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Young people's mental health and wellbeing in the north west during the COVID-19 pandemic: The ALICE study evidence briefing

Authors:
ADOLESCENTS’ LOCKDOWN-INDUCED
COPING EXPERIENCES (ALICE) STUDY
YOUNG PEOPLE’S MENTAL HEALTH AND
WELLBEING IN THE NORTH WEST DURING
THE COVID-19 PANDEMIC: EVIDENCE BRIEFING
Dr Emma Ashworth, Dr Shane McLoughlin,
Dr Pooja Saini, Dr Jennifer Chopra,
Dr Catrin Eames and Anna Hunt
Liverpool John Moores University
SCHOOL OF PSYCHOLOGY
1
The ALICE study is a research project aiming to explore
what risk and protective factors are associated with early
adolescent mental health during Covid-19. Early adolescence
(11-14 years old) is a critical period of development, where
young people are developing social skills and forming
relationships outside the family. During lockdown and tier
restrictions due to Covid-19, usual developmental experiences
in school and with family are interrupted, during a period
of uncertainty. We wanted to nd out how young people
experience and manage their wellbeing during lockdown.
In total, 294 young people took part in the study, between 9th
September 2020 and 22nd December 2020. Most participants
were aged 11 (34.4%), 12 (31%), or 13 (26.5%) years old.
More males took part (52.4%), with 45.6% identifying as
female, 1.4% as other, and 0.7% preferring not to say. In
terms of ethnicity, the majority of young people identied as
White (76.9%), followed by 8.8% Asian or Asian British, 7.5%
Mixed Ethnicity, 2% Chinese or Chinese British, 2% other
ethnic group, 1.7% preferring not to say, and 1% Black or
Black British. Half of those who took part stated having no
religion (51.4%), followed by Christian (32.7%), Muslim (8.2%),
and Hindu (1.4%) as the dominant religious groups. Most
young people identied as heterosexual (79.9%), with 10.2%
preferring not to say how they identied, and 9.5% identifying
as gay, bisexual, transgender, or belonging to LGBTQIA+.
We also asked about young people’s home life. Most said
they did not receive ‘free school meals’ (83%), lived in a semi-
detached (42.2%), terraced (31%), or detached house (15.6%),
lived with a 2-parent family (83.3%) and did not move between
mum and dad’s house (86.1%), and did not have any caring
responsibilities (87.8%). Most lived with 1 sibling (46.9%),
followed by 2-siblings (19.4%) or were lone children (18.7%).
Most did not have anyone at home who were ‘shielding’ or
considered ‘high risk’ (71.8%), and almost half (44.2 %) had a
keyworker in their home (e.g., providing essential work during
lockdown such as nurse, supermarket worker, delivery driver),
while 47.3% did not.
INTRODUCTION SURVEY RESULTS
Young people completed an online survey that
asked questions about themselves and their
experiences of lockdown (see references for
details). They then completed some questions
focusing on four different outcomes: overall
wellbeing, optimism, and mental health.
The mental health questions were split into
internalising difculties (e.g., anxiety and
depression) and externalising difculties (e.g.,
behavioural problems).
We investigated whether any factors related
to the young people and their home life were
associated with their wellbeing, optimism,
or mental health during the COVID-19
pandemic.
1. YOUNG PEOPLE FACTORS
GENDER
Girls were signicantly more likely to experience internalising difculties than boys, and
boys had signicantly higher levels of overall wellbeing and optimism than girls.
MALE FEMALE
Mean Rank Mean Rank
OPTIMISM* 132.98 105.57
WELLBEING* 140.7 112.54
INTERNALISING* 106.06 159.02
EXTERNALISING* 127.64 133.83
*p<.05
ETHNICITY
Caucasian participants had signicantly lower levels of externalising difculties and higher
overall wellbeing than non-Caucasian participants. No other differences were found.
CAUCASIAN NON-CAUCASIAN
OPTIMISM* 123.16 107.44
WELLBEING* 131.13 105.85
INTERNALISING* 124.75 142.87
EXTERNALISING* 122.45 151.67
2 3
MEDICAL OR HEALTH NEEDS AND DISABILITIES
Young people who reported previously receiving help for mental health difculties (anxiety or
depression) had signicantly lower levels of optimism and overall wellbeing, and were more
likely to experience internalising and externalising difculties than those who did not.
