Guidance for parents and carers on supporting children and young people’s mental health and wellbeing during the coronavirus (COVID-19) pandemic

What you need to know

The coronavirus (COVID-19) pandemic is going to affect daily life, as the government and the NHS take necessary steps to manage the pandemic, reduce transmission and treat those who need medical attention.

Regardless of their age, this may be a difficult time for children and young people. Some may react immediately, while others may show signs of difficulty later on.

How a child or young person reacts can vary according to their age, how they understand information and communicate, their previous experiences, and how they typically cope with stress. Adverse reactions may include worrying about their health or that of family and friends, fear, avoidance, problems sleeping or physical symptoms such as stomach ache.

During this time, it’s important that you support and take care of your family’s mental health – there are lots of things you can do, and additional support is available if you need it.

Background

This advice is to help adults with caring responsibilities look after the mental health and wellbeing of children and young people, including those with additional needs and disabilities, during the COVID-19 pandemic.¹

For wider information on how to protect yourself and others, see the guidance on this page.

This guidance will be updated in line with the changing situation.

Looking after your own mental health

As well as thinking about the children or young people in your care, it is important to take care of your own mental health and wellbeing. Children and young people react, in part, to what they see from the adults around them. When parents and carers deal with a situation calmly and confidently, they can provide the best support for their children and young people. Parents and carers can be more supportive to others around them, especially children, when they are better prepared.

See guidance on how to look after your mental health and wellbeing during the COVID-19 pandemic or visit Every Mind Matters for clear advice and actions to take care of your mental health and wellbeing

Helping children and young people cope with stress during the pandemic

There are some key actions you can consider to support your child or young person’s mental health and wellbeing during the pandemic, including:

Listening to and acknowledging their concerns. Children and young people may respond to stress in different ways. Signs may be emotional (for example, they may be upset, distressed, anxious, angry or agitated), behavioural (for example, they may become more clingy or more withdrawn, or they may wet the bed), or physical (for example, they may experience stomach aches).

Look out for any changes in their behaviour. Children and young people may feel less anxious if they are able to express and communicate their feelings in a safe and supportive environment. Children and young people who communicate differently to their peers may rely on you to interpret their feelings. Listen to them, acknowledge their concerns and give them extra love and attention if they need it.

MindEd for families is a free online educational resource on children and young people’s mental health for all adults, which can support parents and carers through these exceptional circumstances.

Providing clear information about the situation. Children and young people want to feel assured that their parents and carers can keep them safe. One of the best ways to achieve this is by talking openly about what is happening and providing honest answers to any questions they have, using words and explanations that they can understand. Explain what is being done to keep them and their loved ones safe, including any actions they can take to help, such as washing their hands more often than usual.

There are resources available to help you do this, including the Children’s Commissioner’s Children’s Guide to Coronavirus, or the Inter-Agency Standing Committee (IASC) have produced a storybook developed by and for children around the world affected by COVID-19.

Make sure you use reliable sources of information such as GOV.UK or the NHS website – there is a lot of misleading information from other sources that can create stress for you and your family. It will not always be possible to provide answers to all the questions that children and young people may ask, or to address all their concerns, so focus on listening and acknowledging their feelings to help them feel supported.

Being aware of your own reactions. Remember that children and young people often take their emotional cues from the important adults in their lives, so how you respond to the situation is very important. It is important to manage your own emotions and remain calm, speak kindly to them, and answer any questions they have honestly.

For further information on how to look after your own mental wellbeing during the pandemic, see the guidance on how to look after your own mental health and wellbeing or visit Every Mind Matters.

Connecting regularly. If it is necessary for you and your children to be in different locations to normal, make sure you still have regular and frequent contact via the phone or video calls with them. Try to help your child understand what arrangements are being made for them and why in simple terms.

Support safe ways for children and young people to connect with their friends. They can meet indoors or outdoors in groups of up to 6. Where this isn’t possible they can also connect online or via phone or video calls. For more advice on helping your children stay safe online, see this guidance on staying safe online during the COVID-19 pandemic.

Creating a new routine. Life is changing for all of us for a while. Routine gives children and young people an increased feeling of safety in the context of uncertainty, so think about how to develop a new routine, especially if they are not at school:

• make a plan for the day or week that includes time for learning, playing and relaxing
• schools have started to welcome back more children, but if they have to stay home from school, ask teachers what you can do to support continued learning at home. The Department for Education has published a list of recommended online educational resources for home schooling
• encourage maintaining a balance between being online and offline and discover new ideas for activities to do from home if needed. The Children’s Commissioner guide signposts to some ideas to help fight boredom
• children and young people ideally need to be active for 60 minutes a day, which can be more difficult when spending longer periods of time indoors. Plan time outside if you can do so safely or see Change4Life for ideas for indoor games and activities
• don’t forget that sleep is important for mental and physical health, so try to keep to existing bedtime routines
• it may be tempting to give children and young people treats such as sweets or chocolate but this is not good for their health, especially as they may not be as physically active as normal. See Change4Life for ideas for healthy treats
• children under 18 that do not live in the same household as their parents or someone with parental responsibility can be moved between their parents’ homes to continue existing arrangements

Limiting exposure to media and talking more about what they have seen and heard. Like adults, children and young people may become more distressed if they see repeated coverage about the COVID-19 pandemic in the media. A complete news blackout is also rarely helpful as they are likely to find information from other sources, such as online or through friends. Try to avoid turning the television off or closing web pages when children or young people come into the room. This can pique their interest to find out what is happening and their imagination can take over. Instead, consider limiting the amount of exposure you and your family have to media coverage.

