CONNECT
search advanced search
UNICEF Innocenti
Office of Research-Innocenti
search menu

Mental Health

Mental Health

Even before the COVID-19 pandemic started, mental health emerged as a critical issue for children and young people – one that requires more research and evidence to better inform programmes, policies and practice.

In November 2019, UNICEF Innocenti’s inaugural Leading Minds event gathered thought leaders, researchers, and young mental health advocates to discuss the pressing issues surrounding mental health of children and young people. UNICEF Innocenti has continued to build on the momentum created by this groundbreaking event by contributing to the growing knowledge and evidence base looking at the impacts of events, programmes and policies on mental health and also outcomes for mental health.

“Too many children and young people, rich and poor alike, in all four corners of the world are experiencing mental ill health as we have never seen before. This is the silent emergency of our times. It has no borders and requires urgent attention.”
– Henrietta H. Fore, Executive Director of UNICEF

 

Why mental health?

Up to 20 per cent of adolescents globally experience mental disorders, three out of four adult mental health problems begin during childhood and adolescence, and an alarming proportion of adolescents – 5-10 per cent in high-income countries and 15 per cent in low- and middle-income countries –  attempt suicide. 

These are just a few data points collected right before the pandemic struck. Since the onset of COVID-19, concerns over the mental health of children and young people have soared. UNICEF Innocenti has been working hard to fill gaps in knowledge on mental health for children and young people as it relates to COVID-19 and beyond.

The role of research on mental health of children and young people

Strengthening the evidence base on mental health for children and young people is imperative to ensure that UNICEF’s programming efforts as well as recommendations for policy and practice related to mental health are effective.

UNICEF Innocenti’s new research programme on mental health aims to shed light on the state of mental health of children and adolescents in various settings, including and beyond the context of the COVID-19 pandemic. This research will help identify how best to respond in ways that maximize effectiveness and efficiencies of interventions and promote the realization of the right to health of every child and adolescent everywhere. Research will also create a deeper understanding of the social determinants of mental health, including risk and protective factors at various developmental phases of a child’s life.

Explore our recent research and stay tuned for our forthcoming publication this fall: Life in Lockdown: Child and adolescent mental health and well-being in the time of COVID-19.

Publications

Life in Lockdown: Child and adolescent mental health and well-being in the time of COVID-19
Publication Publication

Life in Lockdown: Child and adolescent mental health and well-being in the time of COVID-19

COVID-19 lockdowns have significantly disrupted the daily lives of children and adolescents, with increased time at home, online learning and limited physical social interaction. This report seeks to understand the immediate effects on their mental health. Covering more than 130,000 children and adolescents across 22 countries, the evidence shows increased stress, anxiety and depressive symptoms, as well as increased alcohol and substance use, and  externalizing behavioural problems. Children and adolescents also reported positive coping strategies, resilience, social connectedness through digital media, more family time, and relief from academic stress. Factors such as demographics, relationships and pre-existing conditions are critical. To ensure children and adolescents are supported, the report recommends building the evidence on the longer-term impact of the pandemic on child and adolescent mental health in low- and middle-income countries, including vulnerable populations. To ensure children and adolescents are supported, the report recommends building the evidence on the longer-term impact of the pandemic on child and adolescent mental health in low- and middle-income countries, including vulnerable populations.
Mind Matters: Lessons from past crises for child and adolescent mental health during COVID-19
Publication Publication

Mind Matters: Lessons from past crises for child and adolescent mental health during COVID-19

COVID-19 is a crisis like no other in modern times. It has reached every population and community. While the evidence base is still nascent, this report looks at the impacts of disasters and past epidemics – such as Ebola, HIV, SARS/MERS and Zika – on child and adolescent mental health and psychosocial wellbeing, and examines how these insights can guide policies and progammes to support children, their families and communities during the current pandemic.
Rapid Review Protocol - Life in Lockdown: Child and adolescent mental health and well-being in the time of COVID-19
Publication Publication

Rapid Review Protocol - Life in Lockdown: Child and adolescent mental health and well-being in the time of COVID-19

