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The Royal College of Paediatrics and Child Health (RCPCH) have published an open letter from its members, which calls for the UK government to make reopening schools a priority.
Dr Maria Loades, Clinical Psychologist and Senior Lecturer in Department of Psychology, University of Bath, said:
“Our rapid review of what is known about how loneliness impacts on mental health in children and young people found that loneliness is associated with both depression and anxiety. This is both when loneliness and mental health are assessed at the same point in time, and when loneliness is measured now, and depression and anxiety are measured subsequently, up to 9 years later. Of relevance to the COVID-19 context, we found some evidence that it is the duration of loneliness which is more strongly associated with later mental health problems. As school closures continue, playgrounds remain closed, and at best, young people can meet outdoors for a socially distanced walk, chances are that many are lonely, and will continue to be so over time.
“For many young people, loneliness will reduce as they are able to re-establish social contacts and connections as lockdown eases – for example, as they return to school or college. For some, though, and particularly for those who were more vulnerable to being socially isolated before lockdown ensued, and to those who may not be able to resume social activities due to shielding, for example, loneliness may be prolonged by their struggle to resume social life, and they are particularly likely to struggle.
“In young people, there is some evidence that taking up a new hobby is a good way to combat loneliness. There is also evidence that building social skills can help to overcome loneliness. More widely, we know that physical activity, getting a good night’s sleep, and doing things we enjoy and are important to us is good for our wellbeing.
“It’s key that children and young people are allowed to return to activities such as playing together, even if outdoors, as soon as possible, and that they are able to resume attending school, which gives them a structure for their day, and provides them with opportunities to see peers and to get support from adults outside of the nuclear family. There have been several open letters including #playfirst, a letter led by Prof Ellen Townsend, and also a letter from Paediatricians in the UK calling on the government to consider children’s needs more in their strategy for easing lockdown. Alongside this, the government could target children’s wellbeing in public health messaging.
“Meanwhile, we should also continue to embrace technology as a way to keep in touch. When we’ve explored the experience of psychological therapy by videocalls, what young people and therapists have told us is that it’s a different sense of connection to face-to-face therapy. It’s better than connecting via the phone (or not meeting at all), but not as good as meeting in person. So social networking and video calls can fill the human connection void to some extent, and they are certainly better than nothing, but not as good as seeing each other in person. And what really gets lost is opportunistic, informal meetings – that chat with someone in the corridor, or at a café. And those informal interactions which are unplanned have a feel-good factor, but also, crucially, for children and young people, help to build social skills and to develop their self-identity.
“So whilst we do what we can to mitigate the effects of loneliness, and to re-establish social connections for children and young people as soon as we can, we also need to prepare for an increase in mental health problems, in part due to loneliness, and also due to the other unintended consequences of lockdown, such as a lack of structure, physical inactivity and social and/separation anxiety that might be triggered when resuming social interactions outside of the home. Specialist mental health services in the UK were struggling to meet demand even prior to the pandemic. There are several levels at which we can prepare for the heightened demand. The first of these is to take a universal approach to promoting wellbeing – by public messaging, and by schools doing activities to promote wellbeing in children and young people as they resume. The second of these is to seek to identify those who are struggling as early as possible, and to do targeted interventions to help them to overcome their struggle as soon as possible. This may be by providing them with extra support in schools, like helping them to overcome anxieties about returning to school or giving them an extra hand with reconnecting socially with peers. And by signposting them to evidence-based materials like ThinkNinja, a self-help programme based on Cognitive Behaviour Therapy (CBT) principles, which has been made freely available in the UK during lockdown. For those who continue to struggle over time, and can’t get back to doing the things they normally do as a result of their struggles, we need to ensure that they are made aware that services are open, and can provide specialist help, and to make sure that they know how to access this help and are supported to do so.”
Prof Keith Neal, Emeritus Professor of the Epidemiology of Infectious Diseases, University of Nottingham, said:
“There is increasing evidence that children are not significant transmitters of COVID-19.
“There is definite evidence that children do not get seriously ill with COVID-19, bar an exceptionally small minority.
“Much of the media is reporting the dangers of schools reopening which has not been substantiated anywhere across Europe.
“Sweden never closed their schools for the under 16s without problems and teachers there are no more at risk than other workers in Sweden.
“Parents have been scared on the risks to their children by sending them to school.
“Many parts of the education system seem to be what we can’t do when it should be what can we do.
“One of the other questions is why have some state schools managed to deliver online learning and others have not. Surely if many can do it there should be questions why others have not done online learning. Schools that have delivered online learning should share with schools that have not been able to do this.”
RCPCH Letter:
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