Help children cope with pandemic by setting predictable routines: Dr Alok Kulkarni

Children, adolescents have shown remarkable maturity in coping with crisis


Rohit was a chirpy 26-year-old software professional who loved hanging out with his buddies on weekends. He would plan an outdoor biking trip to one of the many beaches on the coastline of Karnataka. But things took a drastic turn for the worse with the outbreak of the pandemic; Rohit’s weekend escapades came to a halt, and he could now socialise with his friends only virtually. The warmth and tenderness of a physical meeting was now being missed. Rohit’s youthful restlessness and zest for life had to cope with an unprecedented challenge. It was not long before he slipped into clinical depression, and was referred to have a chat with me.

Covid-19 has thrown a bevy of complex variables before us. Among these, uncertainty, social isolation, and disrupted routines have had an impact on the mental health of children and adolescents alike. Children have understandable worries related to the consequences of Covid-19. Many are wondering if they will ever be able to freely play with their friends as during the pre-Covid times. Parents are not equipped to calm their children’s anxieties as they themselves are battling numerous uncertainties.

At this critical juncture, one can barely hope to plan for the future as everything is on hold. The challenges facing parents may interfere with their usual ability to address their children’s emotional needs. The United Nations Children’s Fund (UNICEF) recently conducted a poll to assess the impact of Covid-19 on the mental health of adolescents and young people in Latin America and the Caribbean. It assessed 8,500 adolescents and young people between the ages of 13 and 29 in nine countries and territories. The report gave an account of the feelings children and adolescents faced in the first months of the response to the pandemic. Among the respondents, 27 per cent reported feeling anxious, and 15 per cent reported feeling depressed in the last seven days before the poll was conducted. Interestingly, for 30 per cent respondents the main reason that influenced their current emotional state was the economic situation. A significant proportion (46 per cent) of the respondents reported a perceptible lack of motivation to do tasks which they previously enjoyed. Their perception of the future has also been negatively affected, particularly in the case of young women.

In India, schools have remained shut for the entire academic year. Classes are being conducted virtually. This has presented a new set of challenges to both the teaching and student community. Teachers have had to adapt to newer technologies, and students have had to adjust to attending classes from home. Online classes have provided children and adolescents an opportunity for increased internet usage. Students tend to remain glued to their screens long after the classes are over. Alarmingly, frequent and unsupervised internet use is associated with self-harm and suicidal behaviour in adolescents with psychological risk factors. I have had ophthalmology colleagues complain that cases of myopia, dry eyes and computer vision syndrome are increasingly coming to their attention.

I ventured to ask my house-help how her children were coping during the pandemic. Her answer disturbed me a great deal. “My elder son does not want to go back to school. He wants to start working. He is barely fifteen. His father and I are doing everything possible to give him an opportunity to educate himself—something that we were denied. This virus has shattered our dreams,” remarked Shobha, who has been with us for the past 12 years.

Disturbingly, many adolescents have had to deal with the demise of a family member. This itself can spark a range of psychopathology in the longer run. Shalini, a 21-year-old medical student, has had to process the demise of her aunt. Her aunt came down with fever followed by breathlessness. She was immediately shifted to the ICU of a well-known hospital. The very next day she was declared dead. “The randomness and acuteness of the situation is what scares me,” said Shalini during one of the counselling sessions.

I have always been a great believer in the fortitude and resilience of people in the face of a crisis. Children and adolescents have shown remarkable maturity in coping with the ongoing crisis. One of the ways in which we can help our children to cope with this randomness is by setting predictable routines. Structuring their day will enable them to cope better with uncertainty. This is also a great time to pick up new hobbies and skills. Reading is one useful pastime that can be incorporated now more than ever before. It is advisable to indulge in reading physical books which will enable us to switch off from online spaces. Children are filled with boundless energy and enthusiasm. We will have to resort to finding creative ways to channelise this youthful energy productively. Combined workout sessions can be organised at home. This will also provide an opportunity for the parents to bond better with their children. Yoga and aerobic exercises have a calming effect on the mind. I have also been encouraging adolescents to dedicate 15 minutes a day doing nothing. In these 15 minutes, I have been asking them to contemplate as to what they would do once this pandemic settles down. I have had adolescents come to me and say that those 15 minutes have renewed their hope that things will eventually fall into place. It is also vital that children and adolescents seek professional mental health support during this crisis. A great deal of stigma is attached to seeking help to mental health in our country, and it is our responsibility to ensure that every individual has access to good quality mental health care.

The author is senior consultant psychiatrist at Manas Institute of Mental Health in Hubli, Karnataka.