interior and Northern B.C., where there is lower participation.

The study has collected data from children aged 10 to 17, as well as from parents with children aged six to 17.

Participants speak to a researcher first, then spend about 30 minutes filling out an app called MyHEARTSMAP. A shorter followup self-assessment is done three months later.

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Based on the youth’s and parents’ answers, the app will provide recommendations for services and resources that could help them. In severe cases, a nurse working on the study will reach out to the family.

Two-thirds of youth not only said they had psychiatric worries during the pandemic, but the same percentage also reported mild-to-moderate social concerns — also much higher than in pre-pandemic times, Doan said. This includes conflicts over relationships at home, at school and with friends, as well as alcohol use.

So far, the data shows a smaller increase in more serious mental health issues. Just 15 per cent of the 350 families reported a moderate level of challenges, such as no longer being able to cope with going to school and losing hope.

Four per cent reported a severe mental-health issue, which includes life-threatening behaviour.

Concerns expressed by parents and children appear to be roughly the same, Doan said, although parents worry slightly more about their kids’ school work while the youth talked a bit more about suicidal thoughts and drug and alcohol use.

‘I worry about her every day’

Fourteen-year-old Lana had no mental health challenges, that her mother Susan was aware of, before the pandemic arrived and the restrictions came into effect in spring 2020.

“Prior to the pandemic, Lana was enthusiastic, had a group of nice friends, did well in school and participated in extracurricular activities,” recalled Susan, a pseudonym to protect her daughter’s identity.

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But after students were required to do their classes online last April, Lana became depressed and her family doctor prescribed antidepressants. Two months later, she attempted suicide and spent the night in a local hospital, where it was suggested Lana visit a Child and Youth Mental Health (CYMH) office close to the family’s Metro Vancouver home.

She was assessed as having a moderate risk of suicide, but the family was told there was at least a six-month wait to see a psychiatrist.

“I then called back because she was really having difficulty readjusting to school and she was just not herself,” said Susan, who herself works in counselling.

The family was able to see a CYMH psychiatric nurse in September and finally a psychiatrist in November.

But the appointment with the psychiatrist went badly, as Susan felt he was rude and dismissive of the family’s concerns. This meant Lana faced a much more difficult path to navigate the already-hard-to-access youth mental health system, Susan added.

The family has filed a complaint against the doctor with the B.C. Human Rights Tribunal, which has been accepted by the agency and is awaiting the next steps in the investigation process.

Today, Lana is 15 and has seen a psychiatrist on a one-off basis through Royal Columbian Hospital, but her family is still searching for long-term, consistent care for her. She is taking new medication that has reduced her depression and anxiety, but not eliminated them.

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“I worry about her every day. She’s at school now, and I have to carry my phone with me wherever I go,” Susan said.

“The advice I would give to other parents is to take their child’s struggles seriously and to know that you may need to advocate strongly on their behalf.”

Half of British Columbians suffer poor mental health

This week’s provincial budget included $97 million for mental health supports for children and youth, $53 million to expand the early psychosis intervention program, $14 million for the First Nations Health Authority, and $8 million to expand eating disorder care and suicide prevention.

Charlesworth, the children’s representative, said the budget made some good investments in areas such as an Aboriginal child development program. But she argued the expansion of integrated youth teams in schools will still only reach 24 of B.C.’s 60 education districts, and despite bolstering the popular Foundry Centres, which provide a variety of services to youth, they will still be available in just a handful of communities.

And the new money does little to reduce the wait-list for CYMH services, Charlesworth added. “We need to have a fundamentally expansive and more robust child and youth mental health system, available to everybody.”

In November, Charlesworth’s office sponsored a report by SFU researchers who studied the outcome of other pandemics, and predicted COVID-19 will have “significant mental health consequences” for youth, and called for more investments in B.C.’s “overstretched and underfunded” child and youth mental health system.

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This week, Charlesworth said there is new data to backup that dire prediction. Research by the office of Provincial Health Officer recently found 53.1 per cent of British Columbians over age 15 had somewhat or much-worse mental health during the pandemic, which is nearly double what researchers were seeing before COVID arrived.

“Sick Kids (Hospital) in Toronto is finding the same things, a 30 to 40 per cent increase in mental health concerns for young people, particularly depression, anxiety, behavioural challenges and difficulty focusing — all indications of stress,” she said.

This can be even more pronounced in certain populations such as those with special needs, residents of remote communities with less access to services and online resources, and among First Nations.

“Indigenous communities have been so clear with us that they are worried about their children and their mental health. This has been a really hard on them,” Charlesworth said.

‘We’re severely under resourced’

Preliminary results from another new study, the Personal Impacts of COVID-19 Survey (PICS), being conducted by researchers from B.C. Children’s Hospital, found the prevalence of major depression, generalized anxiety, and obsessive compulsive disorder appear three times higher in adults and children compared to pre-pandemic measures.

“We’ve all been suffering from this sort of unending marathon of challenges associated with the pandemic, but mental health challenges can be quite hidden,” said the study’s co-lead, Dr. Hasina Samji, an assistant professor at SFU and a senior scientist with the B.C. Centre for Disease Control.

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Since the study began in November, more than 2,000 British Columbians have filled out the survey, which collects information about people’s thoughts and feelings during the pandemic, and what resources and services could help them. Samji hopes another 1,000 participants will enrol.

“Our goal with the PICS study is to find out who urgently needs supports and resources to help overcome mental health challenges that are making it difficult for people to go about their daily lives. And some of the populations we’re especially concerned about are children and parents, families with low income, people with pre-existing mental illness or with disabilities,” said Samji, who is co-leading the study with Dr. Evelyn Stewart, a B.C. Children’s Hospital psychiatrist and a UBC professor.

Researchers also want to hear from residents of rural, remote and northern communities, and from underserved groups such as racialized people.

The study collects responses from parents, adults without children, and youth ages eight to 18, who can participate with permission from a guardian.

Early results show mental-health challenges among parents have risen three to four times. Half of those surveyed wanted help to manage the emotions of their children, and about a third said they needed assistance with their own mental well-being.

However, only two out of every five parents said they were able to access the services they needed.

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“Unfortunately, globally, whether it’s for child mental health, or adult mental health, we’re severely under resourced,” Samji said.

“And given the increases that we’re seeing across the board, for children, for parents, for non-parent adults, there are going to be more mental health impacts, and we are going to continue to be under resourced. So investments by all levels of government for clinical resources and for community resources are absolutely imperative.”

Her survey results also indicate that young adults without children, in the 20- to 39-year-old age group, are faring poorly too, which she believes is due to social isolation. And of the 100 children who enrolled in the survey, almost half reported experiencing poor or fair mental health since November.

“Do we know what we need to do to have positive mental health, the same way we know what to do to achieve good physical health? I think now, more than ever, we as a society need to have that conversation, and also to reach out and extend support to those who don’t have the resources to cope,” Samji said.

lculbert@postmedia.com

If you need mental health help, call 310-6789 (no area code) for emotional support, information and resources specific to mental health, or 1-800-SUICIDE (1-800-784-2433) if you are experiencing feelings of distress or despair, including thoughts of suicide.