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As schools reopen, experts say parents must pay attention to children’s mental health

Dr Kamna Chhibber, a clinical psychologist at Fortis Healthcare, said, "What adults need to do is keep giving children a lot of reassurance, talking to them and encouraging them to express."

Outdoor activities like sports and yoga in school can help with the development of child, experts said. (Express Photo by Praveen Khanna)

From social anxiety to excitement about meeting peers, the reopening of schools after nearly two years in most places has invited varying responses from children.

The lockdown saw an increase in feelings of sadness, anxiety and fear among children and adolescents. However, returning to classrooms and interacting with batchmates may usher in ‘normalcy’ and help with their development.

Dr Priyanka Halwasiya, a child psychologist at Delhi’s Ganga Ram Hospital, said, “Socialising…seeing more than 4-5 faces within the households can expand your horizons. When you meet a friend physically, you understand more things, you pick up their body language. It offers so much more growth than when you see things online.”

However, experts agree that returning to school can also cause problems like social anxiety or trouble concentrating for long hours in the classroom.

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Children exercise at a school in Delhi. (Express Photo by Praveen Khanna)

Dr Halwasiya shared that when schools opened briefly in Delhi in 2021, “we saw a lot of social anxiety cases and secondary depression because of that. It takes a while for children to adapt to social nuances and deal with their anxiety. Social anxiety is becoming a lot more common in even younger children of classes 2 and 3, who have not gone to school much. Now, they don’t know how to make friends and talk to people in public spaces.”

These younger students, who may be attending schools for the first time or have only gone for a year, will also be faced with separation anxiety. Children who haven’t been separated from their parents earlier and have now turned four to five years old will be “as good as a child going to playschool.” “The schools have to be cautious while making this transition smooth and go slow. These children may have seen their teachers or may know their names but that’s not enough for establishing a rapport,” the child psychologist added.

Recounting a recent conversation with a Class 12 student, Dr Halwasiya warned that older students may also struggle with social anxiety at the thought of “facing everyone”. “He has not met or interacted with most of them (peer) over two years. So, he’s kind of nervous as to how people will respond and maybe they have formed their own groups and they have been pallier or more connected than he was to them. He’s already feeling like an outcast.”

Children may also face trouble matching up to their peers academically. While there have always been varying levels of educational status in a class of 40-45 students, the disparity has increased over the pandemic due to online classes, Dr Halwasiya noted. As the number of hours also increase in school over online classes, concentrating and focusing for the full six hours may also be a challenge.

Sandhya Basu, a PhD student at BITS Pilani, who has been extensively looking at the impact of Covid-19 on children’s mental well-being, found that several non-clinical children were reluctant to change their routine such as getting up early in the morning. In her interaction with nearly 20 families of lower socio-economic backgrounds in Mumbai, she also noted that symptoms of children clinically diagnosed with mild to moderate ADHD have increased during the pandemic, causing lower concentration levels in schools. “With special schools reopening as well, some of them have gone back to pre-primary grade from the primary level because one, they have forgotten what they had learnt or two, their symptoms have become severe due to lack of therapy in the last two years.”

Younger children may face trouble adjusting to new routines. (Express Photo by Praveen Khanna)

What can be done: ‘Talk, reassure and express’

Dr Kamna Chhibber, a clinical psychologist at Fortis Healthcare, said, “What adults need to do is keep giving children a lot of reassurance, talking to them and encouraging them to express. These three things are going to be cornerstones in ensuring that the impact is mediated in the best way possible as far as children are concerned.”

“I think it’s important to keep on having conversations with children to understand the various factors – how is their socialisation experience in school coming along, whether they’ve been able to adjust to the new settings and connect with their peer group, and whether they are able to concentrate and transition to the new mode of learning,” she added.

Dr Chhibber said that parents must stay vigilant about reluctance in children in going to school or reconnecting or avoidance of academic curriculum. “Instead of forcing a course of action, it’s crucial to have more conversations to help them work through whatever may be causing that kind of resistance,” she explained.

“First-timers or younger students may not be happy about going to school every day or waking up early. So parents must keep encouraging them and push gentle reminders about why it’s important to do certain things. They may require more hand-holding in terms of parents dropping them at school and being available. It may also help to engage the teacher if the child shows more resistance. The teacher can then also be extra attentive and help integrate them and make them feel more comfortable,” Dr Chhibber added.

Increase in mental health issues during pandemic but a long way to acceptance

Throughout the lockdown and Covid-19 curbs, several children struggled with their mental health. Dr Halwasiya observed a “tremendous increase” in the number of children seeking help since the onset of the pandemic. She said, “I can’t say for sure if there’s more awareness (now) but there’s definitely more amount of helplessness.”

Children wait for parents to come pick them up from schools. (Express Photo by Kamleshwar Singh)

Though the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore saw overall lower help-seeking numbers, Assistant Professor Eesha Sharma at its Department of Child and Adolescent Psychiatry stated that this was not reflective of the ‘larger impact’ of the pandemic on children’s general mental well-being. “If I talk about our child and adolescent psychiatry clinic at NIMHANS alone, we have not seen an increase in the absolute numbers of children/parents consulting. In fact, given the lockdowns and fear of the pandemic, help-seeking numbers have been overall lower than the pre-pandemic years. Having said that, it is important to understand that visiting mental health professionals or hospitals may be more likely only when mental illnesses manifest in unmanageable emotions and behaviours that parents and caregivers may not be able to address at home. The larger impact of the pandemic, however, has been on general mental and physical well-being and development,” professor Sharma shared in an email response to indiaexpress.com.

For instance, Basu in her research, in collaboration with IIT Bombay, found an increase in indicators of hyperactivity among children as young as six years of age, largely driven by an addiction to mobile phones.

Dr Chhibber told indianexpress.com that Fortis’ national helpline (+91 8376804102), which used to receive 50 to 75 calls a day pre-pandemic, now gets approximately 150 calls. Roughly 40 per cent of these are from callers under 20 years of age.

When asked if the rise in numbers indicated a growing awareness towards mental health, Dr Chhibber said, “It is now not as much of a taboo topic in conversations within households but there is no doubt that we have a long, long way to go. There’s often hesitancy in admitting that my child is getting treatment but at least there is a willingness to consider an expert intervention may be required, which could mean a psychiatrist or psychologist and not necessarily just the school counsellor.”

She added that with the increase in digitisation due to the pandemic, “it’s not just the urban areas which are seeing a shift, but it’s also increasingly happening in the further reaches of the country”. The 24-hour helpline of Fortis, which is run in 14 different languages, “has seen so many calls by children, adolescents and their family members from different parts of the country. There is still a long way to go, but it’s certainly a move in the right direction.”

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📣 The above article is for information purposes only and is not intended to be a substitute for professional medical advice. Always seek the guidance of your doctor or other qualified health professional for any questions you may have regarding your health or a medical condition.

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