School supplies — check. But have you looked into children's back-to-class mental health?

Whether it's a child who's suddenly anxious and reluctant to leave the house, or a teen whose underlying depression has worsened because of social isolation and online schooling pressures, the mental health of young people has suffered during the pandemic, experts say. 

A recent University of Calgary study of over 80,000 children from around the world found symptoms of anxiety and depression doubled amid COVID-19 — a finding echoed by mental health advocates, psychologists and parents.

J.D. Clarke's 17-year-old daughter had been struggling with her mental health. The circumstances of pandemic-related lockdowns actually helped her mental health because being at home meant not having to deal with social pressures of school.

"What happened with COVID for her was the simplification of things," Clarke said from London, Ont.

However, his younger daughter, who had some general anxiety before the pandemic, needed serious help.

She lost activities she loved, like cheerleading and the social infrastructure of school, and they were replaced with screen time, Clarke said. Even her therapist was online. She would also get anxious going to restaurants or the mall.

"Her mental health really started to deteriorate through it, to a point that over the last, I would say, three months, developed an eating disorder and is in an inpatient program to try to assist [with] that," Clarke said.

He speculates COVID-19 could have triggered her, because children thrive in environments where there is predictability and scheduling, and eating disorders can be about controlling the body in a chaotic world. 

Call for teacher training to ID student issues

Tracey Bazso is a volunteer with the Hamilton-based non-profit Youth Mental Health Canada, and works with kids as part of her youth ministry.

"I'm dealing with kids who are in 5th, 6th grade, sometimes younger, who are acknowledging, 'I'm struggling with my body image because I don't see people like me in the media' or 'I'm struggling because people at school are making fun of me,'" she said.

"In [adults'] minds, they're not thinking that a child is dealing with depression or anxiety, and it's a lot more common than we want to acknowledge. But it's often passed off as, 'That kid has behaviour issues, they're not a good kid, they don't want to listen, they don't want to be in class, they don't want to do their homework.'"

Bazso said more training is needed so teachers can identify students' unique mental-health challenges.

"We all know stress has a large role in your cognitive abilities and how you process information, so allowing students to have a safe environment to explore that and talk about their stress, and allow them to say, 'You know what? I need a mental health day from school where I just stay home and focus on me.'"

Bazso, a student at Redeemer University in Hamilton, is doing a double major — in honours social work, and religion and theology. She's gone through her own personal struggles with depression and suicidal thoughts, and started volunteering in part to connect with and help other young people. 

"When mental health challenges aren't addressed through childhood, they tend to get prolonged, they tend to continue into adulthood, and maybe spread wings, and get a little bigger and get a little more severe, because you are just used to it at that point almost," said Bazso. 

No education without mental health

Sheryl Boswell is executive director of Youth Mental Health Canada, where Bazso volunteers. Boswell said access to mental health services is a severe problem and families in crisis are often given advice, but not real help.

"Before COVID, during COVID, and as we struggle with what is the return to something that will likely include COVID, parents are told these things: The importance of early intervention, the importance of good communication with your children, and the importance of mental wellness, healthy habits, sleep, healthy eating daily physical activity — you know, all those kinds of ways of relaxing," said Boswell.

"They are doing all those things, and then they are told by a professional, 'I'm sorry, you're going to have to get on a wait list.'" 

Her group and others are doing what they can to help. In September, they're launching a school and community peer support program, and about 100 schools across Canada have already registered.

She said schools can help create an environment conducive to fostering good mental health. But she's also concerned there will be a big focus on "catching up." Instead of intensifying the demands on young people, there should be a gradual transition with plenty of mental health support, said Boswell.

"There is no education without mental health… people are starting to understand that it takes precedence over everything else."

Helping kids depends on 'unique personality'

For children and teens dealing with a clinical diagnosis such as depression or anxiety, highly specialized psychotherapy can help, said child psychologist Tina Malti, director of the Centre for Children's Mental Health, Development and Policy at the University of Toronto (Mississauga).

"For younger children, it could be play, it could be artistic, it could be family talk together with the parents. In other words, there are different methods…. to reach the child's soul and well-being, and as a practitioner, we have to consider the age, the setting, and then the unique personality who is sitting in front of us."

Malti and her colleagues are also studying children to find out how the pandemic has affected them.  

There are "protective factors" that make some children more resilient, such as being able to feel empathy towards others, an ability to regulate emotions and move past setbacks, and having strong relationships with caregivers.

Two groups Malti will pay particular attention to are kids ages three to eight, and adolescents — considered "sensitive periods" as that's when they experience a lot of change and growth. 

"If we target those developmental periods, the hope is that we can do lots of good."

Return to class brings hope

For Clarke and his daughters, it's hoped a return to school will give their mental health a boost. 

His teenager has moved to Halifax for college. He's a bit concerned about academics because she did not have to write exams during her final year in high school, but she seems happy in her new home away from home.  

His younger daughter is excited to be going back to in-person schooling because she did not like online learning, but still has some anxiety, he said.

"It's the standard stuff [she's worried about] — who will be my teacher, who will be in my class. It's just a lot more heightened than it ever was before."  

Clarke believes it's crucial to have a safe environment for children to say if they're struggling, and have teachers watch for any cues.

"What you have to kind of focus on is behaviours you should be doing, and part of that is focusing on how to care for somebody else, how to notice that somebody might not be doing well ... I do think there has to be an element that's built into the curriculum around it."

He hopes telling his family's story will help break down some of the stigma of talking about such issues.

"When we had issues with my older daughter, one of the things I remember saying to people in the office is, 'You know I'm going through these challenges ... You may notice me distracted, or I may have to cancel meetings at the last minute.'" 

He discovered something he didn't expect — other people started sharing their own stories.