Young people will also hear things from friends and get information from social media. Talk to them about what is happening and ask them what they have heard. Try to answer their questions honestly but reassure where you can.

How children and young people of different ages may react

All children and young people are different, but there are some common ways in which different age groups may react to a situation like the COVID-19 pandemic. The common reactions to distress will fade over time for most children and young people, though could return if they see or hear reminders of what happened. Understanding these may help you to support your family.

For infants to 2-year-olds

Infants may become more easily distressed. They may cry more than usual or want to be held and cuddled more.

For 3- to 6-year-olds

Preschool and nursery children may return to behaviours they have outgrown, such as toileting accidents, bed-wetting, or being frightened about being separated from their parents or carers. They may also have tantrums or difficulty sleeping.

For 7- to 10-year-olds

Older children may feel sad, angry, or afraid. Peers may share false information but parents or carers can correct the misinformation. Older children may focus on details of the situation and want to talk about it all the time, or not want to talk about it at all. They may have trouble concentrating.

For preteens and teenagers

Some preteens and teenagers respond to worrying situations by acting out. This could include reckless driving, and alcohol or drug use. Others may become afraid to leave the home and may cut back on how much time they connect with their friends. They can feel overwhelmed by their intense emotions and feel unable to talk about them. Their emotions may lead to increased arguing and even fighting with siblings, parents, carers or other adults. They may have concerns about how the school closures and exam cancellations will affect them.

Children and young people who are accessing mental health services

Children and young people with an existing mental health problem may find the current uncertainty around the COVID-19 pandemic particularly difficult. Their increased stress may lead to a change in their behaviours and their mental health needs. If you are concerned about how to access support if they need to stay at home, you may want to think about the following actions.

Speak to your child or young person’s mental health team

Contact them to discuss any concerns and check how care will continue to be accessed. Update any safety and care plans as agreed.

Identify how the support your child or young person normally receives can be maintained

Ask about having appointments by phone, text or online, and how their health professional can offer extra support if your child or young person needs it.

If you usually have support in your home, check with your local authority or care provider what alternative arrangements are in place. Make sure it is clear if support is still needed for your child or young person.

If your child or young person has been admitted to an inpatient mental health unit, talk to the staff about their policies on access to mobile phones and think about how you can stay in contact, particularly if you have to stay at home. Ask the unit if you could participate in a virtual ward round to keep in touch with your child or young person’s mental health team. If you need to stay at home this will also impact on whether your child or young person can come home on leave, so talk to your child or young person about what might happen so they are fully informed.

If your child or young person becomes affected by COVID-19 they will need to be cared for appropriately, so talk to the unit about what plans are in place should this happen and how best to communicate these to your child or young person.

Plan how you will access medication

You might be able to order repeat prescriptions by phone. Or you may be able to do this online using an app or website if your doctor’s surgery offers this.

Ask your pharmacy about getting medication delivered or think about who you could ask to collect it for you. The NHS website has more information about getting prescriptions for someone else and checking if you have to pay for prescriptions.

Continue to order repeat prescriptions in your usual timeframe. There is no need to order for a longer duration or larger quantities.

Your GP might convert your child or young person’s repeat prescription to one that is supplied under the repeat dispensing arrangements. This means you can go back to the pharmacy for a certain number of repeats without having to get a repeat prescription from the practice.

Be careful about buying medication online. You should only buy from registered pharmacies. You can check if a pharmacy is registered on the General Pharmaceutical Council website.

You might also want to make arrangements for your child or young person if you become unwell, for example, making sure a partner, friend, family member or neighbour is aware of important information including their care plan, medications and emergency numbers.

Eating disorders

Children and young people with an eating disorder may find aspects of the current situation particularly challenging, for example, reduced availability of specific foods, social isolation and significant changes to routine.

If your child or young person has an eating disorder, you can seek support and advice from your local community eating disorder team. Most community eating disorder teams support direct access that is not reliant on a referral from your GP.

For children and young people with avoidant restrictive food intake disorder (ARFID), take care about issues that arise if there is:

• reduced availability of specific foods. This may mean your child or young person who is on a limited diet cannot get the foods they eat. Many will go without rather than have something else, but with risk of weight loss or further nutritional deficiency
• significant changes to your child or young person’s routine – for those with ARFID this can be extremely distressing and challenging to manage. Seek advice on how you can reduce the distress and risk of further reduction of their food intake
• general heightened anxiety – monitor existing anxiety and obsessive-compulsive behaviours that are associated with distress and how this is interfering with eating

The eating disorder charity BEAT provides a helpline and have developed guidance with clinicians on how to support your child or young person during this difficult time.

Children and young people with learning disabilities

Children and young people with learning disabilities can feel a loss of control in times of uncertainty. They may need more support or adapted explanations about the pandemic. See the easy-read COVID-19 guide to looking after your feelings and your body for ideas.

A good way to help them could be by:

• supporting their decisions
• representing choices visually through written words, pictures, symbol systems or objects if helpful
• supporting them to express their emotions
• letting them know they are not alone

While listening, take their feelings seriously and don’t judge their emotions. They may feel anxious about big changes, such as the possibility of having to stay at home for a long period. Where possible, it can be helpful to explain any upcoming changes to routine and circumstances before they happen and help them to plan and come up with solutions, such as finding a hobby or doing exercises to relax and cope with anxiety.

For useful tips for talking about feelings, see Skills for Care advice. For further guidance on COVID-19 for those with learning disabilities, including easy read materials, see the Mencap website. BILD (the Learning Disability Professional Senate) have also published a collection of resources that may be useful to support families and carers of people with learning disabilities during the COVID-19 pandemic.