Youth mental health: An eye on the effects after a year of COVID-19 pandemic

This article was exclusively written for The European Sting by Ms. Lucero Baca, a 22-year-old Peruvian student passionate for public health issues, mental health, and public policies. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

There is no health without mental health. Addressing human health from a biopsychosocial approach is a challenge that allows us to focus on those interrelated determinants that gradually influence our integral well-being.

Mental health continues to be a global priority that often goes unnoticed but has been affected to a greater extent a year after the onset of the pandemic. The pandemic impact on youth mental health has been increased due to the duration of quarantine, fear of infection, boredom, frustration, lack of necessary supplies, lack of information, financial loss and stigma appear to increase the risk of negative psychological outcomes [1].

A determining factor for the psychological disorders development has been the establishment of containment measures [2] that have a great impact on youth populations due to the higher risk of developing mental health problems compared to adults [3]. Moreover, young people may also find it more difficult to cope with the current crisis as their coping and adaptation skills are not equivalent to that of a fully-fledged adult as coping is a developmentally acquired skill [4].

Therefore, the first indications in the context of COVID-19 indicate that more than one-third of adolescents report high levels of loneliness [5] and almost half of 18- to 24-year olds are lonely during lockdown [6]. Loneliness is the painful emotional experience of a discrepancy between actual and desired social contact and develops well-established links to mental health [7,8].

According to the Professor Liu, loneliness strongest association is with depression [9]. This, being of particular relevance in the COVID-19 context and having evidence as a background in studies where young people who had experienced involuntary isolation, had five times more likely to require mental health service inputs, experiencing higher levels of posttraumatic stress and mild symptoms of anxiety [2].

Pandemic-related stressors are strongly associated with internalizing problems in adolescents, and individual differences in emotional reactivity and regulation and their underlying neural mechanisms contribute to stress-related vulnerability [10]. On the other hand, social anxiety was more strongly associated with loneliness than other anxiety subtypes triggered by a perceived threat to social relationships or status [2].

In this current pandemic crisis, educational, health and social care services have had to reduce the level of services offered to young people and their families [4], reflecting once again a gap in universal mental health coverage and low affordability of mental health services corresponding to all levels of attention.

As you can see, these effects have been very impactful in our populations, but, have you ever think about on how to approach them from our position? Meaningful youth participation through empowerment and training is the key to promote activities that prevent future mental health disorders based on education, raising awareness to end stigma, and advocating for public policies that ensure equitable access to mental health services and achieve a positive impact on society in the short and long term. The floor is ours!

References:

[1] Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet. [Internet] 2020 Mar; 395(10227):912-20.

[2] Loades ME, Chatburn E, Higson-Sweeney N, Reynolds S, Shafran R, Brigden A, et al. Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19. J Am Acad Child Adolesc Psychiatry. 2020 Nov;59(11):1218-1239.e3.

[3] Deighton J, Lereya ST, Casey P, Patalay P, Humphrey N, Wolpert M. Prevalence of mental health problems in schools: poverty and other risk factors among 28 000 adolescents in England. Br J Psychiatry. 2019 Sep;215(3):565-7.

[4] Power E, Hughes S, Cotter D, Cannon M. Youth mental health in the time of COVID-19. Ir J Psychol. Med. 2020 Dec;37(4):301-5.

[5] Lim M. Achieving resilience during COVID-19: psycho-social risk & protective factors amidst a pandemic in adolescents [Internet]. Org.uk. 2020 [cited 2021 Jun 22]. Available from: https://mentalhealthresearchmatters.org.uk/achieving-resilience-during-covid-19-psycho-social-risk-protective-factors-amidst-a-pandemic-in-adolescents/                   

[6] Loneliness during coronavirus [Internet]. Org.uk. 2020 [cited 2021 Jun 22]. Available from: https://www.mentalhealth.org.uk/coronavirus/loneliness-during-coronavirus

[7] Jose PE, Lim BTL. Social Connectedness Predicts Lower Loneliness and Depressive Symptoms over Time in Adolescents. Open J Depress. 2014;03(04):154-63.

[8] Wang J, Lloyd-Evans B, Giacco D, Forsyth R, Nebo C, Mann F, et al. Social isolation in mental health: a conceptual and methodological review. Soc Psychiatry Epidemiol. 2017 Dec;52(12):1451-61.

[9] Liu H, Zhang M, Yang Q, Yu B. Gender differences in the influence of social isolation and loneliness on depressive symptoms in college students: a longitudinal study. Soc Psychiatry Epidemiol. 2020;55(2):251–7.

[10] Weissman DG, Rodman AM, Rosen ML, Kasparek S, Mayes M, Sheridan MA, et al. Contributions of emotion regulation and brain structure and function to adolescent internalizing problems and stress vulnerability during the COVID-19 pandemic: A longitudinal study. Biological Psychiatry Global Open Science [Internet]. 2021 [cited 2021 Jun 22]; Available from: https://sdlab.fas.harvard.edu/publications/contributions-emotion-regulation-and-brain-structure-and-function-adolescent

About the author

Lucero Baca is a 22-year-old Peruvian student passionate for public health issues, mental health, and public policies. She is currently a fourth year medical student at Universidad Nacional Federico Villarreal in Lima, Perú (UNFV) and member of IFMSA-Peru, where she is the Capacity Building Assistant at SCOPH national committee and Vicepresident at her local organization SOCEMVI.