Rapport 6: The mental health adolescents and emerging adults: Current status and policy recommendations 

Although adolescents and emerging adults are not particularly vulnerable for the medical consequences of the COVID19 virus, they are disproportionally vulnerable for the psychological side effects of the current pandemic and the accompanying restrictions. Research at different Belgian universities shows that the current situation of adolescents and emerging adults is very worrying, both in terms of their school and social development as well as their overall mental health. For this reason, the ‘Psychology & Corona’ expert group asks specific attention and immediate action for this group. Scientific evidence shows that (1) sufficient and high-quality social interaction has a protective effect against psychological maladjustment and contributes to motivation, school performance, and academic success and that (2) a focus on rewards, appreciation and empathic support instead of punishments and criticism is far more motivating. After summarizing key findings illustrating the motivation and mental health problems that adolescents and emerging adults phase nowadays, we provide a set of eight policy recommendations.   

 

  1. Current status

 

1.1 Importance of social interactions and relatedness 

                          

As a result of the corona situation, adolescents and emerging adults are deprived of much needed social interactions. Developing social relationships with peers and experiencing connectedness is a basic psychological need, the satisfaction of which contributes to the mental health and social and academic integration of young people[1]. Strong ties with friends is not only important for their personal development, it also prevents them from dropping out academically. Such drop-outs do not only jeopardizes their personal future, but also that of the society as a whole.

 

During adolescence (10-18 years old) and emerging adulthood (18-25 years old), social interactions with peers are crucial to meet normative developmental tasks. Young people start to function independently of their family, develop their own identity, build intimate friendships, start romantic relationships, and grow into active, responsible citizens. For all these steps, social interaction and social relationships with peers are crucial[2]. Yet, findings among both adolescents and emerging adults point out worrisome trends, as discussed next. 

 

Adolescence. Even in non-COVID times, one out of five adolescents (i.e., 20%) reports moderate to severe mental health problems and social support and good social skills are found to be associated with fewer mental health complaints[3]. Cross-sectional results in 2008 Belgian adolescents and emerging adults (16-25) showed 65% being mentally distressed during the first wave of COVID19, and this was again related to loneliness, lack of social support and social contact[4]

 

Students and emerging adults. For students in higher education, social relationships and interactions are not only crucial for their well-being, but also for their study success, thereby reducing the risk of drop-out. We get a lot of signals that students and young people in general, are not functioning well. These personal stories of students and those in their close network (e.g., parents, student psychologists) are also confirmed in recent study findings. More than other age groups, students report lower overall mental health[5] (table 1), they suffer from loneliness, a lack of motivation, and psychological complaints (figure 1)[6]. Findings from the motivation barometer indicate that Flemish 18-25 year olds systematically report lower relatedness and autonomy need satisfaction (see figure 2), while reporting less voluntary motivation, a higher sense of pressure and more discouragement to adhere to the measures (see figure 3). 

 

Conclusion: It is crucial for the young people themselves as well as for the future of our society to maintain and/or restore as much as possible the social fabric of young people within or even despite the current circumstances.

 

1.2 Focus on rewards instead of punishments

 

The current communication about the corona measures is very focused on what is not going well and its potential consequences. For the many young people who are little at risk and follow the measures to the best of their abilities, this feels as if there is little recognition and appreciation for their efforts. Learning theories have shown that rewarding individuals has a more motivating impact than (threats of) punishment and criticism. At the moment, communication from the government is experienced by young people as largely punitive rather than rewarding. This may be one of the explanations for the observation that their motivation is declining and that many feel excluded from the social debate. Instead, youngsters want to be heard and giving them a voice is critical, even when there is little choice to reconsider the measures. 

 

Conclusion: To help youngsters and students to cope with the current challenges and to foster their motivation, it is crucial to place their efforts in a positive perspective. 

 

2. Policy recommendations

 

Several decisions taken so far, such as appointing 1500 extra psychologists and offering forums where young people can talk or chat, are aimed at coping with mental health problems rather than at preventing them. These are interesting and valuable initiatives, but their focus is on the individual and on remedying what went wrong. We suggest that it is critical in addition to that to prevent mental health problems in young people by restoring their necessary social network within the boundaries of what is virologically safe. It is also essential not to increase social inequalities and distress of vulnerable groups. We must promote an inclusive discourse to help reduce disparities.Overall, it is important to not only work for young people but also with them, actively engaging them in the public debate and in concrete discussions on measures relevant to them, using their creativity to find solutions that serve their needs in these difficult circumstances.

