The Mental Health Decline in Children during the Covid-19 Pandemic.

Objectives: To examine the impact of the COVID-19 lockdown on children’s mental health. Methods: The sample included a cross-section of children aged 2 to 17 years (2019; n =4, 194; 2020; n = 5, 172), from the National Health Interview Survey. In multivariable models, survey years 2020 and 2019 were the main independent variable used to predict anxiety, depression, and social behaviors in children after adjustment for sociodemographics. Bivariate analysis examined sociodemographics, health care utilization and sleep disturbances by anxiety, depression, and social behaviors. Results: In multivariable models, there was an increased risk of anxiety (aOR = 1.3(1.1, 1.6), depression (aOR= 1.2 (1.0, 1.4) and difficult social behaviors (aOR= 1.2 (1.0, 1.4) in children from 2019 to 2020. Girls were at increased risk compared to boys for anxiety and depression (anxiety; aOR= 1.4 (1.2, 1.8), depression; aOR= 1.2 (1.0, 1.3), however, girls were at decreased risk compared to boys for uncontrolled social behavior; aOR = .51 (.43, .61). Children who lived in poverty compared to affluent children were at increased risk for anxiety and depression. In bivariate analysis using 2020 data, about 57.4% of children reported never feeling well rested and 13.7% of children reported difficulty getting out of bed. Conclusions: Anxiety, depression and difficult social behaviors were exacerbated by the lockdown. Millions of children reported sleep disturbances in 2020, consistent with a population under distress. Effective public health interventions could prevent further declines in mental health and a trajectory into adulthood of poor mental health.