We Are A Priority!

by HCC

We Are A Priority! – The Need for a Renewed Focus on the Psychosocial Impact of COVID-19 on Youth in the Caribbean on the occasion of World Suicide Prevention Day

We Are A Priority! – The Need for a Renewed Focus on the Psychosocial Impact of COVID-19 on Youth in the Caribbean on the occasion of World Suicide Prevention Day.

The onset of the Coronavirus disease 2019 (COVID-19) pandemic in March 2020 has disrupted life as we know it, globally and particularly in the Caribbean. The once normal way of life ceases to exist and continues to be halted by government-imposed public health regulations such as prolonged periods of national lockdowns, curfews, quarantine and social distancing, in efforts to slow the transmission of the infection. The COVID-19 pandemic has caused a complex array of challenges which led to or exacerbated mental health repercussions for everyone, particularly children and adolescents[1]. More young people are experiencing an increased tendency toward psychological problems and post-traumatic stress disorder (PTSD) symptoms, due to the disruptions to friendships and family support during the pandemic[1],[2]. As governments race to protect and preserve the lives of citizens especially the most susceptible groups in society, the psychosocial impact of the pandemic on youth is often forgotten, overlooked or swept under the rug of societal prioritisation to be dealt with later, possibly post-pandemic. But will then be too late to tackle these issues?

The Implications of COVID-19 on Youth

Mental Health has been a key concern broadcasted during the COVID-19 pandemic. A recent poll conducted by the United Nations Children’s Fund (UNICEF) on the impact of the COVID-19 crisis on the mental health of adolescents and young people, between the ages of 13 and 29 years in Latin America and the Caribbean, found that 27% of participants felt anxious while 15% felt depressed[3]. For 30% of these participants, their economic situation was the main contributor to their current emotions3. However, despite the need for support, the COVID-19 response has disrupted the delivery of much needed physical and psychological support within schools and community settings, especially dedicated to the children and young people in society.

Young people have been treated as one of the groups of the “lowest priority” during the pandemic; with poor job opportunities or prospects and disruptions to their education[4]. These concerns were also highlighted during a virtual event co-hosted by the Commonwealth Secretariat, Caribbean Community (CARICOM) and Caribbean Development Bank (CDB), which gathered young people from several regional youth ministries in the Caribbean. Youth unemployment and low-quality education were highlighted as the main challenges faced by youth, which have been further exacerbated during the pandemic[5].

Across the Atlantic, “lack of support” was – a saddening and unanimous theme emphasised among young people across Europe when reflecting on the effects of the pandemic on their lives[4]. Undoubtedly, these sentiments can also be applied to youth and young persons living with chronic non-communicable diseases (NCDs) in the Caribbean; with the availability of only selective clinic services and disrupted or limited access to psychological support.

Among young people across Europe, feelings of anxiety, depression, fear, overwhelmingness, uncertainty and burnout due to the pandemic were expressed[4]. For myself and some of my peers, these feelings are mutual and, in some cases, have been magnified during the pandemic. Feelings of anxiety, depression and uncertainty about our futures, owing to the loss of jobs or limited job opportunities, the monotony and loneliness of staying at and working from home and the lack of physical and social peer interaction that we once had and cherished, are present.

Impact of the Home Environment and Virtual Lifestyle on Mental and Social Health Outcomes among Youth

Initially, with the nuance of the COVID-19 infection and naivety in the knowledge of its effects, many people welcomed the stay-at-home or work from home mandate as it gave them an opportunity to slow down or a much-needed break from school, work or life in general. However, the realities of this “new normal” quickly started to take effect.

Peer support is particularly crucial to the development of youth[5]. According to a 2020 report on the Impact of the COVID-19 Pandemic on Children, Youth and Families, the social isolation associated with the public health restrictions implemented can increase the risk of depression and anxiety among youth[6]. With limited face-to-face social and peer interaction and support due to closures of schools and other places of social gathering in response to the COVID-19 pandemic, the adverse impact on the population’s mental health, particularly on children, adolescents and young adults is undeniable. The school environment provides structure, intellectual stimulation, peer interaction, reliable meals and access to recreational facilities and healthcare for many children, and thus the transition to online learning and a virtual way of life has disrupted this source of structure and routine; resulting in adverse consequences on the health and well-being of youth and those with pre-existing chronic health conditions[7].

The social, psychological and economic implications on the health of children and young people are all interconnected. A variety of stressors have emerged during the pandemic such as the daily monotony, disappointment, lack of face-to-face contact with peers or classmates, lack of adequate personal space at home and family financial losses during lockdowns, can and have triggered negative psychological outcomes among youth[8]. While many young people have recognised the need for help regarding their physical and mental health during this time, not many have acted upon it. According to the UNICEF survey previously referenced, 73% of participants have felt the need to seek help regarding their physical and mental health but only 33% did[3].

