L E T T E R S TO TH E E D I T O R

Mental Health in High School Students Within a pandemic environment of furloughs and job
at the Time of COVID-19: A Student’s cuts, families may struggle to purchase technology for high
Perspective school students who could benefit from school-based
counseling support for mental health problems. Efforts
should be made for equitable access to technology for ad-
To the Editor: olescents seeking telemental health services through school
he global impact of 2019 novel coronavirus dis- and community providers.3

T ease (COVID-19) is unprecedented and has left

countries grappling with uncertainties. Various
public health measures all over the world have been
POTENTIAL IMPLICATIONS OF THE COVID-19
PANDEMIC FOR HIGH SCHOOL STUDENTS’
implemented to reduce associated illness severity and mor- MENTAL HEALTH
tality. Countries are now coming out of lockdown with The last few months have seen social media platforms such
cautious optimism after successfully flattening the curve as Instagram, Snapchat, Reddit, and TikTok flooded with
with measures such as social distancing, quarantine, and COVID-19 materials.4 Trending of information on these
closure of public places including schools. However, the social media sites is due to the “likes” and “shares,” and any
challenges related to the impact on students’ mental health misinformation leaves adolescents exposed to associated
continue beyond this phase of the pandemic. This article vulnerabilities. The social media infodemic has been linked
highlights key issues and offers practical solutions to address to anxiety, feeling powerless, and catastrophizing situa-
the mental health of adolescents during the COVID-19 tions.4 Further, COVID-19–themed jokes and memes
pandemic from a high school student’s perspective. circulating on social media can lead to pandemic issues not
being taken seriously, which increases the risk of infection
IMPLICATIONS OF THE COVID-19 PANDEMIC and associated distress and trauma.4 Partnerships with par-
FOR HIGH SCHOOL STUDENTS’ ROUTINE ents and social influencers can guide students toward
As with many schools and universities, my school has been healthy information-seeking behavior and positive mental
closed since March 13, 2020, and it is uncertain when classes health strategies. Both increased social media use and
will resume. Adolescence is a crucial period for social devel- traditional forms of education moving to digital platforms
opment. Social distancing and school closures during the have led to the majority of adolescents spending more time
COVID-19 pandemic can worsen existing mental health in front of screens.5 Excessive screen time is often associated
problems in adolescents and increases the risk of future with poor sleep, sedentary habits, mental health problems,
mental health issues.1 A loss of routine for many students, and physical health issues.5
social isolation, and feelings of loneliness increase the risk of Uncertainty, fear of getting the virus, sleep problems,
mental illness.2 An increase in domestic violence and abuse and worries about the future are some of the common
during this pandemic further exposes adolescents to risks of mental health issues impacting adolescents in the face of
developing mental health problems. Historically, schools may the pandemic.3 Increased incidence of mental health
provide a social support network and mental health services problems, including stress-related disorders, depression,
for vulnerable teens. However, closure of schools during the anxiety, and substance abuse, have been described in
COVID-19 pandemic has taken away the protective layer of adolescents during a pandemic.3 Quarantine, trauma, and
school-based mental health support. Closure of community grief during the COVID-19 pandemic further increase
agencies makes the situation even harder. Conversely, the the risk of mental health problems.3 A lack of adequate
COVID-19 quarantine has afforded time for family bonding support systems leaves adolescents to find resources by
over traditional board games and other activities. However, themselves in an underfunded area that continues to face
some students may need additional support for their well- stigma. Family and community supports to foster stron-
being. Virtual meetings with guidance counselors from ger relationships with children and adolescents and
schools can facilitate early recognition and referral to primary involvement of children safeguarding agencies when
care and mental health services. needed can help mitigate risks.

Journal of the American Academy of Child & Adolescent Psychiatry www.jaacap.org 1309
Volume 59 / Number 12 / December 2020
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LETTERS TO THE EDITOR

FIVE STRATEGIES TO SUPPORT HIGH SCHOOL Accepted August 19, 2020.

