In March 2020, when the pandemic set in and lockdown was first imposed, spread of the virus, lack of adequate medical care, the lack of vaccines and loss of livelihoods of millions of citizens were the primary concerns among the government and the people. However, as time progressed and the radical changes to lives, livelihoods and lifestyles became more pronounced, increasingly, the discussions – both at a personal and at policy level – turned to the pandemic’s impact on mental health. Add to that the several reports about skewed access to education and problems related to online education among children of all age groups – pre-primary, primary and secondary – and it became clear that even children and younger adults were not protected from the stress.
Psychologists and parents have been raising concerns about anxiety, loneliness and depression among young children. Excessive dependence on gadgets, internalisation of pandemic-related conversations around them and the inability to learn through online classes are some of the major challenges children face today.
Citizen Matters spoke with Dr Savita Malhotra, senior child psychiatrist with over four decades of experience, former dean and head of psychiatry department, Postgraduate Institute of Medical Education and Research, and former president of the Indian Association for Social Psychiatry. She spoke on various issues related to the impact of COVID-19 on children, ranging from online education to stress at home. Excerpts…
In the past year and a half, children have been prevented from socialising, interacting and meeting their friends. How has that affected their social skills?
It is more difficult for younger children than older children. It is a developing stage for children under five years and naturally it has been affected because of lockdown restrictions. Older children are slightly better because they can still find some different activities and can engage themselves better. However, with older children, there have been challenges related to over exposure to gadgets and internet.
Parents speak about children processing the pandemic fears in different ways, such as severe anxiety and fear about the outside world. What has been your experience?
This is not a very common problem. It is happening in cases where parents have developed strong anxiety or are stressed about the pandemic and might unknowingly pass it on. The children, who are internalising these fears, are reluctant to go out or socialise. Parents need to take care of their reactions because children interpret these messages in their own way, especially when parents constantly complain about the pandemic or lockdown or related stress.
What are the signals to identify when a child is under stress, especially over pandemic-related issues: illness, death, vaccines, lockdown, isolation?
Children who are under stress might show one or more symptoms. They may be quieter than usual or they may lose appetite. Sometimes they have trouble sleeping, or even have aches and pains frequently. Sometimes they speak about things that worry them. Also, some obvious signs are being more clingy than usual, or breaking into tears over insignificant issues. Refusing to play or saying they are tired is also an indication as children are usually full of energy.
Teachers have started online classes and parents often say that the children under the age of 5 are not able to concentrate or sit in one place or listen to instructions by teachers or parents. How do you look at this style of learning?
Again, online education has had different challenges for younger children and older children. For children under five years of age, it is difficult to hold attention in an online class because for them it is most unusual and unreal to not be taught by an actual teacher but by an image on the screen.
For older children, they get distracted because there are games, chatting etc happening simultaneously. It is one thing to have a computer class among other physical classes and completely another to have the entire school day of four to six hours online, day after day. It is highly stressful for children of all ages. It is neither an effective nor a healthy medium of instruction.
We see schools reopening in some states now; do you think that is advisable? What are the problems or challenges in doing so?
We have recommended opening of schools with COVID protocols in place. Schools and governments are both keen on reopening but many parents are anxious and not keen on sending their children to schools. Some are misguided or ill-informed. The messaging in the media is also partly responsible. It has been confusing, contradictory and problematic sometimes.
Those who are anxious are affected adversely and want to be safe. COVID was fatal and lethal but this virus, much like other viral infections, is here to stay. Earlier we didn’t know about it and all agencies were grappling in the dark but now we know about it much more than before. We should take precautions and start normal life as much as possible.
Parents are unable to provide dedicated time because of Work from Home (WFH) pressures and lack of support systems. They end up oscillating between indulgence and neglect. How is this affecting parent-children relations and children?
This is really the biggest problem. Work from home has created huge challenges for parents and children. Especially if both the parents are working, it is much worse. At the same time, women who are homemakers have shouldered unimaginable burden of household chores in the pandemic and lockdowns. Earlier there were clear demarcations – home, school and office. Children and parents both knew their roles and specific environments in each of these. Now everything is at home. Everyone is managing schooling, chores, office from the same space. Limited space and increased work and pressure are all adding to the mental health crisis.
Many parents don’t know whether to treat this as a passing phase, or to actually seek professional help. What roles can schools play under the current circumstances? How can teachers be sensitised to spot mental health issues and how should they respond?
Those who are alert to their child’s everyday behaviour will anyway spot some of the signals that I flagged earlier. It is better to seek support than not, especially if the entire family has been through or is going through a lot of stress. As far as teachers are concerned, in most schools, teachers are handling a huge number of children – from 40 to 60 – and it is very difficult to pay individual attention. They also need to be sensitised and more awareness has to be created about mental health issues among children and young adults.