 

 

1) Alternative bubbles: The current measures are largely tailored to a typical family situation (i.e., parents + children) or to people living alone, but not to the typical situation of students or other people living in ‘group’ accommodation. For example, students living in dorms or student housing and teenagers in residential institutional care are considered living alone and are not allowed to form a ‘bubble’ with their housemates, depriving them from the necessary social contacts. 

Recommendation: Because it is unclear whether alternative bubbles can be formed today, this grey zone needs to be clarified immediately. 

  • We propose to give people (including students) the possibility to create alternative bubbles (e.g. dorm, study or institution bubbles) outside the current family bubbles. 

  • Individuals are asked to commit themselves to (sign) a social contract, which specifies their way of conduct and the implications of forming an alternative bubble.

  • Such a commitment would imply that they can only exchange this bubble (e.g. with those of their parents) after a negative corona-test and/or that they have to adhere to the strict corona-measures when visiting others (such as their parents) outside their alternative bubble. Easy access to test facilities for free should be facilitated.

 

2) Priority to secondary and higher education: Education is one of the most important ways to develop and get in touch with. In contrast to primary and secondary education, higher education is now almost entirely online, with obvious negative social consequences for students. Online education and online contacts are not a full replacement for on-campus education and real informal contacts. It is incomprehensible for +18 years why students in secondary schools are allowed to go (part-time) to school while this is very restricted for students in higher education. 

Recommendation: We strongly recommend allowing on-campus contact moments in smaller groups for all students (which is now very much the exception) – e.g. one contact moment per student per week. 

  • This can be in the form of practica or seminars in small groups (e.g. 8 persons), but could also be in the form of a study group of 8 students that study together once a week on campus. 

  • These contact moments among students can be organized safely and according to regulations, while giving students some structure and the highly needed social contact and connectedness.

 

Recommendation: It is recommended to implement specific and more intensive testing strategies in this age group to increase the possibility for social interaction, including these weekly on-campus contacts in smaller groups or for other social or school activities such as class trips (e.g. the strategy used to let professional soccer players play but also recent developments that are being taken in Austria[7]). If students can be first tested (or self-test) before taking part in on-campus or other social activities, the group meetings in smaller groups should be feasible without increasing the risk of virus spreading. 

3) Increasing possibilities for social contacts outside school context: It is important to also investigate how social contact outside a school context can be allowed. Informal social contacts are highly important for the development of young people, but it would also impact young people that are no longer attending school. Sports and physical activity also contribute to the youngsters’ well-being. Such activities need to be organized in a safe and regulated environment.

Recommendation: In the sequence of relaxations, we recommend prioritizing opening up youth sport and youth movements for +12 as well. In a next step of easing restrictions, student organizations could be included as well. These are structured activities where clear agreements can be made on what is safe and acceptable, given the current virus situation. Again, a more intensive testing strategy could be helpful in this respect.

 

4) Financial and academic support for students: The government provides support for many sectors and groups of the population. We believe that support measures are also important for the target group of young people. First, a flexible and supportive approach is needed towards delays in academic progress.  Second, working students are extra vulnerable because they typically combine different (psychosocial and financial) risk factors. 

Recommendation: First, we suggest temporary but substantial flexibility in the requirements for learning credits during this academic year as a sign of support for students not to give up. Second, financial support is needed for young people who depend on student jobs (largely suspended now) and for young adults struck by (temporary) unemployment to support their current living situation. 

 

5) Public recognition: Although it is stated that mental well-being of young people is high on the agenda, this is not experienced as such - not by young people themselves, nor by people who work with them on a daily basis (illustrated by more than 300 signatures on an open letter[8] calling for more support for youngsters, and by a recent study showing that the longest the waiting lists for mental health in Flanders were for youngsters[9]). Also, in the public opinion, standing up for young people appears to be very polarizing. 

