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Children and COVID-19 Research Library

UNICEF Innocenti's curated library of COVID-19 + Children research

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Emergency department encounters among youth with suicidal thoughts or behaviors during the COVID-19 pandemic

AUTHOR(S)
Kathryn K. Ridout; Mubarika Alavi; Samuel J. Ridout (et al.)

Published: September 2021   Journal: JAMA Psychiatry

Population-level reports of suicide-related emergency department (ED) encounters among youth during the COVID-19 pandemic are lacking, along with youth characteristics and preexisting psychiatric service use. This study aims to characterize population-level and relative change in suicide-related ED encounters among youth during the COVID-19 pandemic compared with 2019. This cross-sectional study evaluated ED encounters in 2019 and 2020 at Kaiser Permanente Northern California—a large, integrated, community-based health system. Youth aged 5 to 17 years who presented to the ED with suicidal thoughts or behaviors were included.

Peer connectedness and pre-existing social reward processing predicts U.S. adolescent girls’ suicidal ideation during COVID-19

AUTHOR(S)
Emily A. Hutchinson; Jennifer S. Silk; Stefanie L. Sequeira (et al.)

Published: August 2021   Journal: Journal of Research on Adolescence
There is major concern about the impact of the COVID-19 pandemic on adolescent suicidal ideation (SI) and peer relationships. This study investigated (1) rates of SI and (2) the extent to which peer connectedness and pre-existing neural activation to social reward predicted SI during the initial stay-at-home orders of the pandemic (April–May 2020) in a longitudinal sample of adolescent girls (N = 93; Mage = 15.06; 69% White non-Hispanic). Daily diary and fMRI methods were used to assess peer connectedness and neural activation to social reward, respectively. Nearly 40% of girls endorsed SI during the initial stay-at-home orders. Greater peer connectedness and neural responsivity to anticipated social reward were associated with a reduced odds of SI during the pandemic among girls.
COVID-19-specific suicidal thoughts and behaviors in psychiatrically hospitalized adolescents

AUTHOR(S)
Taylor A. Burke; Alexandra H. Bettis; Anastacia Kudinova (et al.)

Published: August 2021   Journal: Child Psychiatry & Human Development
This study examined the presence and correlates of COVID-specific suicidal thoughts and behaviors (i.e., thoughts of or engaging in intentional COVID-19 exposure with associated suicidal intent) among psychiatrically hospitalized adolescents. Adolescents (N = 143) completed study measures as part of the standard intake process between March 13th and August 14th, 2020. Participants answered questionnaires assessing COVID-specific passive and active suicidal ideation (SI) and suicidal behavior, as well as COVID-related stressors and emotions, and public health guidance compliance. Findings highlights that COVID-specific SI is common in high-risk youth. COVID-specific SI was associated with COVID-19-related negative emotions, elevated stress, and decreased public health guidance compliance.
Implementing and adapting the SAFETY treatment for suicidal youth: the incubator model, telehealth, and the Covid-19 pandemic

AUTHOR(S)
Jennifer Hughes; Joan R. Asarnow

Published: August 2021   Journal: Cognitive and Behavioral Practice
The Safe Alternatives for Teens and Youth (SAFETY) treatment was developed to decrease the risk of repeat suicidal and self-harm behavior in youth presenting with elevated suicide risk. This paper uses case illustrations to demonstrate the SAFETY treatment, building upon the companion paper describing our “incubator” treatment development model and process (Asarnow et al., 2021). As illustrated in the second case illustration, the incubator model approach was particularly useful during the COVID-19 pandemic switch to telehealth. SAFETY specifically targets suicide and self-harm risk reduction using an individually tailored principle-guided approach, grounded in a case conceptualization that identifies cognitive-behavioral processes and reactions that contribute to increased suicide attempt risk and explains the youth’s suicidal/self-harm behavior within the context of his or her broader social systems. The SAFETY treatment has been tested in two treatment development trials, and results support the efficacy of SAFETY for preventing suicide attempts in adolescents presenting with recent self-harm.
COVID-19 related daily stressors, coping, and suicidal ideation in psychiatrically hospitalized youth

AUTHOR(S)
Anastacia Y. Kudinova; Alexandra H. Bettis; Elizabeth C. Thompson (et al.)

