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Key findings from the study conducted by Bal Raksha Bharat with 4200 children, across 5 states on India, on coping pattern highlights:
Problem-focused, emotion-focused, and avoidant coping patterns among children

  • One in two children used avoidant coping (52.7%), and problem-focused coping (51.0%) often/more often, followed by using emotion-focused coping (43.3%) mechanism. The most commonly used coping strategies were religious coping followed by acceptance, active coping, seeking informational support, positive reframing, planning, emotional support, and self-distraction. Religious coping was practiced more among rural adolescents compared to urban settings.
  • Children in institutions, more often sought/utilized emotional support, and avoidant coping patterns such as denial and disengagement compared to children living with families and communities. Verbal aggression, coupled with limited access to external support, threatens adolescents’ mental health and well-being. Children who experienced repeated verbal aggression by their family members, more often sought emotional support and utilized coping mechanisms such as venting (24%), acceptance (34%), self-blame (24%), and often disengaged from stressful situations (28%), more often than using adaptive coping patterns.

Key findings from secondary literature review across different countries highlight:

  • Onset of new mental health concerns owing to COVID19: The literature review revealed that the mental health impact during the pandemic ranged from anxiety and fear of COVID-19 infection, emotional distress due to changing and uncertain circumstances, to symptoms of depression and Post Traumatic Stress Disorder (PTSD). Across the studies reviewed, rates and nature of mental health concerns varied according to age. Pandemic-related stress was experienced by children through key proximal factors such as parental conflict, parental mental illness, and socio-economic disadvantage. Additionally, dropping out of school had a negative impact on the mental health of children.
  • Worsening of pre-existing mental health conditions: The secondary literature highlighted that children with pre-existing mental health conditions (like Post Traumatic Stress Disorder, Attention Deficit Hyperactivity Disorder) were a vulnerable subpopulation to develop new mental health concerns owing to the pandemic ‘Loneliness’ during the pandemic was found to be associated with depression and anxiety in children and young people with pre-existing mental health conditions. Perceived COVID-19-related threat positively correlated with PTSD symptoms, whereas positive youth developmental qualities such as emotional competence, resilience, caring family environment, spirituality, and continued connectedness with important social relationships were found to be associated with overall lesser PTSD symptoms
  • Disproportionate effect of COVID-19 on children from disadvantaged groups: Living on the margins of society, children in street situations are deprived of normative nurturing experiences and relationships, are exposed to multiple, and cumulative adverse childhood experiences and their rights are often violated and compromised. This was further compromised during the pandemic, with the sudden cessation of opportunities for livelihood.
  • Excessive burden on healthcare infrastructure neglected psychiatric needs
    In India, an online surveys of mental health care professionals both in the public and private sectors (109 institutes and 396 practicing psychiatrists) reported that key mental health services including electroconvulsive therapy, inpatient services, outpatient services, and psychotherapy services were significantly affected during the pandemic. In most of the institutes, mental health professionals were involved at different levels in COVID-19-related responses such as expansion of telepsychiatry services, nationwide helpline, programmes to sensitize the public and increase awareness related to the mental health impact ofCOVID-19 and capacity building.
  • Loss of access to child-friendly ‘spaces and ‘play’: Among the key challenges posed by the pandemic, the loss of child-friendly spaces such as schools, parks and playgrounds had a significant impact, especially on younger children, compromising healthy movement behaviours. Unlike their typical daily routines, preschool and primary school children were expected to stay at home, engage in structured activities within the home context and participate in online learning.

Call to Action:

  • Promote Mental Health and Psychosocial Support and Services (MHPSS) for all children and adolescents – Strengthen existing government policies and programmes related to mental health of children and adolescents.
  • Improve access to Mental Health and Psychosocial Support and Services (MHPSS) to all vulnerable children, such as those in Childcare Institutions (CCI) and for Children with Disabilities
  • Integrate mental health interventions within existing education, social protection, and health care programmes such as Rashtriya Bal Swastha Karyakram, Rashtriya Kishori Swastha Karyakram, Adolescent Reproductive and Sexual Health (ARSH), etc.
  • Strengthen family and caregiving environments to support mental well-being of children and adolescents – Coordinate with multi-sectoral departments (such as protection, education, food security and livelihoods) to develop family strengthening interventions.
  • Protect children and ensure safety for those facing mental health issues – Enhance community support through collaborative efforts of child protection systems, local community-based protection committees (VLCPC/WLCPC), NGOs and mental healthcare services.
  • Prevent potential disruptions in mental healthcare services and systems: Strengthen the National Tele Mental Health Programme as an independent vertical.
  • Generate evidence and systematic research on the impact of mental health on children, especially among the socio-economically disadvantaged groups.

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