Recommendation: Policy makers and politicians need to acknowledge explicitly that young people are experiencing very difficult times and make lots of efforts in the interest of society (not in their own interest). 

 

6) Schools for young people with special needs: Schools for young people with special needs serve an important function. Continuity in contact with professionals is important for the personal development of the children, but it is also important for parents. Taking care of a child with special needs requires a constant presence and psychological investment. Families are also often less supported by friends or extended family.

Recommendation: We recommend to keep schools for children with special needs open during the coming break in February (and definitely not to extend this break for this group).  

 

7) Positive and motivating communication: The communication from the government so far is mainly focused on sanitary measures and on the potential risks still ahead. Yet, a more rewarding and motivating approach should be put forward to give perspective and hope while messages that cause despair (‘no matter what we do, things keep getting worse’) should be avoided. This is particularly important for young people!  

Recommendation: It is important to give people (including young people) 

  • a time frame with intermediate goals which serve as critical virological and psychological milestones, and

  • provide systematic, concrete and positive feedback on citizens’ efforts, which explains why the curves have decreased, lives have been saved and has put us in a better position than our neighbouring countries.

 

8) Student psychologists: Because of the strongly increasing demands from students in need of intensive support and care, there is a shortage of student psychologists at several universities.

Recommendation: We propose to provide financial support to institutions in higher education to (temporarily) hire additional student psychologists. 

 

9) Emerging adults (+18 year olds) outside education: We are particularly worried about young people (+- 18-25 yr old) outside the well-structured contexts of higher education. Often, they work in little solid vocational contexts (small businesses, horeca, etc.) that may be struck by temporary unemployment and/or high job insecurity while living alone with little financial resources. Few may be member of youth organisations and many of them are likely to fully depend on friends for their social life. Because we have little or no information on them, they run the risk of being a forgotten group.  

Recommendation: we suggest that policy makers reach out to this group to 1. assess their psychosocial conditions and mental health; 2. provide support for their specific needs that would emerge from the assessment.  

 

Contact:

 

Inez Germeys: Inez.germeys@kuleuven.be , 0498 543049

 

Omer Van den Bergh: omer.vandenbergh@kuleuven.be

 

Maarten Vansteenkiste: Maarten.Vansteenkiste@UGent.be

 

Anne-Marie Etienne: am.etienne@uliege.be

 

References: 

[1] Vermote, B., Waterschoot. J., Morbée, S., Van der Kaap-Deeder, J., Schrooyen, C.,

Soenens, B.,Ryan, R., & Vansteenkiste, M. (in revision). Do psychological needs play a role in times of uncertainty? Associations with well-being during the corona crisis. Journal of Happiness Studies 

[2] See also opinion piece of Prof. Crone (Erasmus University Rotterdam) in NRC: https://www.nrc.nl/nieuws/2020/12/31/het-welzijn-van-jongeren-is-in-ieders-belang-a4025797

[3] SIGMA study KU Leuven

https://gbiomed.kuleuven.be/english/research/50000666/50000673/cpp/images/sigma-rapport-w1

[4] Rens E., Smith P, Nicaise P, Lorantz V, Van den Broeck K. Mental distress and its contributing factors among young people during the first wave of COVID-19: a Belgian survey study. Frontiers in Psychiatry (accepted), https://www.researchgate.net/publication/348382312_Mental_distress_and_its_contributing_factors_among_young_people_during_the_first_wave_of_COVID-19_a_Belgian_survey_study

[5] Glowacz, F., & Schmits, E. (2020). Psychological distress during the COVID-19 lockdown: The young adults most at risk. Psychiatry research, 293, 113486. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7518205/

[6]https://docs.google.com/document/d/1B1SmBPwgMRu1Z_l91sKPkuQlLzM3F_rp3owJFQQeJwM/edit?usp=sharing

[7] https://www.proximus.be/pickx/nl/2109642/oostenrijk-wil-scholen-heropenen-door-wekelijks-thuistests

[8] https://www.standaard.be/cnt/dmf20201217_94653152

[9] https://www.statengeneraalggz.be/wp-content/uploads/2021/01/Uitgebreid-rapport-wachttijden_Def2.pdf

See pdf for additional figures

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