Published: July 2021   Journal: Child & Youth Care Forum

Given reports of the adverse effects of COVID-19 on adolescent mental health, it is critical to understand how it impacts psychiatrically hospitalized youth who may be particularly vulnerable to its effects. This study aimed to advance our understanding of high-risk adolescents’ experiences of COVID-19, including COVID-19-related stress, changes in daily functioning, and coping as they relate to suicidal ideation (SI).

The changes of suicidal ideation status among young people in Hong Kong during COVID-19: a longitudinal survey

AUTHOR(S)
Shimin Zhua; Yanqiong Zhuang; Paul Lee

Published: July 2021   Journal: Journal of Affective Disorders

Pandemics affect the physical and mental well-being of all potentially at-risk young people globally. This longitudinal study examines changes of suicidal ideation status among adolescents during COVID-19. A follow-up after nine-months of a school-based survey among 1,491 secondary school students was conducted during COVID-19. Psychological well-being, psychological factors, family support, and COVID-19-related experiences were examined.

Stressful events and adolescents’ suicidal ideation during the COVID-19 epidemic: A moderated mediation model of depression and parental educational involvement

AUTHOR(S)
Gang Cheng; Jia Liu; Yiying Yang (et al.)

Published: May 2021   Journal: Children and Youth Services Review
This study examined the association between stressful events and adolescents’ suicidal ideation and determined the roles of depression as a mediator and parental educational involvement as a moderator during the COVID-19 epidemic. Survey data from a sample of 1595 Chinese adolescents and their parents were subjected to path analysis. The results indicated that stressful events of the COVID-19 epidemic were significantly positively associated with adolescents’ suicidal ideation, and this association was mediated by depression. In addition, adolescents’ parental educational involvement significantly moderated the path from depression to suicidal ideation.
The men’s mental health perspective on adolescent suicide in the COVID-19 era
Published: April 2021   Journal: Acta Neuropsychiatrica

The COVID-19 pandemic has drastically changed society and introduced many new factors to consider in adolescent suicide risk assessment and prevention. One complexity that warrants consideration is the male-specific impacts of the pandemic within adolescence. A review of the relevant literature.

Suicide among adolescents and youths during the COVID-19 pandemic lockdowns: A press media reports-based exploratory study

AUTHOR(S)
Md. Dilshad Manzar; Abdulrhman Albougami; Norina Usman (et al.)

Published: April 2021   Journal: Journal of Child and Adolescent Psychiatric Nursing

Suicide incidences among adolescents and youths during the Coronavirus Disease 2019 (COVID‐19) lockdowns have been reported across the world. However, no studies have been carried out to investigate cumulative nature, patterns, and causative factors of such suicide incidences. A purposive sampling of Google news between 15 February and 6 July was performed. After excluding duplicate reports, the final list comprised a total of 37‐suicide cases across 11 countries.

Suicidal thoughts and behaviors in psychiatrically hospitalized adolescents pre- and post- COVID-19: a historical chart review and examination of contextual correlates

AUTHOR(S)
Elizabeth C. Thompson; Sarah A. Thomas; Taylor A. Burke (et al.)

Published: January 2021   Journal: Journal of Affective Disorders Reports
Psychiatrically vulnerable adolescents may be at heightened risk for suicide during the COVID-19 pandemic. This study characterizes suicidal ideation (SI) and suicide attempts (SA) in a sample of adolescents psychiatrically hospitalized during COVID-19. Rates of SI and SA are compared to a historical hospital sample from a matched period in the year prior. Associations between specific stressors and COVID-related SI are also explored.
Risk assessment and crisis intervention for youth in a time of telehealth

AUTHOR(S)
Melissa Holland; Jessica Hawks; Lauren C. Morelli (et al.)

Published: January 2021   Journal: Contemporary School Psychology
For the last decade, there has been growing concern regarding the rising rates of youth engagement in self-injury and suicide. The worldwide outbreak of the coronavirus disease 2019 (COVID-19) has elevated these concerns due to increased risk factors pertaining to social, family, economic, and health stressors, in addition to changes to typical routines and support systems. Unfortunately, there are many barriers to at-risk youth being able to access evidence-based mental health services including cost, lack of trained providers, transportation issues, and physical distancing due to the pandemic. Providing school-based prevention and intervention programs that promote social, emotional, and behavioral well-being helps to address many of these barriers. This article highlights important considerations to providing these services in a school-based telehealth modality.
COVID-19 awareness, adoption of COVID-19 preventive measures, and effects of COVID-19 lockdown among adolescent boys and young men in Kampala, Uganda

AUTHOR(S)
Joseph K. B. Matovu; Stephen N. Kabwama; Tonny Ssekamatte (et al.)

