Learning from the trajectories of mental health challenges for children, young people and parents over the course of the Covid-19 pandemic

Lead Research Organisation: University of Oxford
Department Name: Experimental Psychology

Abstract

COVID-19 and the related public health measures have led to major disruptions to families' lives, with different pressures arising for children, young people, and their families over time. The Co-SPACE project in the UK and CORONA-CODOMO (C-C) project in Japan are two nation-wide online survey-based studies tracking how children, young people, and parents have been affected since the start of the pandemic. Both studies, separately, have found that lockdowns and school closures were associated with deteriorating mental health and increased stress in young people and parents. Certain groups (e.g., families with financial difficulties, and with children with special education needs) appear to have been particularly vulnerable to elevated stress and mental health symptoms throughout the pandemic. However, at this point, we still know little about how to best support families coming out of the COVID-19 pandemic and, in particular, how needs may vary across countries and pandemic-contexts.

The proposed project builds on a successful existing collaboration that will further utilize available expertise in international data analysis, text-mining approaches, patient and public involvement, and translating research into practice. In turn, it will promote knowledge exchange and involvement of early career researchers. The aim of this proposal is to: (i) capitalise on what can be learned from these parallel international surveys about the impact of COVID-19 and how it has been managed across countries; (ii) develop a further understanding of medium and long-term impacts of the pandemic on the mental health symptoms of young people and parents, as well as their pathways to recovery; and (iii) together with young people and families, co-design guidelines for policy makers and health authorities, which will help to mitigate identified medium to long-term mental health consequences of the pandemic and current policies and to tailor future pandemic management strategies to minimise mental health impacts on young people and families.

The above aims will be achieved through three workstreams, while actively engaging young people and parents from both countries in decision making throughout the research lifecycle:
(1) The already collected online survey (including cross-sectional) data will be merged and analysed using a multi-level modelling approach to examine how immediate mental health consequences for children, young people, and parents across Japan and the UK have varied over the COVID-19 pandemic according to policies and restrictions, as well as child, family, and other key characteristics;
(2) Three 6-monthly follow-up surveys with comparable measures will be conducted and analysed using time series and text-mining approaches across both countries to examine who is and is not 'bouncing back' and what are the medium and long-term consequences of the pandemic;
(3) Through a series of online events, we will co-design guidance for policy makers and practitioners with young people from both countries in collaboration with the Leaders Unlocked, an organisation which enables young people and underrepresented groups to have a voice on issues that matter.
 
Description Key findings, so far, indicate that:
1) Children's behavioural and attentional difficulty scores have remained relatively stable between July 2021 and March 2023.
2) On average, children's emotional difficulty scores have increased between July 2021 and March 2023.
3) Children vulnerable families (i.e., with SEN/ND and those from low-income and single adult households) continue to show elevated behavioural, emotional and attentional difficulties relative to the rest of the Co-SPACE sample.
4) Parent/carer financial stress decreased during the first UK national lockdown but was at its highest in October 2022.
5) Financial stress scores, in general, were higher among parents of children with SEN/ND, from single adult or lower income households than the sample as a whole.

We have also found that the majority of children and young people (72-77%) reassuringly had low emotional, conduct, attentional symptoms and impact throughout the first two years of the pandemic. However, children and young people who had high mental health symptoms at the beginning of the pandemic (~9%) were less likely to recover and tended to have persistent difficulties across sub-scales. Children and young people with pre-existing mental health diagnosis, SEN and neurodevelopmental diagnoses were less likely to recover after the first national lockdown, whilst adolescents were less likely to recover longer-term.
Exploitation Route Children and young people show different rates of recovery, with the majority experiencing low symptoms and impact over-time. These findings emphasize the need to consider resilience and recovery patterns for the small proportion who were the most impacted by the pandemic by both researchers and policy makers.
Sectors Communities and Social Services/Policy

