Children's Mental Health Problems During the Initial Emergence of COVID-19

On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a global health pandemic. The impact of COVID-19 on mental health has received widespread attention, but almost no longitudinal studies exist that examine changes in children's mental health during its initial emergence. Using a regression discontinuity natural experiment via a longitudinal cohort design, the present study examines trajectories of children's mental health from December 2019 to March 2020. Participants were 231 children (female n = 106 [45.8%]; average age = 5.69, SD = 2.09) in 22 early childhood education classrooms across Toronto, Canada. Children's mental health was assessed via educator reports on the Strengths and Difficulties Questionnaire in gender-adjusted percentiles, with the Impairment Rating Scale serving as a secondary measure. Data were analyzed with 3-level (classroom, individual, and time) Markov Chain Monte Carlo estimation (MCMC) growth curve models. Of the three assessments conducted per child, many of the final assessments occurred formally after the pandemic announcement and prior to the closing of childcare centres. Results suggest that male children enrolled in early childhood education showed a modest decline in mental health problems prior to the pandemic announcement by the WHO. However, following the WHO announcement, male children's mental health problems worsened significantly. No post-pandemic differences over time were observed for females. This study provides the first longitudinal evidence in Canada of heightened risk to children's mental health during the early emergence of the COVID-19 pandemic. Findings support initiatives aimed at increasing access to mental health care for children during and after the pandemic, in addition to incorporating mental health in home and school based educational services.

Automated summary

This study used a longitudinal cohort design to examine the impact of the early emergence of the COVID-19 pandemic on children's mental health trajectories in Toronto. The findings suggest that male children enrolled in early childhood education showed a significant worsening of mental health problems following the WHO announcement, while no post-pandemic differences over time were observed for females.