Benjamin Landman, chief of psychiatry at Paris’s Robert-Debré paediatric hospital, told French weekly Le Journal du Dimanche that lockdown measures and new social distancing norms have had a significant impact on children’s mental health.
Young children were experiencing developmental regression, such as bedwetting, difficulty falling asleep and separation anxiety, while older children were showing behavioural problems, signs of agitation, sudden withdrawal and a fear of going back to school.
“Some children who have never had any particular difficulties are now presenting acute mental disorders linked to the health crisis,” Landman told JDD. “For the past two weeks we’ve seen an influx of some serious situations…such as children and adolescents with suicidal ideas.”
Le pédopsychiatre Benjamin Landman, chef de clinique à l'hôpital Robert-Debré à Paris (AP-HP), s'inquiète des conséquences de la crise du coronavirus sur la santé mentale des enfants. https://t.co/z09hk8A7ea pic.twitter.com/kBVYC9zT4O
— Le JDD (@leJDD) July 8, 2020
While lack of access to outpatient medical care during France’s eight-week nationwide lockdown compounded the situation, things failed to improve when the restrictions eased and children could resume their social interactions and return to school.
“A new home routine had been put in place during the confinement, and then this balance was suddenly disrupted,” Landman said. “With it came the risk of children exposing themselves to the virus and of infecting those close to them…and there were uncertainties about how to resume school.”
Reduced access to mental healthcare
Compounding the problem was the absence of the “medico-social fabric” that usually makes it possible for children to manage their social and psychological difficulties.
“The tone changes each time we switch from one situation to another: confinement, 'deconfinement', recovery,” Landman said. “At first, families no longer brought their children in for fear of catching the virus. Then, when the lockdown was lifted but primary schools remained closed, we saw a resumption of child psychiatric emergencies.”
The role of children throughout the health crisis has been complicated and difficult, and any change in a child's behaviour – withdrawal, loss of appetite – justifies an expert opinion, he added.
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“First they were suspected to be a vector of the disease for adults, then suddenly we sent them back to school telling them that they are safe.”
There’s no hard and fast rule on why some children suffered “adjustment disorders” and not others, Landman said, adding the condition would likely improve without the need for specialised care. However others would be permanently marked – “especially those who have lost loved ones”.
Social inequalities will also see some children fall through the gaps and, with some children worried for parents whose jobs have been lost or put at risk, the epidemic will continue to deliver aftershocks, like an earthquake.
“The full psychiatric impact of the crisis will be revealed in the months to come,” Landman said.