Education

Healthcare

URL https://cospaceoxford.org/
 
Description So far, the findings from this project have enabled us to build a better understanding of medium and long-term impacts of the pandemic on the mental health symptoms of young people and parents, as well as their pathways to recovery in the UK. We have conducted preliminary analyses of the findings, presented through 3 reports on the Co-SPACE website (https://cospaceoxford.org/findings/). We have shared these findings with our network of policy makers, professionals and organisations supporting children and young people mental health. We have also communicated with our participants via mailing list updates and patient and public involvement (PPI) activities throughout the lifecycle of the study and have incorporated their feedback in study design and research dissemination plans. We have presented our findings to the public via podcasts, webinars, radio interviews. We have also disseminated them to the wider academic audiences via invited talks and conference publications. This work has already contributed to national and international policy evidence base (e.g., Department for Education State of the Nation 'Children and Young People's Wellbeing' report). We have also gained additional funding to expand our international collaboration and combine our insights from researchers around the world in a way that can directly inform global policy and practice.
First Year Of Impact 2022
Sector Communities and Social Services/Policy,Education,Healthcare
Impact Types Societal

Policy & public services

 
Description A Department for Education Partners in Practice report
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Citation in other policy documents
URL https://adcs.org.uk/feature/article/social-work-in-a-pandemic
 
Description ECAP review
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in systematic reviews
URL https://link.springer.com/article/10.1007/s00787-023-02206-8
 
Description Norwegian Institute of Public Health
Geographic Reach Europe 
Policy Influence Type Contribution to a national consultation/review
URL https://hdl.handle.net/11250/3067172
 
Description State of the nation 2022: children and young people's wellbeing
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
URL https://www.gov.uk/government/publications/state-of-the-nation-2022-children-and-young-peoples-wellb...
 
Description Broadening Horizons - Psychiatry Conference Travel Grant Scheme
Amount £2,255 (GBP)
Organisation University of Oxford 
Sector Academic/University
Country United Kingdom
Start 07/2023 
End 08/2023
 
Description COVID-19 Supporting Parents, Adolescents, and Children during Epidemics: Co-SPACE International Consortium meeting
Amount € 28,436 (EUR)
Organisation Lorentz Centre 
Sector Academic/University
Country Netherlands
Start 12/2023 
End 12/2023
 
Description Co-SPACE Leaders Unlocked 
Organisation Leaders Unlocked
Country United Kingdom 
Sector Private 
PI Contribution We are working with Leaders Unlocked to design and facilitate a process for engaging young people in the UK and Japan as peer researchers and to co-develop guidance for policy makers and practitioners in Japan and the UK. Together, Leaders Unlocked and the University of Oxford Co-SPACE team will conduct a series of online international focus groups and events with young people (aged 11-16 years) and parents/carers. This work will be used to inform and enable a similar process to be implemented by collaborators at the National Center for Child Health and Development in Japan.
Collaborator Contribution Leaders Unlocked train and support young people in the UK to enable them to have a voice on the issue of COVID-19 mental health impact and to work with researchers, policy makers and practitioners to influence decision making. Together, Leaders Unlocked and the University of Oxford Co-SPACE team will conduct a series of online international focus groups and events with young people (aged 11-16 years) and parents/carers. This work will be used to inform and enable a similar process to be implemented by collaborators at the National Center for Child Health and Development in Japan.
Impact Co-researcher kick-off meeting (Engagement activity) Co-researcher focus group and research training session (Engagement activity)
Start Year 2023
 
Description Learning from the trajectories of mental health challenges for children, young people and parents across Japan and UK over the course of the Covid-19 pandemic 
Organisation National Center for Child Health and Development
Country Japan 
Sector Public 
PI Contribution We hold monthly meetings where we share expertise, advice and review ongoing research outputs, provide support with PPI, share our cleaning and analysis scripts, and plan simultaneous data collection.
Collaborator Contribution The NCCHD team has also shared their expertise, reviewed our survey materials, provided new questions, and shared their research information such as variable guides.
Impact doi: 10.1186/s13034-022-00525-3
Start Year 2022
 
Description ACAMH podcast 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In this Papers Podcast, Dr Simona Skripkauskaite discusses her JCPP Advances paper 'Changes in UK parental mental health symptoms over 10 months of the COVID-19 pandemic'
Year(s) Of Engagement Activity 2023
URL https://www.acamh.org/podcasts/changes-in-uk-parental-mental-health-symptoms-over-the-covid-19-pande...
 