Published: January 2021   Journal: Journal of Community Health
There is growing evidence of the challenges with adherence to COVID-19 prevention measures and the effect of the prevention measures on the health of populations in various parts of the world but with limited documentation in sub-Saharan Africa. This study assessed COVID-19 awareness, adoption of COVID-19 prevention measures, and the effects of COVID-19 lockdown on the mental health status, socio-economic disruptions and engagement in unhealthy behaviours among 2500 in- and out-of-school adolescent boys and young men (ABYM) aged 10–24 years in Kampala, Uganda.
Increase in suicide following an initial decline during the COVID-19 pandemic in Japan

AUTHOR(S)
Takanao Tanaka; Shohei Okamoto

Published: January 2021   Journal: Nature Human Behaviour (
There is increasing concern that the coronavirus disease 2019 (COVID-19) pandemic could harm psychological health and exacerbate suicide risk. Here, based on month-level records of suicides covering the entire Japanese population in 1,848 administrative units, this study assessed whether suicide mortality changed during the pandemic. Using difference-in-difference estimation, this study found that monthly suicide rates declined by 14% during the first 5 months of the pandemic (February to June 2020). This could be due to a number of complex reasons, including the government’s generous subsidies, reduced working hours and school closure. By contrast, monthly suicide rates increased by 16% during the second wave (July to October 2020), with a larger increase among females (37%) and children and adolescents (49%).
COVID-19’s effect on students: how school counselors rise to the rescue

AUTHOR(S)
Robert Pincus; TeShaunda Hannor-Walker; Leonis S. Wright (et al.)

Published: December 2020   Journal: NASSP Bulletin
The COVID-19 global pandemic has brought about many changes to our society, which will have long-term effects for our youth and adolescents. Due to social isolation and adverse childhood experiences, there are concerns of suicidality, technology addiction, and school safety as schools attempt to transition to a state of normalcy in the months to come. This crisis will require coordinated efforts to assist students in not only getting back on track academically but also in helping students cope with the trauma they have and are continuing to experience. As a result, insights from school counselors can be used to obtain a better understanding of the social and emotional effects of COVID-19 by collaborating with administrators to emphasize using school counselors as a mental health provider in schools. The authors highlight school counselors’ mental health training and their role in combating this issue and provide practical applications that can employed to create a systemic approach for social and emotional prevention and intervention during and after the pandemic.
Impact of the COVID-19 pandemic on students at elevated risk of self-injury: the importance of virtual and online resources

AUTHOR(S)
Penelope Hasking; Stephen P. Lewis; Elana Bloom (et al.)

Published: December 2020   Journal: School Psychology International
Non-suicidal self-injury (NSSI), which involves deliberate damage to body tissue without suicidal intent, has long been a concern for schools and school staff. Secondary schools are an ideal setting in which to identify, and appropriately refer, students who self-injure as well as implement evidence-based prevention and early intervention programs. However, in the context of the global COVID-19 pandemic, schools have been closed and students sent home to learn online. This may result in the exacerbation of existing anxieties and pose several new stressors that cumulatively may increase risk of NSSI. In this article, we draw on recent research and our collective experience working with schools, as well as digital mental health, to outline some of these potential stressors and offer resources for school staff to help students who are engaging in or at risk of NSSI.
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UNICEF Innocenti's Children and COVID-19 Library is a database collecting research from around the world on COVID-19 and its impacts on children and adolescents.

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COVID-19 & Children: Rapid Research Response

UNICEF Innocenti is mobilizing a rapid research response in line with UNICEF’s global response to the COVID-19 crisis. The initiatives we’ve begun will provide the broad range of evidence needed to inform our work to scale up rapid assessment, develop urgent mitigating strategies in programming and advocacy, and preparation of interventions to respond to the medium and longer-term consequences of the COVID-19 crisis. The research projects cover a rapid review of evidence, education analysis, and social and economic policies.