Youth mental health declining
CAMH study reveals nuanced picture of how young adults are feeling
Pandemic isolation has compounded mental health challenges for many young people — while simultaneously bringing some surprising new benefits, an about-to-be-released study has found.
The Centre for Addiction and Mental Health study, currently under peer review, shows an overall deterioration of mental health among young people with growing concerns about depression and anxiety. But the impacts of sudden self-isolation are nuanced, with many respondents reporting reduced substance abuse and deeper connections with family.
It’s part of an emerging portrait of mixed youth mental health reactions to a global pandemic.
The CAMH survey, conducted from April 10 to 24, asked people ages14 to 27 to answer questions about their mental health. They reported “statistically significant deterioration of mental health from pre-pandemic times to the point of data collection,” the study reads.
Of the 622 respondents, about half had previously sought mental health services while the other half had not. Mental health declines were evident in both groups overall, but pandemic stressors were more impactful on those with pre-existing mental health challenges, the study found.
More than two-thirds of respondents who previously sought mental health support — 68 per cent — and 40 per cent of those who had not previously sought support were experiencing problems consistent with depression, anxiety and other mental health challenges, the study reports.
“They are doing worse because they started off with difficulties,” said senior study lead Dr. Joanna Henderson, a clinician scientist and director of the Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health at CAMH.
“Those who haven’t been experiencing mental health difficulties are experiencing them now and that means we’re going to be having new people coming to our doors.”
Overall, 18 per cent of respondents said they thought about suicide in the previous month before completing the survey (during the early stages of the pandemic).
But there was a clear split among the two groups of respondents. Thirty per cent of those who had previously sought mental-health care referenced suicide versus eight per cent of those who had not previously sought help.
Population level data from Statistics Canada suggest six per cent of Canadians ages 15 to 24 had thoughts of suicide in the past year.
“I am concerned about the number of young people across both groups experiencing thoughts of suicide and it signals to us we must find ways as a system to offer ongoing services that meet the needs of these youth,” Henderson said.
Among the added concerns triggered by COVID-19 isolation are disruptions in education and career plans, economic concerns triggered by loss of employment and worries about the virus infecting themselves or loved ones.
“Like many of the youth in this survey, I’ve seen a huge impact on my education and the way it’s being delivered and what was expected versus what I’m getting,” said Em Hayes, who is currently enrolled in a master’s of education program at the
University of Toronto and works part time as a youth facilitator at CAMH.
“The amount of digital fatigue is a thing when school is delivered online so intensely. I, and my classmates, have been overwhelmed.”
At a time when mental-health services are most needed, half of respondents with pre-existing mental-health challenges said their access to mentalhealth care — ranging from therapy to “someone to talk to” — has been disrupted.
But there’s ambivalence in the message respondents conveyed.
When asked about positive changes resulting from COVID, nearly half with previous mental-health challenges and 40 per cent of those without treatment history identified pandemic lifestyle benefits, including improved “self-reflection and self-care,” the study found.
Examples listed by respondents included more time with family, less stress from work and school, and more engagement in activities — such as hobbies, and rest and relaxation — that assist with mental health.
“Even people who are experiencing significant mentalhealth problems can feel a bit improved because the pressure may be off of them in these important domains,” Henderson said.
Substance use also declined during the pandemic, the survey found.
“Many have moved back into the family home, so the opportunities (for substance abuse) may be fewer,” said Henderson. “If you’re under the legal age limit, your access to alcohol or cannabis and other substances may be diminished.”
Mardi Daley, 26, said the “deep breath” brought on by the pandemic revealed to her just how stressed young people are during normal times.
“As a young person in Toronto who lives alone, it made me realize how much it takes to keep a roof over my head, work every day and stay on task because in this market, you can’t slip,” said Daley, who has several parttime jobs including as a youth facilitator at CAMH.
“My stress level has taken a dramatic decrease.”
She points to social media-induced pressures as a key generational stressor.
“It’s a constant bombardment of advertising, messages and having to keep up with everything socially, educationally and with family … A lot of people are making money off of our stress. It’s markedly different from previous generations.”
Another recent Canadian survey — the Social Impacts of COVID-19 on Canadian Youth — detected a similar mixed emotional response to outbreak-induced isolation.
The survey, released earlier this week and conducted by the Association for Canadian Studies in partnership with Experiences Canada and the Vanier Institute of the Family, asked nearly 1,200 young people 12 to 17 about their pandemic state of mind.
While 72 per cent of girls reported feeling sad often or sometimes since the outbreak, the figure for boys was 55 per cent. The older group of respondents — 15 to 17 — also showed higher levels of outbreak-related sadness with 72 per cent reporting sadness often or sometimes versus 59 per cent of those 12 to 14.
At the same time, a large majority of respondents reported feelings of happiness “often or sometimes” since the outbreak began — 89 per cent for 12- to 14-year-olds and 84 per cent for 15- to 17-year-olds.
“Kids are having high levels of anxiety, there’s a lot of uncertainty about the future and for the first time ever, they’ve been asked to stay home and figure out online learning,” said Ashley Manuel, managing director of the non-profit research organization Association for Canadian Studies.
“But it’s also interesting to see that kids are having more meaningful conversations at home with their family. It is a strange time when they’ve been asked to stay at home but they are also connecting with their parents, and the dynamic in the home and family is very important, too.”
Eric Windeler, who in 2010 founded the national youth mental-health charity Jack.org with his wife Sandra Hanington following the suicide of their son Jack, has been tracking the mix of youth responses to the pandemic.
“Those who are best prepared to cope will manage OK and possibly even well. But we’re getting a lot of anecdotal feedback that those who are struggling already will be even more impacted, especially in terms of education and opportunities,” he said.
“We were already facing a mental-health crisis with over 20 per cent of youth deaths being via suicide. Then comes COVID-19 and the increased mental-health challenges for many, especially for those who were already struggling.”
Statistics Canada has also been tracking the issue in its surveys.
In April, the agency reported the percentage of Canadians 15 years old and over reporting excellent or “very good” mental health had fallen during the COVID-19 outbreak — to 54 per cent from 68 per cent in 2018.
And the mental health decline between 2018 and 2020 was particularly striking among those 15 to 24. Forty-two per cent reported excellent or very good mental health during the pandemic compared to 62 per cent in 2018. The CAMH study recommends a number of supports to address youth mental health during the crisis, including better access to online or phone counselling for youth, financial support aimed at young people and high-quality, “positively framed” information online. Swiftly growing mentalhealth demands have inspired new approaches in many places.
The outbreak triggered an immediate pivot to virtual counselling services at a national network of youth mentalhealth centres called ACCESS Open Minds (AOM), which serves urban, rural and Indigenous communities from Nova Scotia to the Northwest Territories.
“I am grateful that they offered (telephone) services during this time,” wrote a 24-yearold client at the network’s Eskasoni First Nation centre in Cape Breton. “It relieves a lot of the stress and worry because you know you have someone 24-7.”
Beginning early on in the pandemic, young clients were reporting worries about meeting basic needs such as income, stable housing, isolation, caring for younger siblings and the new demands of online course loads and exams, according to an AOM summary report on pandemic response provided to the Star.
At the same time, however, some communities reported the pandemic has brought families together.
“Perhaps a silver lining of the pandemic is that it brought mental health services into the 21st century and created innovation at lightning speed,” the report reads. “The network’s sites report that some young people, who were reluctant earlier to seek services due to anxiety, seem to be more comfortable sharing concerns and attending groups over the phone or online.”