While there has been a global rush to generate rapid evidence on COVID-19 mental health impacts among adults, limited evidence exists on the potential impacts on children. This is the protocol for our rapid review that seeks to (i) understand the immediate impact of COVID-19’s first wave on the mental health of children and adolescents (0–19 years); and (ii) apply lessons learned from this pandemic to mitigate the impacts of future health crises. The key research questions of this review are: What has been the immediate impact of COVID-19 and associated containment measures on the mental health and psychosocial well-being of children and adolescents? How and which risk and protective factors have affected mental health during COVID-19 and have they varied across subgroups of children and adolescents?
Worlds of Influence: Understanding What Shapes Child Well-being in Rich Countries
Publication Publication

Worlds of Influence: Understanding What Shapes Child Well-being in Rich Countries

A new look at children from the world’s richest countries offers a mixed picture of their health, skills and happiness. For far too many, issues such as poverty, exclusion and pollution threaten their mental well-being, physical health and opportunities to develop skills. Even countries with good social, economic and environmental conditions are a long way from meeting the targets set in the 2030 Agenda for Sustainable Development. Focused and accelerated action is needed if these goals are to be met. The evidence from 41 Organisation for Economic Co-operation and Development (OECD) and European Union (EU) countries tells its own story: from children’s chances of survival, growth and protection, to whether they are learning and feel listened to, to whether their parents have the support and resources to give their children the best chance for a healthy, happy childhood. This report reveals children’s experiences against the backdrop of their country’s policies and social, educational, economic and environmental contexts.
Leading Minds Conference 2019: Healthy Minds, Healthy Futures. Summary report
Publication Publication

Leading Minds Conference 2019: Healthy Minds, Healthy Futures. Summary report

Summary report of the inaugural Leading Minds conference "Healthy Minds, Healthy Futures", eld in Florence on 7-9 November 2019

Journal Articles

We Are All in This Together: COVID-19 and a Call to Action for Mental Health of Children and Adolescents
Journal Article Journal Article

We Are All in This Together: COVID-19 and a Call to Action for Mental Health of Children and Adolescents

The COVID-19 pandemic has exposed the urgent need to tackle the crisis of mental health among children and young people. We call for a multi-stakeholder Global Mental Health Alliance for Children, which would achieve the following objectives: to strengthen evidence and understanding of mental health and well-being, causes and risks for children and young people; to scale up investment in mental health programming for children and young people, and particularly expanding the global cadre of health workers, social workers and community workers, with a focus on prevention and promotion of mental health; to support youth-led, evidence- and rights-based initiatives; to expand advocacy and knowledge of mental health for children and young people among the wider public, and reduce stigma, marginalization and discrimination against those experiencing mental ill-health; and to enhance funding from both the public and private sectors for promotion of mental health, prevention of ill-health and treatment of mental health disorders.
Contextualising the link between adolescents’ use of digital technology and their mental health: a multi‐country study of time spent online and life satisfaction
Journal Article Journal Article

Contextualising the link between adolescents’ use of digital technology and their mental health: a multi‐country study of time spent online and life satisfaction

Evidence on whether the amount of time children spend online affects their mental health is mixed. There may be both benefits and risks. Yet, almost all published research on this topic is from high‐income countries. This paper presents new findings across four countries of varying wealth.We analyse data gathered through the Global Kids Online project from nationally representative samples of Internet‐using children aged 9 to 17 years in Bulgaria (n  = 1,000), Chile (n  = 1,000), Ghana (n  = 2,060) and the Philippines (n  = 1,873). Data was gathered on Internet usage on week and weekend days. Measures of absolute (comparable across countries) and relative (compared to other children within countries) time use were constructed. Mental health was measured by Cantril’s ladder (life satisfaction). The analysis also considers the relative explanatory power on variations in mental health of children’s relationships with family and friends. Analysis controlled for age, gender and family socioeconomic status.In Bulgaria and Chile, higher‐frequency Internet use is weakly associated with lower life satisfaction. In Ghana and the Philippines, no such pattern was observed. There was no evidence that the relationship between frequency of Internet use and life satisfaction differed by gender. In all four countries, the quality of children’s close relationships showed a much stronger relationship with their life satisfaction than did time spent on the Internet.Time spent on the Internet does not appear to be strongly linked to children’s life satisfaction, and results from one country should not be assumed to transfer to another. Improving the quality of children’s close relationships offers a more fruitful area for intervention than restricting their time online. Future research could consider a wider range of countries and links between the nature, rather than quantity, of Internet usage and mental health.
Government of Malawi's unconditional cash transfer improves youth mental health
Journal Article Journal Article

