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THE EFFECT OF COVID19 ON ADOLESCENT MENTAL HEALTH

CHAPTER ONE

INTRODUCTION

Background of the study

“With the nationwide lockdowns and pandemic-related movement restrictions in Nigeria, children have spent indelible years of their lives away from family, friends, classrooms, and play which are key elements of childhood itself.

“Children have also suffered an increase in violence and abuse, especially girl children. Even before the pandemic, far too many children were burdened under the weight of unaddressed mental health issues.

“This has been compounded by the pandemic. The impact is significant, and it is sadly the tip of the iceberg,” Hawkins said.

He noted that mental health and physical health were an integral part of health hence they should not be viewed or approached differently, citing the London School of Economics estimates that globally, mental health problems that have led to disabilities or death among young people incurred an economic loss of nearly $390 billion.

The report, therefore, called on governments, private, and public sector partners to act to promote mental health for all children, adolescents, and caregivers.

It suggested that this could be achieved through investments in child and adolescent mental health, breaking the silence surrounding mental illness by addressing stigma, and sensitization to improve understanding of mental health.

“The report notes that a mix of genetics, experience and environmental factors from the earliest days, shape and affect children’s mental health throughout their lifetimes.

“These experiences include parenting, schooling, quality of relationships, exposure to violence or abuse, discrimination, poverty, humanitarian crises, and health emergencies such as COVID-19.

“Protective factors such as loving caregivers, safe school environments, and positive peer relationships can help reduce the risk of mental health problems.

“Significant barriers, including stigma and lack of funding, can, however, prevent many children from experiencing positive mental health or accessing the support they need,” the report stated.

The COVID-19 pandemic has disrupted the lives of adolescents and young people, worsening their prospects for social and economic advancement. The adverse impacts on education, employment, physical and mental health, and wellbeing of populations are unfolding rapidly and in an unpredictable manner. Urgent action is necessary to mitigate the severe and long-lasting impacts from the pandemic and secure the future of young adults. Global findings highlight that the impact on young people is systemic, deep and disproportionate. Youth, and young women in particular, in lower-income countries are bound to suffer intensely.

COVID-19 represents the greatest threat to global public health and economies in the 21st century. To date, more than 100 million people have been infected and over 2.1 million died; likely the tip of the iceberg of this devastating pandemic [1]. The impact on other pandemics and health challenges is masked by the continued dominance of COVID-19 on our lives. The economic and social impact is formidable and growing. In the United States (US) alone, the pandemic’s total cost is estimated at more than US$16 trillion, or approximately 90% of the country’s annual gross domestic product [2]. No country or region has been spared; the crisis has laid bare stark weaknesses in almost every health care system. Within and between countries we have witnessed how already vulnerable and marginalized populations bear a disproportionate burden of infection, with reversal of the development gains made to date.

1.2 Statement of the problem

The United Nations Children’s Fund (UNICEF) says the impact of the COVID-19 pandemic on children’s mental health in Nigeria was rising, as one in six young adults aged between 15 and 24 years was currently experiencing depression.

UNICEF said this in its flagship report, “State of the World’s Children 2021; On My Mind: promoting, protecting and caring for children’s mental health” released on Tuesday, in Abuja.

The report is UNICEF’s most comprehensive look at the mental health of children, adolescents, and caregivers in the 21st century.

It estimates that the current impact of COVID-19 on children’s mental health was a ‘tip of the iceberg’ as the trend was likely to continue in the next years.

The report said that the negative trend can, however, be reversed if the Federal Government increased funding for mental health.

“What we see now is just a ‘tip of the iceberg’. As COVID-19 heads into its third year, the impact of the pandemic on children and young people’s mental health and well-being will continue to weigh heavily.

“One in six young Nigerians between 15 to 24 years, often feel depressed or have little interest in doing things. Data from UNICEF shows that globally, one in seven children have been directly affected by lockdowns.

“More than 1.6 billion children have suffered some loss of education; the disruption to routines, education, and recreation. Concern for family income and health is leaving many young people feeling afraid, angry, and concerned for their future.

“Although almost 46,000 adolescents die from suicides every year, wide gaps persist between mental health needs and mental health funding. Only 2 per cent of government health budgets is allocated to mental health spending globally,” the report said.

The report also said that mental health challenges such as anxiety, depression, eating disorders, intellectual disability, and conduct disorder, can harm the health, life outcomes, and earning capacity of young people.

According to the report, globally, more than one in seven adolescents between 10 to 19 years have been diagnosed with a mental health problem.

The report quoted Peter Hawkins, the UNICEF Nigeria Country Representative, as saying that the lockdown in Nigeria, increased the risk of violence and abuse, especially, among girl children.