STUDENTS’ MENTAL HEALTH DURING THE Mr. Thakur is with White Oaks Secondary School, Oakville, Ontario, Canada.
COVID-19 PANDEMIC The author has reported no funding for this work.
The COVID-19 pandemic is a challenging time, and a The author wishes to thank Anupam Thakur, MBBS, MD, Assistant Professor,
multilayered action plan to support students’ mental health University of Toronto and Psychiatrist at Centre for Addiction and Mental
Health, Toronto, for his guidance in manuscript preparation.
during the pandemic is necessary. Such a plan could include
Disclosure: Mr. Thakur has received honoraria from Children’s Mental Health
the following strategies: Ontario (CMHO) and Reach Out Centre for Kids (ROCK) for various volunteer
roles.
 Improving resilience of high school students with self- Correspondence to Aditya Thakur, White Oaks Secondary School, 1330
help strategies: The psychological impact of COVID-19 Montclair Drive, Oakville, Ontario, Canada, L6H 1Z5; e-mail: Aditya.edu@
outlook.com
on adolescents will be felt both in the short-term and
in the long-term,3 and efforts should be made to equip 0890-8567/$36.00/ª2020 American Academy of Child and Adolescent
Psychiatry
adolescents with strategies to build resilience. Students https://doi.org/10.1016/j.jaac.2020.08.005
can be encouraged to create short-term goals and sched-
ules and taught mindfulness techniques to build resil-
ience.3 Acts of gratitude and compassion, such as helping
those in need through volunteer activities, can also help. REFERENCES
1. Clemens V, Deschamps P, Fegert JM, et al. Potential effects of “social” distancing mea-
 Developing peer support networks (buddy system): sures and school lockdown on child and adolescent mental health. Eur Child Adolesc
Psychiatry. 2020;29:739-742.
Creating a buddy system allows high school students to 2. Lee J. Mental health effects of school closures during COVID-19. Lancet Child Adolesc
form peer connections and check in on friends through Health. 2020;4:421.
3. Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the coronavirus
network hubs or mentoring supports, either created by 2019 (COVID-19) pandemic for child and adolescent mental health: A narrative review to
adolescents connected to each other (eg, sports clubs, highlight clinical and research needs in the acute phase and the long return to normality.
hobby clubs) or facilitated by youth organizations. Child Adolesc Psychiatry Ment Health. 2020;14:20.
4. Wiederhold BK. Social media use during social distancing. Cyberpsychol Behav Soc Netw.
 Leverage digital technology for mental health support: 2020;23:275-276.
5. Nagata JM, Abdel Magid HS, Gabriel KP. Screen time for children and adolescents during
High school students can access digital options for sup- the COVID-19 pandemic. Obesity (Silver Spring). 2020;28:1582-1583.
port and resources by exploring online portals that offer 6. Torous J, J€an Myrick K, Rauseo-Ricupero N, Firth J. Digital mental health and COVID-
19: Using technology today to accelerate the curve on access and quality tomorrow. JMIR
resource hubs and self-assessment tools. Self-help apps, Ment Health. 2020;7:e18848.
digital counseling, and telemedicine services will continue
to allow increased access to mental health services from
home.6 Elements of the New Conversation
 Collaborative partnerships: Community mental health
organizations should partner with high school students,
To the Editor:
their families, and schools to co-create mental health
promotion programs. The COVID-19 pandemic has n the editorial comment1 on Greenhill et al.’s
provided us with an opportunity to be digitally connected
and work on collaborative projects, such as community
I report of new MTA data on growth effects of
stimulant medication for ADHD,2 Dr. Charach
calls for a new conversation on stimulant use and makes
mindfulness sessions.
 Ongoing government support through its networks: As a high several important points that we would like to amplify.
school student, I would like to advocate for greater cohe- She notes that “In view of these data, the search for
siveness in governance across all levels—regional, provincial, evidence-based nonmedication interventions ought to
and national—to mobilize and invest in community resources intensify” and recommends “.integrating non-
that promote engagement with local youth organizations. pharmacological interventions that provide proven benefits
to limit total lifetime medication exposure.” In fact, we
Benjamin Franklin famously said: “Out of adversity already have some evidence-based nonmedication
comes opportunity.” The COVID-19 pandemic has pre- interventions. The MTA itself found evidence for a
sented us with myriad challenges, and the way we respond is significant reduction of stimulant dose with better outcome
going to shape the mental health of adolescents for the by adding currently available behavioral treatment
future. (behavior modification, parent training, training in study
Aditya Thakur skills, school programming, daily report card) to optimal
Student medication. However, not only should nonpharmacological

1310 www.jaacap.org Journal of the American Academy of Child & Adolescent Psychiatry
Volume 59 / Number 12 / December 2020
Downloaded for Fakultas Kedokteran Universitas Hasanuddin (meetingresidenpsikiatriunhas@gmail.com) at Hasanuddin University from ClinicalKey.com
by Elsevier on February 09, 2023. For personal use only. No other uses without permission. Copyright ©2023. Elsevier Inc. All rights reserved.