Young adults have suffered the worst mental health effects of COVID-19 as the pandemic cuts them off from vital social interaction, new research suggests.
Children are less likely to suffer severe symptoms or death from COVID-19, but a mental health crisis sparked by the pandemic - often referred to as the 'shadow pandemic' - has particularly targeted the young.
A study from the Australian National University showed 15 to 18-year olds have been the worst-impacted group, as the pandemic severely cut social interaction and work opportunities.
Melbourne-based Madeline, 16, said her motivation had plummeted since the city endured its three-month lockdown in 2020.
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She said she has stopped watching the news, which had become overwhelming, and felt less connected to friends.
"I thought that if we go through this and I do it positively, it's all going to work out. But because it's now seeming like a never-ending thing, I'm trying to block all of the negativity in my life ... But then it's also led to me blocking off the positivity," she said.
"I want to be a doctor and obviously need to work really hard. But that's not motivation enough anymore. It's too doom and gloom."
She has missed out on numerous milestones - friends' 16th birthdays, school trips - and was unable to hug her grandfather, who turned 90 on Thursday. Worse still, her motivation to socialise, even via the limited means allowed under health restrictions, had plummeted.
"You don't want to be bombarding your friends, because they're probably going through the same thing as you. You don't want to put that extra weight on top of them," she said.
"I've noticed I just don't have the energy to text people. I don't have the energy to meet them for a walk or a picnic, now that we can do that."
Madeline said her friends had been disciplined with following health advice and were getting vaccinated. But she was dismayed to see images of anti-lockdown protests she said made a return to normal feel less attainable.
Psychologist with the Australian Association of Psychologists Betty Chetcuti said lockdowns had created a unique psychological reaction in adolescents.
"They're just disconnecting. That numb feeling ... is really serious, and I've not seen this before in any of the years of my practice," she said.
"These kids aren't able to experience these important parts of their childhood and transitioning into adulthood. They're being robbed of those opportunities, and they're fundamental to their wellbeing."
Dr Chetcuti said it was vital that psychologists inform governments' response to the pandemic.
"We're the ones that are best available to help guide the well being of young people. It's leading to a type of distress in young children that we've not seen before in our rooms," she said.
The older a child was, the more significant the effects; 61.8 per cent of parents and guardians of the five-to-nine range reported a negative impact, compared to 63.4 per cent in the 10-to-14 range.
In the 15-to-18 age range, 71 per cent of parents reported their child's mental health had worsened during the pandemic.
The report's co-author Nicholas Biddle said that age group was particularly susceptible to mental health challenges, even before the pandemic saw schools shut and rite-of-passage events cancelled.
"Relatively speaking, social interaction outside the household is more important for older children than it is for younger children, and more important than it is at most points in someone's life," he said.
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The social impact was exacerbated by shrinking work options for younger people, who often sought jobs in the hard-hit services industry.
"If you're trying to get a job in a café, then COVID has a much larger impact than it has for the types of work which someone someone at an older age [is likely to be in]," Professor Biddle said.
Mental health deterioration was effectively uniform across genders, but was particularly felt by children with Aboriginal or Torres Strait Islander parents or guardians, and in states which have endured long lockdowns.
As with all aspects of COVID-19, the impact was most keenly felt by children from low socio-economic backgrounds who Professor Biddle said were more vulnerable to external shocks.
"If you're in a crowded household, then everyone being restricted to the household can be quite challenging," Professor Biddle said.
"If you only have one or two devices in your household, then it's very hard for older children to keep social interaction going when face-to-face interaction disappears."
The ACT has been warned of a psychology service crisis, with pre-existing backlogs exacerbated by increasing demand. The study found over 40 per cent of parents seeking help for their children said it was either difficult or very difficult to access mental health support.
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Professor Biddle said even those who could access support struggled with online consultations, which he described as a "useful stopgap" but "not a replacement" for in-person treatment.
"It's easier to maintain a relationship online than it is to start a relationship. We know that, particularly for adolescence and young adulthood, they have to create a relationship with the service providers [online]," he said.
But a positive by-product of parents being forced to work from home was increased face-to-face time with their family. Younger children especially benefitted from household interactions, Professor Biddle said.
Around five per cent of parents and guardians believed the pandemic had had a positive impact on their child. Professor Biddle conceded the data set was too limited to draw concrete conclusions on that figure, but said it "lines up quite well with that explanation".
"Despite the national economic shock, some people's income has also improved, because of either government support or other factors specific to them," he said.
"That's likely to flow through into their into their child's outcomes."
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