Having a special educational need or disability (SEND) signicantly affected overall wellbeing
and internalising and externalising difculties, but not optimism.
Having a long-term medical need did not affect any of the outcomes.
NONE
COMMUNICATION** COGNITION** S&P** SPLD** SEMH**
OPTIMISM
13 13 15 13 14 11
WELLBEING*
22.35 22.35 22.35 23.21 18.59 17.71
INTERNALISING*
610 9 12 7 12.5
EXTERNALISING*
23 4 3 3 4.5
** Categories of need: communication and interaction; cognition and learning; sensory and/or physical needs;
specic learning difculties; social, emotional and mental health difculties
HELP-SEEKING INTENTIONS
Young people were asked to report on the likelihood of them seeking help for a personal
or emotional problem, and who they would go to for help. Young people who were more
likely to seek help had signicantly higher levels of optimism and lower levels of
internalising difculties.
Young people who reported having a wide range of people they would go to for help had
signicantly higher levels of wellbeing and lower levels of internalising and externalising
difculties.
2. FAMILY AND HOUSEHOLD FACTORS
RECEIPT OF FREE SCHOOL MEALS
10% of young people reported receiving free school meals (FSM). Those who received FSM
had signicantly higher levels of externalising difculties, but there were no other
differences in their mental health or wellbeing.
FSM NON-FSM
OPTIMISM 116.14 115.99
WELLBEING 104.98 122.61
INTERNALISING 143.67 121.42
EXTERNALISING* 171.28 118.00
FAMILY MEMBERS
Young people who had a key worker in their family had signicantly higher wellbeing
than those who did not. Those who did not know whether they had a key worker at home
had the worst wellbeing.
KEY WORKER AT
HOME
NO KEY WORKER
AT HOME DON’T KNOW
OPTIMISM 14 13 12
WELLBEING* 23.21 22.35 21.78
INTERNALISING* 6 7 10
EXTERNALISING 2 3 3
However, young people having someone at home who was shielding or high risk did not
signicantly affect their mental health or wellbeing.
HOUSEHOLD DIFFICULTIES
Having a higher number of household difculties (lost job, money worries, evicted,
trouble accessing food, trouble accessing medication, hospitalisation for any reason, or
bereavement) was signicantly related to lower levels of optimism and overall wellbeing,
and higher levels of internalising and externalising difculties.
5
4
3. COVID-19 FACTORS
FEAR OF COVID
Reporting high levels of fear of COVID-19 was signicantly related with lower levels of
optimism and overall wellbeing, and higher levels of internalising and externalising
difculties.
KNOWLEDGE OF COVID-19
Young people who felt they had higher levels of knowledge about COVID-19, and who
thought their families had high levels of knowledge, were both signicantly more likely to
report following the Government guidance. However, knowledge about COVID-19 was not
related to mental health or wellbeing.
OPINIONS OF LOCKDOWN
Young people who reported having a positive experience during lockdown were more
optimistic, had better overall wellbeing, and had lower levels of internalising and
externalising difculties
TIMING – THE FIRST INTRODUCTION OF TIER 3 IN LIVERPOOL (14TH OCTOBER 2020)
Young people who completed the survey after the introduction of tier 3 measures in
Liverpool had signicantly lower levels of optimism, but there were no other differences in
their mental health or wellbeing.
WHAT DID YOUNG PEOPLE TELL US?
Interviews with young people revealed both positive and negative aspects of lockdown.
Four key themes regarding their perceptions of the impact of the COVID-19 pandemic
and lockdown on their wellbeing: Change, Embracing Lockdown, Feelings of Loss, and
Stress, Worry and Challenge.
CHANGE: “LIFE FEELS WEIRD”
Several young people described life as feeling “weird” during lockdown. They identied
several key changes in their life, mostly relating to either their lifestyle or school.
Lifestyle changes included changes to their daily routine, including their sleeping and
eating habits, changes to their relationships (both getting closer to their family and drift-
ing from their friends) and changes to their physical activity.
“I denitely played a lot less with [my friends]. I don’t know why it was I just
wasn’t really enthusiastic enough to play with them. They didn’t really play
with each other as well”
“Well, I’ve got to spend more time with my family, and with my sister and stuff.
