The coronavirus has pressed the Pause button on life as we knew it. Adults are having a bad enough time coping, but imagine the impact on young minds who are still trying to make sense of the normal world, let alone one that has turned on its head.

As familiar structures around children crumble, it’s up to others around them to find ways of making them feel safe again. BusinessLine speaks with Child & Adolescent Psychiatrist Dr Amit Sen on the challenge of tackling a situation none of us have known before.

No school, no homework, lots of free time. Are children enjoying a bit of a holiday at this time?

When schools were first closed for the lockdown, many children were indeed happy not to have to go to school and tackle class work. They were thrilled to have a nice stretch of holidays before them. But it didn’t take long for the loss of structure to be felt acutely. Getting up on time, tidying your room, going to school, playing football with friends, going for guitar practice, catching a movie with the family — these are all things that were suddenly taken away. Children had more free time, but no freedom. Within a short while, young people found this lack of structure and choice very very difficult to deal with. And they actually even began to miss having to do homework.

Did youngsters react with anxiety to the loss of structure?

Structure and predictability, it turns out, is actually very important to development. It is what gives a sense of safety and security; it gives meaningfulness and purpose and a feeling of working towards something.

Children now find themselves at a loss and this is when we realised just how important a role structure plays in their well-being, really — knowing that such-and-such a thing is going to happen through the week: that we will have tuition on this day, go out with friends on the weekend or complete a project by a specific deadline, are all really important day-to-day things. In its place, we now have anxiety, fear, boredom and uncertainty about what will happen next.

They also begin to worry about the future. Teenagers, specially, are grappling with understanding the outer world, and the world inside themselves, where they are attempting to form their identity. This is chaotic at the best of times. Now, at this time, the pandemic situation only adds to it.

Though teens resist the structure imposed on them, the family and school or college is actually the scaffolding that supports them. Now, teenagers are coming out of their rooms, feeling lost. They even worry over what will happen to their plans for the future and how that will now come about. After all, so many children haven’t been able to give their exams. Instead of getting ready to join colleges and universities they find themselves locked in the house. At this point, they can’t tell — nor can anyone else — whether the goals they wanted to achieve will be back on track as planned.

How are parents managing the mental well-being of their children, in addition to coping with their own anxiety?

Because parents were also initially hit hard by this crisis, they could not do anything to help, nor did they really think it was important. After all, no family really gears up for a situation like this. Working with children for many years, we know that their mental health is something that, as a society, we don’t think about much in our country. It’s way down the priority list and comes into question only when children begin to behave badly and their grades begin to plummet.

Unless there are some developmental problems or something going drastically wrong, people don’t consider the idea that children can actually go through so many kinds of mental health challenges.

When the lockdown began, there was hardly any talk about mental health, let alone for children. It’s not altogether surprising because it’s normal that in a disaster situation you would first think about your physical safety. With the virus lurking around, of course the first worry would be about whether you or anyone in the family could be affected. So in the beginning, even our regular clients at Children First dropped out of therapy and said they didn’t need this now and were too busy fighting multiple battles at home. The concept of mental health just went out the window.

If you look at trajectories of how mental health issues come up during disaster, it takes a little while, maybe a couple of weeks, for it to sink in. Then you begin to see the impact psychologically. So, specially with the lockdown extended, parents began to reach out again.

Do you find that now, in the pandemic, children are coming to you with different problems compared with earlier?

It’s very different for diverse groups. We’ve always had a lot of smaller kids coming to us for developmental problems and issues like autism or ADHD. But because we have had to shutter the usual spaces where we work with them, it’s become very difficult to replicate those spaces with online ones for this. So the challenges for this group are in their own category. Then there are teenagers and young adults who may have, say, depression or anxiety or other issues. They know how to use digital media so well that they are much more readily accessible and can be more easily helped.

But, of course, what is also important is what’s happening in the larger community. We now have our previous clients as well as new families getting in touch for help with issues that are clearly stemming from the pandemic and lockdown.

What would be the best way for parents and adults in the family to help children through the turmoil of this time?

Children are very sensitive to the anxiety of their parents. It’s more than ever important to calm down and face things remembering that everyone is in this together. It’s also critical to build new routines and structures at home. This is where creativity is called for. Maintain the old routines as much as possible, while looking for new activities that can be done regularity and together.

In my own family, we make sure we spend a nice chunk of time together when we take turns reading from our favourite books from childhood. To vary things, we pick up other activities; like the other day we decided to talk about all the movies that made us cry. I know of a family in which new activities are quite elaborate, so each Thursday they have the kids making a meal and then serving it to the family as if everyone were at a restaurant. These are things everyone can actually contribute to and play along with a lot of enjoyment. And everyone learns something as well.

While making new routines however, it’s best not to impose them on children top-down but to involve them in planning so that they have a sense of agency and choice. Families have responded creatively even while tackling household chores together but at the same time, adults should be able to reassure young people that they can still hold on to their larger goals in life. Although we don’t know what the post pandemic world will be like, we do know that the crisis will pass and life will resume.

Technology and being connected must surely help?

Zoom classes have actually helped a lot. Children feel a lot more held and there’s a purpose to wake up for. Although the bases outside the home are so important for young people, digital media really has been a godsend. Kids are constantly on Instagram and Houseparty and playing games, with no one having the heart to tell them to stop so they like this rather a lot, but they also do reach a point where they’ve had enough when they realise this is about the only thing they can do. The lack of choice gives them a sense of loss.

Beyond just playing around online there are so many things youngsters can do with technology. Learn new skills, take online courses, try coding, learn a new language... the opportunities are endless.

And what happens to children who don’t come from privileged homes but who also have their lives now disrupted?

One can only imagine how lives that were already so difficult would be now. So many of these kids will obviously not be getting on video chat as readily, so connecting with them, whether with the intention of knowing their plight or to provide help, is much more of a challenge. Their problems right now may be more about where to get one square meal a day, as most of the institutions and businesses that are sources of their daily bread have shut down. The immediate impact of the disaster will be felt much more acutely by them, and naturally they are more likely to experience panic and pain than more privileged families. The effect of this pandemic, including the loss of livelihoods and abject poverty, will play out on them in the long term.

Sadly, such crises are not unfamiliar to the marginalised and deprived. There are natural and man-made disasters that disrupt their lives year after year in different pockets of the country. There are hundreds of NGOs that are trying their best to reach out to such kids, including Salaam Baalak Trust, with whom I have worked closely for many years now.

No disaster is all disaster. There’s always something positive, if one but cares to look. We encourage all the children and families who reach out to us to use this time to reflect and re-examine priorities and values. We help them question what success really means, what materialism is all about, and what ambitions are. We encourage them to see the larger picture, think outside of themselves and of the world we live in. We make them see that there are more options in life than they imagined. Buying a posh car or quickly getting a white-collar job aren’t the only definitions of success as a person. For this sort of reflection, there’s probably no better time.

Dr Amit Sen is a Child and Adolescent Psychiatrist and founder of Delhi-based Children First, whose mission it is to create communities of concern for children.

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