Government of Malawi's unconditional cash transfer improves youth mental health

We explore the impacts of Malawi's national unconditional cash transfer program targeting ultra-poor households on youth mental health. Experimental findings show that the program significantly improved mental health outcomes. Among girls in particular, the program reduces indications of depression by about 15 percentage points. We investigate the contribution of different possible pathways to the overall program impact, including education, health, consumption, caregiver's stress levels and life satisfaction, perceived social support, and participation in hard and unpleasant work. The pathways explain from 46 to 65 percent of the program impact, advancing our understanding of how economic interventions can affect mental health of youth in resource-poor settings. The findings underline that unconditional cash grants, which are used on an increasingly large scale as part of national social protection systems in Sub-Saharan Africa, have the potential to improve youth mental wellbeing and thus may help break the vicious cycle of poverty and poor mental health.

News & Commentary

Past crises offer solutions to the mental health fallout of COVID-19
Article Article

Past crises offer solutions to the mental health fallout of COVID-19

(29 July 2021, FLORENCE) From the outset of the COVID-19 pandemic, concerns about its impact on the mental health of children and young people were widespread. While the evidence is still emerging, there are many signs it could be severe and widespread. Faced with a potential “pandemic within a pandemic”, evidence-informed responses are urgently needed to support mental health.   A new report by UNICEF Innocenti, ‘Mind Matters: Lessons from past crises for child and adolescent mental health during COVID-19’, reviews the impact of past crises (such as natural disasters and the HIV epidemic) on youth mental health with the aim of informing responses to the current crisis. A second report – Life in Lockdown – to be released later this year (protocol available here), will synthesize the evidence on COVID-19’s impact on youth mental health.  “Too many children and young people, rich and poor alike, in all four corners of the world are experiencing mental ill health as we have never seen before. This is the silent emergency of our times. It has no borders and requires urgent attention.” – Henrietta H Fore The review finds that children and young people are at elevated risks of anxiety and depression, trauma, loneliness and isolation, suicide, and loss, which can have acute and long-lasting effects on child and adolescent mental health. Interventions to address these adverse impacts include rapid screening, parenting programmes, community and school-based programmes, and using digital tools and platforms. These interventions must be mindful of ages and stages. For example, younger children may struggle to process the temporal nature of the pandemic, whereas older children understand the implications of the pandemic more fully, which can elevate anxieties.  “Accelerator interventions” that combine interventions with other health care services and through common delivery platforms, such as schools, can address multiple aspects of children’s mental health simultaneously and reap benefits beyond the sum of those achieved through individual interventions. A review of 158 studies confirm key accelerating measures for improving mental health: interpersonal skills, emotional regulation, and direct alcohol and drug education. As is often the case, the most vulnerable children and adolescents are likely to be hardest hit by mental health impacts. There is substantive evidence that COVID-19’s biggest impact on children is on their socioeconomic environment, including access to social services, household poverty, and mobility restrictions. These children and adolescents should receive particular attention through screening and targeting of interventions. “All my plans are cancelled which means I have nothing to look ahead to and you find yourself trapped in a void of your own thoughts” – Anonymous, UK The review notes a paucity of evidence on youth mental health, particularly for younger children. While the COVID-19 crisis is generating many studies on the topic, many are methodologically weak. The crisis provides an opportunity to generate rigorous evidence on a topic that until recently had been mostly overlooked. This new evidence should showcase the voices of young people who serve as a vibrant guide to their experience, their solutions, and their priorities.  Visit our COVID-19 Rapid Research Response website. Browse hundreds of entries on COVID-19 and mental health in our Research Library and read our Research Digest on the topic. Listen to our podcast with mental health youth leaders to learn what they think is needed to better support youth mental health.  
What were the immediate effects of life in lockdown on children?
Article Article

What were the immediate effects of life in lockdown on children?

