Child, adolescent, and caregiver mental health difficulties and associated risk factors early in the COVID-19 pandemic in South Africa

Abstract

At the onset of the COVID-19 pandemic in early 2020 in South Africa, many safety measures were implemented to protect the lives of the population. Ironically, these same safety measures have negatively impacted on the lives of children and their caregivers resulting in increased mental health problems. This study forms part of the multicountry Co-SPACE (COVID-19: Supporting Parents, Adolescents and Children during Epidemics) study that explores how families are coping during the COVID-19 pandemic, and what caregivers can do to help support their children’s mental health. This paper aims to gain a better understanding of the mental health status of families specifically in South Africa in the early onset of the pandemic during restrictive lockdown measures, and identify certain risk factors that might contribute towards deteriorating mental health. Two hundred and fifty-four South African parents and carers of children and adolescents completed an online survey about their child’s mental health as well as their own mental health during and post- hard lockdown in South Africa. Data collection took place over the period of the first and second waves of the COVID-19 pandemic in South Africa. Results showed that children experienced significantly higher mental health problems than adolescents (p = 0.016). Younger children were particularly negatively affected by lockdown and had more mental health problems than adolescents (p = 0.023); including emotional problems (p = 0.017), misconduct (p = 0.030), and hyperactivity (p = 0.001). Additionally, the presence of special educational needs/neurodevelopmental disorders (SEN/ND) was associated with more mental health problems (p = 0.001). Surprisingly, single parent households, which is another well-known risk factor showed no differences in mental health problems compared to nuclear families. There was also a reciprocal relationship between parental/carer mental health and child/adolescent mental health, with higher level of endorsement of mental health problems in children by parents/caregivers who themselves associated with higher levels of depression, anxiety and stress (all p’s < 0.001). These results highlight the dramatic impact that COVID-19 had on children, adolescents and parents in South Africa early in the pandemic, and emphasises the need for specific support structures to be implemented within the SEN/ND community, as well as for younger children and single parent households.

Mental Wellbeing among Children with Cancer during COVID-19 Pandemic in Indonesia: A Cross-sectional Study

“…Across the board, adolescents aged 10 to 17 were less likely to be at risk of emotional problems compared with younger children. A study by Bloom et al 43 also supported this finding, showing that younger children were more negatively affected by lockdown and had more mental health problems than adolescents, including emotional problems, misconduct, and hyperactivity.…”

“…Reciprocal relationship between parents' and children's mental health was also seen, especially associated with higher levels of depression, anxiety, and stress. 43 Hence, not only should children be provided with psychological support, but also parents should have access to mental health care and make effort to build healthy parent-child relationships.…”

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“…It can be argued that this suggests that more attention is paid to SRH among AGYW compared to other equally pressing health issues such as mental health. On the other hand, there is a growing body of evidence con rming the negative impact of COVID-19 on mental health in younger people in SSA [99]- [103]. For example, a crosssectional study in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania found an association between high levels of depression and anxiety, and self-reported impacts of the pandemic [99].…”

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“…Reflecting on the lockdown measures, it is ironic that the same safety measures put in place to protect children, communities and individuals had a negative impact on the lives of children and their caregivers (Bloom et al 2022). The parents, children and children from single-parent families reported an increase in mental health problems (Bloom et al 2022).…”