As Public Health Scotland’s (PHS) COVID-19 Early Years Resilience and Impact Survey (CEYRIS) has highlighted, the COVID-19 pandemic has had a significant impact on the lives of all young children and their families in Scotland. This Infant Mental Health Awareness Week, Dr Megan Watson, Public Health Intelligence Adviser at PHS shares her reflections on the impact the pandemic has had on the mental health and wellbeing of families across Scotland. In addition, Megan discusses what support needs to be in place to ensure all children and young people can recover from the impacts of the pandemic.

Having been closely involved in all three rounds of the CEYRIS surveys, I would like to take the opportunity, this Infant Mental Health Awareness Week, to reflect on what we’ve learned about the impact of the pandemic on child and parental health and wellbeing. In addition, I’d like to reflect on how we can work together to ensure that the negative impacts of the pandemic are not long lasting.

Close, nurturing relationships are key to positive infant mental wellbeing

In general, the CEYRIS results highlighted that several parents found creative ways to keep things fun and active for their kids, with many families reporting increased time spent outdoors and improved imaginative play in their children during the pandemic. We also saw that many families found the experience of the pandemic brought them together, with the parents of 5 in 10 children reporting a positive impact on their child’s relationships with people inside their household. Given the crucial role of positive, nurturing family relationships in supporting infant mental wellbeing, this is a positive finding for a large proportion of families in our sample. However, it would be remiss of me if I did not point out that for almost 2 in 10 children, parents reported a negative impact on their child’s relationships with people inside their household. This suggests that a minority of families may benefit from support to develop and strengthen the vital relationships inside their household.

Despite generally positive findings about relationships with household members, the stark reality remained that our youngest children in particular weren’t getting to interact with others outside of their immediate family, be that children their own age or other adults. Our survey found that the parents of 7 in 10 children reported their child’s relationships and interactions with others outside of their home had been negatively impacted by the pandemic. This was particularly evident for children under 2 years old where we also saw far more parents reporting worse outcomes related to speech and language development, as well as imaginative play. This indicates further ways that restricted social interactions affected these youngest children.

Parental mental wellbeing is intrinsically linked to the wellbeing of children

It’s not just the children themselves who have been impacted by the pandemic. We found that the parents of 6 in 10 children in our sample reported the pandemic to have had a negative impact on their own physical health, while 8 in 10 reported a negative impact on their own mental health. We also found a clear association between measures of children’s wellbeing and their parents wellbeing, with a greater decline in behaviour and mood for children living in households where parents were experiencing low wellbeing. The negative impact on parental wellbeing was particularly evident for parents with children under 2 years old. Higher percentages of parents of 0 –2 year-olds reported negative impacts on physical and mental health, increased challenges around the loss of a parental support network and that they felt less connected with their family, friends and the local community compared to parents of older children. For a minority, we also saw concerns related to increased shouting/arguing in the home, including with children, relationship breakdown and drug/alcohol use. All of this indicates increased levels of family stress, which can impact on the health and wellbeing of both parents and children.

Same storm, different boat

One of the most important things we found through our survey, was clear evidence that the impacts of the pandemic have not been equal. In almost all areas we asked about, negative outcomes were reported in more families from low-income households compared to high-income households. We also saw worrying levels of negative impacts on household income and employment, which were again disproportionately experienced by households already living on low income. During the pandemic, we saw families who were already experiencing or at risk of poverty being hit the hardest, while simultaneously seeing more families move into precarious financial situations. Given the current cost of living crisis, this has serious implications.

Given that the impacts of the pandemic have not been equal, recovery will not be uniform. For the majority of families, simply recognising that children might be struggling with their emotions and social interactions will be key, because these behaviours are likely to be linked to children processing and reacting normally to an extraordinary experience. A focus on nurturing positive relationships, play and socialisation will likely be enough to help most children thrive. For others, we might need to be creative with how we deliver some of our services. For example, we are working with the Speech and Language service to look at different models of delivering Speech and Language Therapy to meet the growing population level need for support in this area.

In some cases, specialist services will be required. The challenge will be learning to recognise those children who have been impacted the most and who have the greatest needs. Here, it will be vital that key children’s practitioners in childcare, education and health receive training to recognise and respond to families in need, and we have already started working with the Early Learning and Childcare sector to develop mental health training.

Knowledge is power

Whilst it’s vital that we recognise these uncomfortable truths about some of the ways children and families have been negatively affected, it’s equally important that we recognise these do not have to translate into long lasting impacts. Knowledge is power, and knowing how children have been impacted gives us, all of us, the power to act. As soon as we reported the findings from our first round of the survey in Summer 2020, PHS worked with partners to ensure that policies guiding the COVID response in Scotland protected our youngest children from the harms we were seeing. Now, we continue to work with others to address various issues, including the growing concerns over speech and language and social development.

While some of the findings from our study may seem like common sense, those working with and caring for children have told us how useful it has been to have evidence that what they are seeing and experiencing with children in their care is not unique. This evidence, along with the powerful experience of those seeing the impacts play out first-hand, highlights why it is so crucial that we take a public health approach to recovery. We need to ensure that throughout Scotland we have the right people, with the right resources, in the right places ready to act early to create supportive environments for all our children to thrive, rather than waiting for individual children and families to present for support.

If we can recognise that the pandemic has hit some harder than others, Scotland is well placed to put the needs and rights of children and families at the heart of our COVID recovery. We already have some vital building blocks to work with, including our efforts to enshrine child rights into Scots Law, our commitment to improving support for families through The Promise and the Whole Family Wellbeing Fund, and our collective national and local actions to reduce Child Poverty. We look forward to playing our part in working collaboratively with partners to realise this potential and ensure we create a Scotland where all children can recover from the impacts of the pandemic and thrive.

Addressing the financial and mental health needs of parents and carers will be vital to ensure that all children are given the chance for positive, sustained recovery from the impacts of the pandemic.

For more information on the PHS COVID-19 Early Years Resilience and Impact Survey (CEYRIS) visit our webpages.

For more information on public health messages of good practice in supporting children and young people’s mental health and wellbeing, please visit our webpages.

Last updated: 16 June 2022