10 October 2021 – Building on the first report in a series on child and adolescent mental health and timed with the launch of UNICEF’s State of the World’s Children 2021: On My Mind: Promoting, protecting, and caring for children’s mental health, a new report released for World Mental Health Day in 2021 looks at how the early stages of the global COVID-19 pandemic in 2020 affected the mental health of children and adolescents. A rapid evidence review was conducted to understand two key research questions: What has been the immediate impact of COVID-19 and associated containment measures on the mental health and psychosocial well-being of children and adolescents? Which risk and protective factors have affected the mental health of children and adolescents during the COVID-19 pandemic, and how have these factors varied across subgroups of children and adolescents? Building on a framework established for UNICEF Innocenti’s Worlds of Influence research report, the conceptual framework guiding the report explored the ramifications of COVID-19 on the child’s intimate world, the world around them and the outer worlds of influence while also assessing pre-existing and on-going risks. Uniquely the report also looked at positive mental health outcomes of the pandemic and found evidence on the impact of the pandemic on special populations and vulnerable groups including but not limited to migrant children, children in humanitarian settings, and children with disabilities.  Life in Lockdown’s rapid research review included more than 130,000 children from 22 different countries. Most studies were from high- and upper-middle-income countries that were immediately affected by high infection and death rates in the early part of the pandemic, namely: China, the United States, and Italy. Key findings: Females reported greater depressive symptoms, anxiety and externalizing behaviout while males reported greater alcohol and substance abuse during COVID-19. Older children and adolescents reported higher and more severe rates of depressive symptoms. Children living in more affected areas, rural areas, or near the epi-centres of COVID-19 outbreaks were associated with higher stress and depressive symptoms including anxiety and substance abuse. Children living in poverty or in lower socio-economic status were found to be at greater risk of stress and depressive symptoms, whereas higher socio-economic status was found to be a protective factor. Children with pre-existing conditions were more significantly affected by pandemic-related changes. Children in lower socio-economic settings or humanitarian settings experienced more depression and trouble adapting to online education. Children who were exposed to pre-existing childhood abuse and neglect were at increased risk of stress. Family conflict increased the risk of mental distress among children and adolescents. Separation from families and parental depression were also risk factors for stress and adjustment during the Pandemic. Stigma based on ethnicity and all forms of racial discrimination were associated with greater anxiety among adolescents. Social isolation and loneliness during lockdowns contributed to a range of outcomes including depression, irritability, anxiety, stress, alcohol use and sedentary behaviours.  However, in some studies, children reported benefits of confinement including spending time with family, relief from academic stressors, which correlated with more life satisfaction. Experience or fear of exposure to COVID-19 predicted stress and depressive symptoms but also positive outcomes of health promotion and infection prevention, great social distancing and news monitoring. Children and adolescents who spent more time on physical activities and maintaining routines were better protected from depressive symptoms. Stress management, leisure activities and regular communication with loved ones proved to be protective coping strategies to deal with the lockdown stressors. Engaging in recreational activities, using technology to communicate with loved ones, having more time for oneself and one’s family, protected against anxiety and contributed to overall wellbeing during the pandemic.  Recommendations from the research for policy and programming: It’s never too early to start building a foundation for positive mental health in children.  Foster family-friendly policies to support parents and quality family time during pandemics. Invest in age- and gender-sensitive child and adolescent mental health care interventions and services. Promote physical activity and good nutrition for young people. Make schools a safe space for positive mental health. Focus on at-risk young populations. Address stigma and discrimination in mental health. Support digital technologies as a force for change.  Download the report to read about the recommendations to close the gaps in research on effects of COVID-19 on mental health.  

Events

Beyond Masks: A Policy Panel Discussion
Event Event

Beyond Masks: A Policy Panel Discussion

UNICEF Innocenti’s new report – Beyond Masks: Societal impacts of COVID-19 and accelerated solutions for children and adolescents – offers a comprehensive picture of the health, economic, and social impacts of the pandemic, and its implications for children and adolescents. The report examines evidence from the current crisis, examines past health crises such as HIV/AIDS, SARS and Ebola to provide insights into the current one, and proposes proven and promising solutions.
Leading Minds Conference 2019
Event Event

Leading Minds Conference 2019

7-9 November 2019 - UNICEF convened its inaugural Leading Minds conference this year, taking the pressing issue of mental health of children and young people as its theme. The purpose of the annual Leading Minds conference series is to bring attention to a theme pertinent to the present and future wellbeing of the world’s children and young people by convening some of the world’s leading minds to examine available evidence and solutions and contribute to accelerating progress on solutions and breakthroughs.