Teens are suffering in lockdown isolation. Can tech help?

This won't come as a shock: New research shows that the pandemic is disproportionately impacting children and young people's mental health. But the nuances bear thinking about. The older the child, the greater the chance of being affected; and girls are suffering more than boys. Most aren't getting any help either.

This is the silent scream of the Covid crisis. Although the virus hasn't caused young people as much physical harm, it has left many of them facing not just learning loss but significant emotional distress — be it lack of motivation, anxiety, withdrawal or even suicidal thoughts. Given that half of all adult mental health problems start by age 14, this isn't a problem that can be put off to deal with later. 

Experts advise parents to keep calm, get kids moving and ensure they eat well and sleep enough. No doubt wise advice, but try telling a teenager in a major funk that a walk around the block and the occasional vegetable might be better than bingeing on TikTok or Netflix at 3 a.m.

Part of the answer, at least for those not facing acute problems, is getting kids to better utilize the smart devices they are already glued to. Apps focused on mental health support can help fill in the gaps left by school closures and an overburdened health-care system. 

The first challenge is understanding what kind of support is needed. England's Mental Health of Children and Young People Survey, a large-scale longitudinal study that was published last month, found that 16% of those between the ages of five and 16 have a probable mental disorder, compared to 10.8% in 2017. More than 27% of young women (aged 17 to 22) and 13% of young men now report having a mental disorder. A study from the U.K.'s Education Policy Institute published at the end of January similarly showed a larger drop in well-being for teen girls.

The pandemic has seen a rise in anxiety, depression and behavioral disorders among the young; eating disorders are reportedly also thriving. And many of these effects are being seen around the globe. Some have been dire: Japan found an increase in suicides, especially among girls, during the second wave of lockdowns (they had dropped during the first). 

While the uncertainty and isolation caused by the pandemic affects kids of all backgrounds, the issues are compounded for poorer children. Young people with mental health problems are more than twice as likely to be from families that are falling behind with bills or rent or mortgage payments. These same kids are also suffering the greatest learning losses from lockdowns.

The good news is there's been a surge in digital mental health aids, including some that focus on kids. The hope is that while we wait to regain access to schools and expand support from health care systems, these tools can help prevent the pandemic's emotional wounds from leaving long-term scars.

What used to be a tiny fringe area of health tech has rapidly expanded over the last year, especially in the U.S. Many apps provide chat rooms, text messaging and even one-on-one therapy sessions. They also allow for anonymity and flexibility, and appeal to adolescents who already spend much of their lives online. Unsurprisingly, 2020 was a record year for venture capital investment in mental health tech startups generally, with 146 deals taking in nearly $1.6 billion in VC money as of Dec. 10.

One of the more developed platforms in Britain is from Kooth Plc, the U.K.'s largest provider of digital mental health services for young people, which listed on the London Stock Exchange in September. It provides a range of services from chat rooms to dedicated one-on-one counseling. The company has contracts with 80% of NHS commissioning authorities in England and Wales, so its platform is now widely available. And it says demand for services was up 61% between March and Oct. 2020, compared with the same period the year before. 

Since the start of the pandemic, the youth mental health charity Stem4 has seen more than 500,000 downloads of its free, NHS-approved apps Calm Harm (to discourage self-harm) and Clear Fear (to help manage anxiety). The numbers suggest such apps will become a lot more common if they prove effective.

That remains the big question. Although there are encouraging studies on digital mental health support in adults, especially for those with mild to moderate symptoms, the evidence base for the impact on children and young people is still thin. Around 92% of Stem4 app users say the apps helped reduce the urge to self-harm and symptoms of anxiety at the time of use. But Nihara Krause, the clinical psychologist who founded Stem4, says the apps don't profess to assess or "treat" a problem; rather they're meant to act as aids.

Digital tools are great for reach and accessibility, but they're still best used for those awaiting treatment or those who fall below the threshold of being accepted into NHS mental health services, Krause says. They are not well suited for those experiencing more acute difficulties, where a therapist needs to observe body language or overcome withdrawal. They are also harder to access for those in homes with poor digital connectivity.

As with other areas of pandemic tech-support, the heavy lifting will still be required from schools and public health services. And there will need to be regulatory vigilance as these platforms grow. But bear in mind that young people's mental health needs weren't served all that well before the pandemic. The upside now will be greater awareness and a larger suite of tools they can turn to for support.