1.3 Objectives of the study

1. To understand the effect of covid19 on mental health of adolescents in Nigeria

2. To understand the relationship between covid19 challenges and public health development in Nigeria

1.4 Research Questions

1. What is the effect of covid19 on mental health of adolescents in Nigeria

2. What is the relationship between covid19 challenges and public health development in Nigeria

1.5 Research Hypothesis

H0: There is no relationship between covid19 challenges and public health development in Nigeria

H1: There is a relationship between covid19 challenges and public health development in Nigeria

CHAPTER TWO

Literature review

The COVID-19 pandemic has disrupted the lives of adolescents and young people, worsening their prospects  for social and economic advancement. The adverse impacts on education, employment, physical and mental  health, and wellbeing of populations are unfolding rapidly and in an unpredictable manner. Urgent action is  necessary to mitigate the severe and long-lasting impacts from the pandemic and secure the future of young adults.

Global findings highlight that the impact on young people is systemic, deep and disproportionate. Youth, and  young women in particular, in lower-income countries are bound to suffer intensely

Covid19 had an impact on educational structures across nations. Here are some educational variables related to covid19 pandemic:

» Keeping girls in school has been recognised as an essential pathway to tackle early marriages. School closures coupled with the economic burden and uncertainty for poor and vulnerable households run the risk of reversing decades of improvements in this regard.

» A global survey among young people and adolescents highlights that despite the best efforts of educational institutions to provide continuity through online delivery, 65 per cent of young people report having learnt less since the pandemic began, and 51 per cent believe their education will be delayed.

Socio-economic effect of covid19 among young adults cannot be ignored in this discuss

» The pandemic has created tremendous pressure on the labour market, as businesses shut down and the global economy comes to a standstill. The impact of the crisis on the labour market has hit young people harder than adults.

» Young adults aged 18-24 years are already at greater risk of unemployment, which affects their ability to have stable livelihoods and incomes. COVID-19 worsens these challenges as the supply of quality opportunities is shrinking rapidly and significantly. As unemployment rises, young adults’ prospects of finding decent jobs will become increasingly more difficult in the

short to medium term. Over the long term, it risks the loss of productivity and growth from a significant section of the working age population.

Child Marriage

» Data on child marriage from Nigeria is not available. However, organisations working on and monitoring child marriages have estimated that globally, additional 4 million girls are at risk of child marriage in the next two years due to the COVID-19 crisis.2

» Unmarried adolescent girls and women typically experience challenges in accessing sexual and reproductive health care (SRH) services. Although these services are currently operating at

normal levels, Ministry of Health (MoH) data show a decline in the uptake of new contraception users by (15%) between January and April this year, compared to 2018 and 2019.3 Consultations

with development partners working with adolescents reveal that gender and social norms put SRH services at high risk of being deprioritised, which could lead to an increase in unplanned

pregnancies, child marriages, and unsafe abortions.

» COVID-19 risks increasing levels of the traditional practices of child and forced marriages for labour or money as a way to combat the economic distress resulting from the pandemic.4 Child marriages are more common in families with ethnic groups backgrounds, from rural areas and with mothers and caregivers with lower education levels. In these communities, caregivers often believe that girls are ready for marriage at around age 14.5

Sexual and reproductive health

» The microsimulation model predicts a reduction of contraception prevalence from the baseline of 59.92 per cent to 55.77 per cent in a high-impact scenario.

» Unplanned pregnancies increase the chances of child marriage and consequently, lead to higher school dropout rates. Girls from low-income families, rural areas, especially in northern Nigeria are at highest risk of getting married before the age of 15.

» Due to COVID-19, UNFPA estimates an increase in the number of unintended pregnancies by 15.46 per cent (44,322) in the best-case scenario, and potentially by up to 23.9 per cent (68,541) in 2020-2021 based on the extrapolation of administrative data. Of these unintended pregnancies, 35 per cent are expected to occur among females 15 to 24 years of age. Coronavirus could put 4 million girls at risk of child marriage, 2020

» Instances of child sexual abuse have increased amidst COVID-19 due to the associated lockdown measures. The number of reported rape cases has increased as have the counselling requests for girls under the age of 18 who have been sexually exploited, mainly by family members. Victims often display feelings of depression, trauma, fear and anxiety.

» Discussions with hotline counsellors revealed that many women and young girls experience various forms of violence in Nigeria. For married women, the primary source of conflict that leads to physical and emotional abuse is the distribution of household income. As financial insecurity increases, spousal tensions are likely to increase in many households across Nigeria, increasing the risk of experiencing emotional and physical abuse.Psychosocial Health

» The needs of adolescents differ from those of children or adults; the emotional impact of the crisis and lockdown measures are likely to be far greater on them.6 Adolescence is about developing social skills, empathy and a sense of identity – all of which result from interactions with peers. The COVID-19 crisis places young adults under tremendous psychosocial stress from isolation and is poised to set adolescents back in these critically important social and emotional dimensions of development.

» Adolescents suffer from forced social isolation in powerful ways, both in the short and longterm. Short-term loneliness may encourage adolescents to engage in risky behaviour and

resort to substance abuse. Protracted loneliness can generate mental health issues and increase the long-term risk of depression, obesity and high blood pressure.

» Young people whose education or work is disrupted are almost twice as likely to have anxiety or depression as those who did not experience such disruptions. This underscores the interlinkages that exist between mental well-being, educational success, and labour market integration.

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