Generation COVID: How has the pandemic impacted the mental health of young people?
Being a young adult in the 21st century can be challenging at the best of times. If the pressures to discover yourself, further your education and crack the job market aren’t already enough, you also want to stay connected, to form new friendships and chase new experiences. Throw in a once-in-a century pandemic, where most news is bad news, and it’s not exactly the best climate for staying mentally well.
“If you think about the cascading psychological effects of a pandemic, it’s going to affect people’s lives in many different ways,” says Professor John Gleeson, clinical psychologist and the Director of ACU’s Healthy Brain and Mind Research Centre.
“With those who are in a formative stage of life, just existing in a contemporary world is difficult. The fact that there are additional obstacles – interruptions to study, a loss of things like casual employment, distance from friends and family – you can see that it places a particularly heavy burden on young people.”
While it’s too early to thoroughly assess the effect the pandemic has had on youth mental health, early indications are that students and young workers have felt the stings more harshly than others.
The long-term implications will be studied for many years to come.
“Already there have been some interesting large-scale surveys of mental health in the community, really untangling that question of why it’s hit young people harder than others,” says Professor Gleeson, who has 30 years of experience working with youth and adults affected by mental health disorders.
“It will take some time, but in the near future we’ll have a greater sense of the reasons behind it.”
We sat down with Professor Gleeson to track the impact COVID-19 has had on youth mental wellbeing, and to explore how tech can provide us with future tools for treatment.
You’re a clinical psychologist and an active researcher. In your experience, how has the pandemic affected the mental health of young people?
“We’ve undoubtedly seen a general increase in background fear in the community, particularly when cases are surging about, and an anxiety about the impacts on wellbeing and prospects for the future. These don’t necessarily translate into a mental health disorder, but they still impact a person’s quality of life.
Then there are the effects of the necessary public health interventions, which have impinged on some people’s basic psychological needs for connection. The interruptions to work, study and travel and financial stress can diminish people’s confidence and sense of purpose, which are also fundamental psychological needs.
When it gets down to the individual, one thing that is definitely relevant is what a person’s life and wellbeing was like before the pandemic. For people who might have been approaching a tipping point, the increase in background anxiety can act as trigger for the initial onset of mental health problems.”
How has the pandemic affected those who’ve experienced mental illness in the past?
“It’s complex. There will have been some people who, paradoxically perhaps, may have experienced a sense of relief with the initial lockdown and social distancing interventions, in that it meant there was less immediate pressure and less social demands placed upon them. Life was suspended for a little while, and that can reduce stress on some people.
For others with an existing mental health problem, there’ll be a significant risk of exacerbation in their mental health systems, perhaps risk for a relapse if they’ve been doing well, or problems with achieving recovery. For example, added financial strain and social disconnection may well push them to the point of a crisis in their mental wellbeing.”
What do we know about why this pandemic has hit young people so hard when it comes to mental health?
“That’s a harder question to address, and I should point out once again that we’re still at the early stages of gathering the data on some of these questions.
“Anecdotally speaking, from my own clinical experience, I think it’s true that young people already have some critical developmental changes and stresses they need to traverse. They’re trying to establish themselves, their sense of direction in life. Often they’re trying to develop their skills and credentials, to navigate intimate relationships and develop their identity.
“We also know they’ve been disproportionately affected by the economic impacts that have come from the necessary public health interventions. It stands to reason, I think, that their mental wellbeing is also going to be disproportionately impacted.”
Most of us have been willing to adapt in order to address the public health risks of the virus. It appears the same commitment is required to address the mental health issues. How do we begin to do that?
“This is definitely a complex multifactorial problem, but one thing that’s really important is increasing the awareness of the risks. It’s encouraging to see the Federal Government’s campaign focused on increasing self-awareness for signs of stress and mental health problems.
One of the devilish problems is the issue of access to care, particularly for those with more severe enduring mental health problems. We have to ensure the access is there, so that when a young person makes that important decision to reach out and seek help from a service, they can access it and they can get help in a timely way. That’s a major issue and probably the biggest concern I would highlight.”
As a result of the pandemic, people seeking help with mental health problems haven’t had as much face-to-face access to clinicians as in the past. What have we learnt from this experience?
“We all tend to live with the assumption that life goes on, that there’ll be a continuity in the systems we all rely upon, and I think the pandemic has shown us that might not always be true.
The lesson here is that it’s prudent to have systems available to us for these types of emergencies, because we’re not sure what lies ahead. If there are further lockdowns or emergencies of one kind or another, technology is potentially a really useful way of ensuring some continuity of mental health care.”
How can technology improve outcomes in mental health treatment?
“In recent years I have worked with colleagues to focus on using technology to address the critical shortcomings of mental health services, particularly focused on young people and their families.
We have come to the conclusion that digital technology is a way, not of replacing critical mental health services, but of enhancing their capacity, and a way of effectively engaging young people and their families in ongoing support over a period of time.
It might be possible, for example, for one clinician working online to support potentially up to 100 young people. So I think technology has a role there in providing a background level of step-down support, and our vision is to integrate this with the existing mental health system.”
You’ve worked closely with Orygen to develop the Moderated Online Social Therapy (MOST) intervention for use in digital platforms. Can you tell us about that intervention?
“MOST is a little bit like Facebook but it’s a supportive social network. That means young people experiencing mental health problems can connect with one another in a safe space, and it’s kept safe by having online therapists in that social network, but also peer support workers who are trained to model the use of the system and to engage young people in its use. We think the social network is really important for that engagement function.
Another important part of the system is the evidence-based therapeutic content that has been through quite a number of iterations over the years now. The purpose of the content is to engage and educate young people, to help them to increase resilience, and to support them in using a broad set of tools and skills in everyday life.”
Has the intervention been used over the course of the pandemic?
“As part of its response to the pandemic, the Victorian Government in conjunction with the Telstra Foundation made a really significant decision to support the rollout of MOST to Victorian youth mental health services
That’s a project I’m very much involved with in terms of implementation, but also researching its effectiveness for young people when rolled out on that scale. It’s a really exciting phase for us and we hope it’s a springboard for further development.”
Social media can be a useful tool for connection, but it can also be detrimental if it’s not used appropriately. What are your thoughts on those contrasting outcomes?
“As was recently highlighted in the documentary The Social Dilemma, there was this great promise with social media that it was going to connect people in meaningful ways, particularly those who share common interests and values. What the documentary really brought home was that there are incentives built into commercial social media that are completely oblivious to the wellbeing of the end-user.
That’s potentially very harmful both to the individual, and to society in general … it can actually lead to less social cohesion, not more.
I agree with that as a concern, and our approach has been in contrast to that. Rather than letting technology run loose in the wild, we’ve deliberately designed a system where the end goal is very much for the psychological wellbeing of the young people we’re supporting, and where there is no commercial imperative or competing agenda.
If you ensure the social network is delivered to a high standard, and that it’s in line with the evidence, you end up with a platform that is an incredibly useful tool for treatment, and a novel way of responding to the types of mental health challenges experienced by young people during the pandemic.”
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