Description Co-SPACE featured in University of Oxford's research page of child mental health 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact The Co-SPACE project has been featured in the covering page for Brain and Mental Health from Infancy to Adolescence at University of Oxford. It was featured in the section under research of lockdowns and mental health, highlighting the prompt response to track children and young people's mental health throughout the COVID-19 crisis and identify ways to protect their mental health.
Year(s) Of Engagement Activity 2023
URL https://oxford.shorthandstories.com/brain-and-mental-health-from-infancy-to-adolescence/
 
Description Co-SPACE featured in University of Oxford's research page of parental mental health 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact The Co-SPACE project has been featured in the covering page for Parental and Maternal Mental Health at University of Oxford. It was featured in the section under research of parental mental health and Covid-19, highlighting its prompt response to help us understand the impact of the COVID-19 on the mental health of parents and carers.
Year(s) Of Engagement Activity 2023
URL https://oxford.shorthandstories.com/parental-and-maternal/
 
Description Co-SPACE's Report 13 featured in NIHR News 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Co-SPACE's latest report, Report 13, has been featured in NIHR news and features. The report outlines the changes in child mental health and parental financial stress 30 months after the start of COVID-19 pandemic in March 2020.
Year(s) Of Engagement Activity 2023
URL https://www.arc-oxtv.nihr.ac.uk/news/changes-in-children2019s-mental-health-and-parents2019-financia...
 
Description Co-researcher focus group and research training session 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact Around 10 young people attended this training and planning session for Co-SPACE Leaders Unlocked workstream as co-researchers. The meeting sparked great discussions on how to best engage focus group participants, how to address the aims of research, and consider safeguarding and ethical aspects of conducting research.
Year(s) Of Engagement Activity 2024
 
Description Co-researcher kick-off meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact 15 young people attended the kick-off meeting for the Co-SPACE Leaders Unlocked project as co-researchers. This initial session was aimed at getting to know one another, learning about the project aims and approaches, and reflect on young people's and families experiences during the Covid-19 pandemic.
Year(s) Of Engagement Activity 2023
 
Description Conference key note presentation - Leeds Trinity Global Covid summit 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Presentation as part of a webinar for international audience, with questions and answers afterwards. Feedback from event suggested audience had greater knowledge and understanding afterwards.
Year(s) Of Engagement Activity 2022
URL https://www.leedstrinity.ac.uk/research/british-families-in-lockdown-study/covid-19-summit/
 
Description Futuremakers podcast 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Professor Lennox sits down with Professors Cathy Creswell and Dr Polly Waite to talk about how anxiety affects young people and the complex picture that makes up the risk factors for developing mental health disorders
Year(s) Of Engagement Activity 2023
URL https://open.spotify.com/episode/0L9cCiyNNVSyHPDDqqKRZH?si=a9e3de68bd904729&nd=1
 
Description Interview with Faculti 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Dr Simona Skripkauskaite was interviewed by the academic media Faculti to discuss the Co-SPACE study, with highlight on the Lancet paper, and its partner studies which were set up to help understand how families have coped throughout the Covid-19 pandemic, and what parents can do to support their children's mental health.
Year(s) Of Engagement Activity 2023
URL https://faculti.net/covid-19-supporting-parents-adolescents-and-children-during-epidemics/
 
Description Lorentz Centre: Co-SPACE International Consortium meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In connection to the further funding received from the Lorentz Centre, we held an international in-person meeting on child, adolescent, parent mental health research during the pandemic (December 2023). The workshop was attended by international collaborators from around the world, including from Australia, Denmark, Iran, Ireland, Japan, Malaysia, Netherlands, and Turkey, as well as Dutch young people and clinicians.

