CHILDREN are not the face of the Covid-19 pandemic but they risk being among its biggest victims as the coronavirus impacts their lives in profound ways, said experts.

They said that while children may not be the direct victims of the coronavirus, they may still suffer mentally after being cooped up at home, observing stringent standard operating procedures at schools, or having loved ones infected with Covid-19.

Children also bear the risk of being exposed to domestic violence, which has increased since the movement-control order (MCO) was first put in place in March.

The experts said children mentally absorb their guardians’ worries about the future, while those with families affected by the pandemic may be vulnerable to physical illnesses.

Experts have also highlighted their concerns about children with pre-existing mental health conditions.

Psychologist Dr Andrew Mohanraj told The Malaysian Insight that the consequences of the pandemic’s effects on children are often overlooked.

“The truth is, both parents’ and children’s well-being have taken a serious hit during the pandemic.

“Children too may be preoccupied with uncertainty about the future and may also be exposed to increased violence and the threat of physical illness, particularly in homes most vulnerable to crisis-related hardship,” said the president of Malaysia’s Mental Health Association (MMHA).

He said children can exhibit unruly behaviour, irritability, boredom and stress.

“In some cases, there could be heightened anxiety and even depression. In severe instances it could also lead to long-term psychological trauma,” he said.

Mohanraj said the provision of social support and other interventions to address families’ economic and mental health needs are crucial at this juncture.

He said the government has mitigated the situation somewhat with direct and indirect financial support given to families.

“This has had a positive impact on preventing significant mental health decompensation in families,” he said.

He said by ensuring adequate support, parents going through hard times can secure a child’s mental wellbeing.

He added that the government could also promote learning without interruption to ensure adequate interaction between students and peers in order to maintain the normal social development of a child.

“Well thought-out measures to encourage children to be physically active while maintaining safety standards remain a challenge,” Mohanraj said.

“The government needs to ensure adequate mental health support within the school system to detect early signs of mental health decompensation in children or parental neglect,” he added.

Missing school

A Unicef report titled Covid-19 and Children said school closures, the lack of outdoor activities, and aberrant dietary and sleeping habits are likely to disrupt children’s usual lifestyles.

The report said these things can potentially promote monotony, distress, impatience, annoyance, and various neuropsychiatric manifestations. 

Dr Amar Singh HSS told The Malaysian Insight some students fear going back to school because of Covid-19.

“I talked to students, some of them don’t want to go back to school even now. They fear Covid-19. And they fear going back to school although they do miss their friends intensely,” said the former head of the pediatric department at the Raja Permaisuri Bainun Hospital in Ipoh, Perak.

“And one other issue that we have is the loss of social circles at this time, so while some of them look forward to going back to school, some are afraid to go back because of Covid-19.

“Some also said ‘I go back to school but I can’t play with my friends like I used to because everyone’s wearing a mask’. So, these things have hampered children,” he said.

Amar pointed out that skipping school was a worrying concern for children who live in abusive homes.

“We estimate one in 10 children is sexually abused in the community so when you cannot go to school, you have no escape, and you’re stuck at home, then both physical and sexual abuse will go up in children, including emotional abuse as well,” he said.

Last year, a total of 424,000 children were found to suffer from mental health problems, according to the National Health and Morbidity Survey (NHMS) 2019.

Amar said the current system has caused the feeling of pressure among children to perform, especially when it comes to education.

“I think with Covid-19, we compound these existing mental health problems, especially for children who are struggling already,” he said.

He said children with pre-existing emotional and developmental problems are particularly vulnerable during this period.

“Children are very sensitive and can sense when something is wrong, they are also able to internalise the fears of those around them, especially their parents,” he added.

“But the majority of children will feel the fear of their parents because parents have lots of fear during this Covid-19 pandemic,” he said.

Routine disrupted

Amar said the MCO had also generated a lot of anxiety, fear, and uncertainty among children.

He also highlighted that the psychological impact would be greater on those living in poverty, such as those in the B40 and Orang Asli communities, as there was very little emphasis on mental health in these communities.

Amar’s concerns are in line with a Unicef report that said children from marginalised communities are particularly susceptible to the infection and may suffer from extended ill-consequences of this pandemic, such as child labour, child trafficking, child marriage, sexual exploitation and death.

“I’m very worried about these communities,” he said.

Amar also highlighted that parents who have kids with disabilities have reported that they cannot cope with their children.

“With autistic children especially, the pandemic and MCOs have disrupted their routine. And routine is a significant and important part of a special needs child’s life.”

Amar said when these special needs children are not able to continue with their usual routines, they would get restless and have many breakdowns.

Dr Lihanna Borhan, Associate Professor in Psychology at International Islamic University Malaysia (IIUM) told The Malaysian Insight the government can do more when it comes to addressing mental health issues.

“Mental health issues should not only become a priority when the cases rise, but preventative measures should also be done, and ideally, promotion of mental health should continue to be done,” she said.

“Mental health initiatives should not be about crisis intervention, it should also include preventive and proactive measures,” Lihanna added.

“We know enough about the possible negative impact to know there has to be a more concerted effort to prevent this from happening to the larger population,” she said.

She suggested that while adhering to the SOP, the government could set up a public “safe place” for children to play.

“Provide ‘play-kits’ for parents who cannot afford to provide them – activities that are appropriate to the children’s developmental level that they can do on their own or with siblings,” she said.

Lihanna said teachers should also be taught and empowered to detect children at risk.

“The various government agencies should come together to come up with a strategic framework to prevent and promote mental health among families and children,” she said.

She added that providing support or places for adults in a family to seek help easily and without exposure to stigma, can help adults deal with their own stress, which may alleviate the risk to children. – September 29, 2020.