October 9, 2021

By Rehan Piracha


As Pakistan marks Mental Health Day, mental health experts say the government, parents and educational institutions must prioritise help and assistance for children who are scarred from physical and emotional strain of the COVID pandemic in the country. It is the only way to prevent that the pandemic does not have a long lasting impact on children’s physical and mental health, they say.

Dr Nazish Imran, Professor of Child and Family Psychiatry at King Edward Medical University, says recent studies have pointed out the negative impact on mental health of children, adolescents and parents during lockdowns in Pakistan. “In the initial phase of the COVID pandemic, there was a lot of fear in the society,” she tells Voicepk.net. People were not going out due to the lockdowns and had uncertainties towards treatment of COVID infections. This caused stress and anxiety among the adults in the country.

“When the adults around children are upset, this directly affects emotional health of the children,” Dr Imran says.

Psychiatrists also point out that with the closure of schools, it has been increasingly difficulty for children to maintain their everyday routines.

Parents have noted increased screen time, decreased physical activity, irregular sleep patterns and diet changes in their children, and this is affirmed by a study in China on the effects of home confinement on children during the COVID lockdown.

Cyber bullying & inappropriate exposure

Accordingly, Dr Nazish Imran also notes that researchers found that children spent more screen time due to the lockdowns. The use of their cell phones and connectivity on social media increased due to restrictions on outdoor socializing in the lockdown.

“This lead to increase incidents of cyber bullying of children,” she says. In addition, children also had inappropriate exposure to adult content due to unrestricted access to the internet and social media during the lockdown, she says.

“At first, children were happy that schools were closing down, ,” says Dr Usman Amin Hotiana, Head of Department of Psychiatry at Rashid Latif Medical and Dental College in Lahore. “However they quickly became bored and miserable being confined at home and longed for physical activities outdoor in playgrounds and playing with their friends. As time went by children like the family’s adults, fell prey to stress over restrictions on social and outdoor activities,” Dr Hotiana adds

Children absorbed stress from adults

According to Dr Hotiana, the COVID pandemic also led to the first time that children became closely acquainted with the stark concept of death and critical illness amid the flooding of information and news on the COVID pandemic on television and social media in every home in the country.

“If a mother or any other older person is emotionally distressed or disturbed as the case was in the COVID pandemic, children and adolescents absorb emotions from them,” he explains, adding that psychiatrists saw a range of responses from children under the stress of COVID restrictions.

“We saw that children of parents, who implemented a strategy of a routine in terms of study hours, organized indoor physical activities and addressed their emotional needs, had a better response,” Dr Hotiana says. These children had a new learning and felt better tackling the social restrictions in the lockdown, he says.

“On the other hand, children in disruptive households became irritable, angry and sad from the impact of witnessing quarrels and fights between their parents,” Dr Hotiana explains.

However, Dr Hotiana says, the children also learned to express their new experiences with the COVID restrictions with time. “Children became interested with safety and precautions against the COVID pandemic,” he says. The children began narrating the concept of death and COVID safety in their drawings and stories.

Children with special needs

Another group of children negatively affected in the outbreak were those with special needs. In a study conducted by Dr Nazish Imran, researchers found that children with autism, intellectual disabilities, ADHD and other disabilities showed increase in irritability and behavioral problems in the COVID lockdown.

For these children, routines and therapies are extremely important, says Dr Imran. “With therapy centres closed and outdoor activities curtailed, these children showed increase in irritability and behavioral problems in the COVID lockdown,” she points out.

Similarly, Dr Nazish Imran says children with pre-existing psychiatric problems like anxiety and obsessive compulsive disorder showed an increase of severity in symptoms due to social restrictions imposed in the COVID lockdowns in the country.

Adolescents also fared well handling stress from school closures and uncertainty over schedules of matriculation and intermediate examinations considered very important for entrance to professional colleges and institutions in the country.

In an unpublished study aimed at assessing the prevalence and influencing factors of anxiety and depression among adolescents in Pakistan during COVID-19 outbreak, Dr Nazish Imran says findings showed that 47% of the respondents reported facing anxiety in the time.

“Boys and adolescents with past psychiatric history had higher mean scores in anxiety and depression symptoms compared with girls and those having no psychiatric issues,” the findings say.

Among the 842 participants of the study, 84% were girls. Education emerged as the most negatively affected pandemic domain, the study states.

Most adolescents had reported changes in responsibilities at home including increased time spent in helping family members. Besides, the increase in workload of participants (adolescents) and their parents was prominent.

According to Dr Nazish Imran, it is very important that all stakeholders including the government, parents, and educational institutions , take into consideration that the children suffered traumatic experiences like COVID infections themselves and deaths of close family members and friends during the ongoing COVID pandemic in the country.

“It is imperative that children are closely monitored and watched to provide help and assistance so that the pandemic does not have a long lasting impact on them in terms of both physical and emotional health,” she says


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