During the workshop, we discussed our global findings and experiences, such as different approaches to school closures and potential links to post-pandemic school absenteeism, particularly vulnerable groups, modifiable protective factors, and similarities between pandemic experiences and other public health crises. We also planned how the international Co-SPACE consortium data and insights can be used to inform future policy and strategies that prioritise young people's mental health before, during and after public health crises.
Year(s) Of Engagement Activity 2023
URL https://www.lorentzcenter.nl/covid-19-supporting-parents-adolescents-and-children-during-epidemics-c...
 
Description NIHR ARCs Your Path in Research special edition newsletter 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Co-SPACE's Report 12 on changes in children's mental health two years after the start of the pandemic was featured in the NIHR Arcs newsletter.
Year(s) Of Engagement Activity 2023
 
Description NIHR Arc-OX TV newsletter: Co-SPACE Report 13 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Co-SPACE's latest Report 13 was featured in the NIHR Arc-OX TV newsletter. The report outlines the changes in child mental health and parental financial stress 30 months after the start of COVID-19 pandemic in March 2020.
Year(s) Of Engagement Activity 2023
URL https://www.arc-oxtv.nihr.ac.uk/news/changes-in-children2019s-mental-health-and-parents2019-financia...
 
Description Northern Ireland World article on Leaders Unlocked project 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Newspaper article describing a local student who is participating in the Leaders Unlocked Co-SPACE Japan project
Year(s) Of Engagement Activity 2023
URL https://www.northernirelandworld.com/education/wallace-student-becomes-only-pupil-from-ni-to-take-pa...
 
Description Podcast with Tooled Up Education 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Dr Simona Skripkauskaite was interviewed for a podcast series the ANCHOR where she talked about her Ox-Well study on gaming behaviours and her role in the Co-SPACE project.
Year(s) Of Engagement Activity 2023
URL https://anchor.fm/dr-kathy-weston/episodes/Researcher-of-the-Month-Is-Heavy-Gaming-Detrimental-to-Yo...
 
Description School of Psychology Research Seminar Series, University of Surrey Talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Dr Simona Skripkauskaite gives talk at the University of Surrey on findings from tracking mental health in children and young people during the Covid-19 pandemic
Year(s) Of Engagement Activity 2023
URL https://www.surrey.ac.uk/events/20231026-tracking-mental-health-children-and-young-people-during-cov...
 
Description The Generation Pandemic Podcast 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact In episode 5 of the Generation Pandemic podcast Cathy Creswell (UK) and Jennifer McMahon (Ireland) from the Co-SPACE study discussed the mental health and wellbeing of children before, during and after the pandemic, with a panel to discuss how researchers have tracked children's mental health changes and the urgent need to address the effects they have evidenced.
Year(s) Of Engagement Activity 2022
URL https://generation-pandemic.libsyn.com/covid-19-childrens-mental-health-and-wellbeing
 
Description The Mental Health of Children and Young People Before and During the COVID-19 Pandemic Webinar - Talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Dr Simona Skripkauskaite discussing key findings and implications from recent research into the mental health of children and young people in the UK
Year(s) Of Engagement Activity 2023
URL https://blogs.bmh.manchester.ac.uk/blog/2023/06/13/the-mental-health-of-children-and-young-people-be...
 
Description The Parenting Pandemic Podcast 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Dr Simona Skripkauskaite was interviewed about how families experienced uneven effects of the pandemic.
Year(s) Of Engagement Activity 2022
 
Description Voice of Islam Breakfast Show 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Dr Simona Skripkauskaite talks with the Voice of Islam Radio about children's anxiety during the pandemic
Year(s) Of Engagement Activity 2023
URL https://soundcloud.com/voislam/breakfast-show-podcast-15-08-2023-is-it-good-to-have-houseplants-in-o...