Access to Physical and Psychological Support

In many Caribbean countries, most children and adolescents are treated for mental disorders through the general hospital compared to outpatient facilities[9]. Access to existing services at these facilities that support children and families has also been affected due to the greater challenges that these families may be facing at the time[10]. Schools provide a source of mental health care or counselling for many children and young people living in conditions of vulnerability; and for those with pre-existing chronic mental health conditions and their closures may further limit access to these mental health services[6],[7]. According to a study done in south east London, inequalities were detected in the referral pathways in accessing mental health services among young people aged 12-29 years; thus highlighting the need for an adapted approach to service delivery for children and families to provide special engagement and support through dedicated social media fora[11],[12].

 The Way Forward

As the strain on regional health systems and economies due to the COVID-19 pandemic continues, the psychosocial needs of the lowest priority groups, including young people, is overshadowed by the growing socio-economic implications. Prioritising strategies that address the mental health and wellbeing of children and youth and facilitate access to mental health services among these groups during and post-pandemic is warranted[13].

On the heels of International Youth Day, which was celebrated on August 12th, 2021, it is my duty on behalf of Healthy Caribbean Youth (HCY) and youth across the Caribbean to emphasise the need for regional responses and recovery measures to have whole-of-society engagement. We need our governments to implement interventions that give youth a seat at the table in the decision-making process; to galvanise a more holistic approach and to better address and support the psychosocial concerns of young people presently and moving forward.

Simone Bishop-Matthews holds a Master’s degree in Public Health from the University of Edinburgh. She currently works as a Research Assistant at the Caribbean Centre for Health Systems Research and Development, Trinidad and Tobago; and with the Healthy Caribbean Coalition (HCC) and Healthy Caribbean Youth (HCY), where she strives to incorporate aspects of health research and advocacy in her current and future endeavours toward NCD prevention and control and in the gradual improvement of national and regional health care systems. 

[1] The impact of COVID-19 on children’s mental health [Internet]. [cited 2021 Aug 29]. Available from: https://www.unicef.org/india/impact-covid-19-childrens-mental-health

[2] Liang L, Ren H, Cao R, Hu Y, Qin Z, Li C, et al. The Effect of COVID-19 on Youth Mental Health. Psychiatr Q. 2020 Apr 21;1–12.

[3] The impact of COVID-19 on the mental health of adolescents and youth [Internet]. [cited 2021 Aug 16]. Available from: https://www.unicef.org/lac/en/impact-covid-19-mental-health-adolescents-and-youth

[4] ‘A sacrificed generation’: psychological scars of Covid on young may have lasting impact [Internet]. the Guardian. 2021 [cited 2021 Aug 16]. Available from: http://www.theguardian.com/world/2021/jun/02/a-sacrificed-generation-psychological-scars-of-covid-on-young-may-have-lasting-impact

[5] The Commonwealth. Caribbean countries explore strategies to shield young people from COVID-19 shock [Internet]. 2020. Available from: https://thecommonwealth.org/media/news/caribbean-countries-explore-strategies-shield-young-people-covid-19-shock

[6] Shen J, Pecoraro M, Bellonci C. Impact of the COVID-19 Pandemic on Children, Youth and Families. :16.

[7] Serlachius A, Badawy SM, Thabrew H. Psychosocial Challenges and Opportunities for Youth With Chronic Health Conditions During the COVID-19 Pandemic. JMIR Pediatr Parent. 2020 Oct 12;3(2):e23057.

[8] Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S, et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr Clin Res Rev. 2020 Sep 1;14(5):779–88.

[9] WHO-AIMS. Mental Health System in Saint Vincent and the Grenadines [Internet]. 2009. Available from: https://www.who.int/mental_health/saint_vincent_grenadines_who_aims_report.pdf?ua=1

[10] Health and Equity in Recovery Plans Working Group. Direct and indirect impacts of COVID-19 on health and wellbeing [Internet]. 2020. Available from: https://www.ljmu.ac.uk/~/media/phi-reports/2020-07-direct-and-indirect-impacts-of-covid19-on-health-and-wellbeing.pdf

[11] Chui Z, Gazard B, MacCrimmon S, Harwood H, Downs J, Bakolis I, et al. Inequalities in referral pathways for young people accessing secondary mental health services in south east London. Eur Child Adolesc Psychiatry. 2021 Jul 1;30(7):1113–28.

[12] UNICEF. COVID-19 on children and families [Internet]. 2020. Available from: https://www.unicef.org/easterncaribbean/media/1921/file/COVID19%20on%20children%20and%20families.pdf

[13] Singh S, Roy D, Sinha K, Parveen S, Sharma G, Joshi G. Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations. Psychiatry Res. 2020 Nov;293:113429.