The percentage of suicide attempts more than doubled.

A study published in medical journal JAMA Network Open compares reports of mental health issues in China's primary students, from early November 2019 to mid-May, 2020, in relation to the closure of schools in the midst of the pandemic. The survey covered 1,241 students in different age groups residing in Chizhou, Anhui Province, a region that was not as hard-hit with COVID-19 cases as others.

Schools in China were not in session when the coronavirus initially began to spread in January. Officials then decided to delay the start of the spring semester until May.

Conducted by researchers at Anhui Medical University, the survey showed that 18.5 percent of students reported depression symptoms in November. That number jumped to 24.9 perent in May, roughly two weeks after school reopened. Suicide attempts also more than doubled from November to May—from 3 percent to 6.4 percent.

Other alarming stats include an increase in nonsuicidal self-injury (from 24 percent to 31.8 percent), suicide ideation (22.5 percent to 29.7 percent), and suicide plan (8.7 percent to 14.6 percent).

These numbers point to an underlying crisis for the pandemic—mental health challenges in children and young adults, caused or exacerbated by isolation.

Benefits of in-person classroom training

The American Academy of Pediatrics (AAP) actually recommends the physical presence of kids in schools to reduce their mental stress and depression. The group updated the back-to-school recommendations in June, stating that the overall benefits of in-person learning in the classroom outweigh the risks of the virus.

“The AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school,” said their website.

“The importance of in-person learning is well-documented, and there is already evidence of the negative impacts on children because of school closures in the spring of 2020," AAP continues. "Lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation.”

When schools reopened in August

Some schools in the U.S. that decided to reopen in August resulted in educators and students testing positive shortly thereafter. At that point, a few schools returned to virtual learning, while others simply quarantined the people affected.

“What we do know is children have a harder time social distancing. And we can’t put a whole bunch of them in a classroom with a teacher right now,” said Kentucky Gov. Andy Beshear in an August briefing. “Other states that have tried to open this new school year are now having to close. We don’t want to start and stop. That may be more difficult on our children,” he said.

With many schools still doing online learning or a hybrid approach, the challenges of mental health issues remain. Children are missing the support and interaction of close friends and teachers, all while facing national trauma. 

Kids—especially preteens and teens who are already struggling with the changes of adolescence—may not recognize the symptoms of depression themselves. Those include:

  • Persistent sadness or irritability
  • Angry outbursts, frustration, even over small matters
  • Loss of interest in activities; reduced feelings of anticipation
  • Sleep disturbances, including insomnia or sleeping too much
  • Changes in weight
  • Sluggishness and lack of energy
  • Decreased appetite or increased cravings for food 
  • Low self-esteem
  • Anxiety, restlessness
  • Thoughts or attempts at suicide

If you’re noticing these symptoms in your child, please take note. Talk to your child, keep them active in these days of forced isolation and inactivity, and encourage and motivate them.

“If it’s here today but they’re okay tomorrow, that to me is not a cause for concern. What’s more of a concern is when it persists. You want to be on the lookout for changes in sleep, mood, appetite, and general engagement,” explains Rachel Busman, PsyD, a clinical psychologist at the Child Mind Institute.

 If you feel your closed ones may have suicidal attempts or thoughts, please call the National Suicide Prevention Lifeline at 800-273-8255 or text the Crisis Text Line by texting HOME to 741741 to get help.