Dr Rajesh Sagar, Professor, Department of Psychiatry, All India Institute of Medical Sciences (AIIMS) New Delhi and Member, Central Mental Health Authority explains the impact of the pandemic on the mental health of children and how it can be addressed.

How has the pandemic affected children’s mental health?

Children are delicate—physically as well as psychologically. Any form of stress, worry, trauma can affect them deeply and lead to long-lasting repercussions. The pandemic has altered their normal activities—their schools are shut; the education has shifted to online and their interaction with peers is restricted and limited. Besides, there are some who have lost one or both parents or relatives or caregivers.

All these factors can affect the mental wellbeing of children, depriving them of the emotionally fulfilling environment, important for their normal growth and development.

What is the biggest challenge you face while dealing with distressed children?

Unlike adults, children react differently in stressful situations. Some children become clingy, some are withdrawn, some become aggressive, some depressed. So, it is difficult to understand the mental state of children. What we know is the fact that the surrounding environment affects the emotion or moods of children. At times, children internalise a situation. Panic, illness, or death of near and dear ones can affect them adversely and at times, they may not be able to express their fears, anxiety, or worries.

So, it is important for adults to keep a watch on the behaviour of children. During the current crisis, it is also important that adults encourage children to communicate their views, and perspectives on various issues related to them. For children to be able to express themselves clearly, they must be provided with an enabling environment. If they are unable to talk, they can be encouraged to express themselves through drawing, paintings, and other mediums. The impact of the pandemic on children cannot be addressed with direct questions; caregivers need to be gentle while communicating with children as they may be unaware of what is happening to them internally. So, it is important to encourage usage of creative ways in understanding them but communicate directly when discussing difficult topics, like infection, death, and so on.

The first five-six years of a child’s life are said to be the foundational years when a child requires various stimuli for normal growth and development. How is pandemic affecting younger children and how do you think the effect can be minimised?

The first five years, indeed, are very crucial in a child’s life and we need to provide the child multi-modal stimulus. Lack of a positive environment, lack of stimulation, or social interactions can affect them adversely. Though we cannot put children at risk of catching the infection, we need to build a fun-filled, environment where children can be engaged in various activities. Even online education should focus on activity-based learning. I strongly feel that we need to devise methods that are enjoyable and safe as well so that we can minimise the impact of the pandemic on children.

Older children too are facing uncertainty on the academic front. What will be your advice for them?

It is normal for them to feel uncertain. The pandemic has disrupted their education and career plans. Here the role of the parents, caregivers, or teacher becomes very crucial. They need to guide the children that there is not much we can do about the situation, and they are not in it alone, rather there are many other children across the globe who are facing a similar dilemma. It is also important for the parents to accept the reality and pass it on to the children while supporting them throughout the process. The education boards are being flexible in taking exams and so, I think, we will reach a point when this virus will not impact their education and career choice so adversely.

The pandemic has put a special focus on parenting. How would you counsel parents?

With the fine line between the workspace and personal space blurring, many parents are finding it difficult to deal with the added responsibility of looking after the academic needs of their children. Children of every age group have different needs—they need, time, attention, engagement, resources, and a happy environment. A stressful environment at home can be a trigger for a mental health condition, but a safe environment can protect them from existing mental health concerns.

For parents to be able to engage children, they need to be in a positive frame of mind themselves. Parents need to find ways to calm themselves. They need to streamline their daily activities so that they can take out time for children.

Those who are unable to cope with the stress should seek support from family, friends, or professionals.