Because usually we just like, would say bye in the morning, then when we
come back, we’d just go on our phones and stuff, and not really speak to each
other but we’ve had more time together and stuff so that’s good”
“I’d wake up like, my sleep pattern was very bad. I could wake up at 7pm and
go to sleep at like 9am, like it was so bad”
School changes focused on things that were different about working from home,
changes to the style of their lessons, and changes associated with the period going
back to school in September 2020 with the introduction of new restrictions.
“Well, we’d just go to school and come back and we’d just stay in our uniform,
and we wouldn’t have to worry about Coronavirus but now we need to be
extra careful”
“It’s a bit weird because you have to wear like masks in the corridors and
stuff. And you stay in the same classroom all day. You don’t really get to walk
around as much in school and stuff”
6 7
The loss of face-to-face support from teachers was also noted by lots of young people.
“I didn’t really like it because I’d rather be at school. Because I’d be able to
ask the teacher and all that type of stuff. And, when you’re online you’re not
able to like, do that. I kind of like being in school more”
“So you just message [the teachers] saying I didn’t really understand that
bit and they would get back to me, but I found that bit really hard, because
with some types of work like Spanish, I felt it was better with help from the
teachers, because it’s languages and you need to hear it, so it makes sense”
STRESS, WORRY, AND CHALLENGE
Young people described certain elements of the COVID-19 pandemic that made they
found difcult, or that made them feel stressed or worried. They described experiencing
a range of emotions in response to this, including anger and frustration, nervousness
and sadness, and boredom and confusion.
“It does make me feel upset because I guess I just want to go back to normal
like without COVID and all that. So it’s just a bit upsetting to be honest”
Some annoyance was directed at the Government’s handling of the lockdown and the
restrictions that had been put in place, whilst some focused on the media portrayal of
the pandemic.
“I was feeling quite angry because I couldn’t go and see my friends, because
my dad was working, that made me quite sad, because they would go and
see each other. I feel like the government could have handled it better, so
they could have said wear masks earlier, and I guess just... just like, staying at
home a lot, like, I would get quite annoyed at things”
“Sometimes when I see stuff on the news, reporting like there’s been how
many deaths there’s been, I get a bit worried”
Some were worried specically about COVID-19, including their family members catching it.
“I’m worried that someone in my family is gonna get really sick and then end
up having to go to hospital for a while or, the worst thing happening”
A major challenge for most young people was managing their school work from home, and
most said that they would prefer to be in school. Technology was a particular factor in this.
“At the start, it was really hard because I didn’t really know how like Google
Classroom was working so I was working on my mum’s old Kindle, because
that’s the only thing that would be working, and I couldn’t take photos on it so
I had to say to my teachers, I’ve done it on paper. And then I started using my
tablet, which, that was a lot better. So it was hard to try and, you know, stay
positive about it. But I guess there was nothing else we could do”
EMBRACING LOCKDOWN
Some young people described the positives of lockdown, and made a conscious effort
to engage in self-care and make the most of the situation.
Young people said they enjoyed having more free time, which provided them with
opportunities to relax, learn new skills, and pick up new hobbies. Others enjoyed having
more time to spend with their family, and used technology to keep in touch with their
friends and wider family members.
“We got to spend lots more time with each other. We got to do cooking, like
baking cakes and all that, so that was quite nice and we would spend time in
the garden when it was sunny, so that was nice”
“Well, I got to spend more time at home with my family and stuff, and there
was more time to relax”
“I guess I’ve come to see how lucky I am to have all these friends”
Young people also actively adopted self-care strategies to boost their wellbeing and
identied the things that helped them to cope.
“Doing art things like that really...that made me more happier”
“If I did feel frustrated, I think I’d just probably forget schoolwork for that day
because I could catch it up on another day. I’d probably just listen to music
or something, just to try and cheer me up or like read a book because I know
that just watching TV would just not help that much”
FEELINGS OF LOSS
Lots of young people experienced feelings of loss in several different ways. For some, it
was the loss of routine and their independence that was challenging.
“It was quite frustrating because I just wanted to go out but I couldn’t”
Some described how losing their hobbies or the opportunity to engage in new experi-
ences was particularly difcult for them.
“I used to go to Guides every single Wednesday and in lockdown, we would
just have a zoom call and then it was the summer holidays and it’s just not
been the same really… it does make me feel upset”
For others, it was the sense of loneliness or missing people.
“It was very strange not going into school, I couldn’t really go and see my
friends, because we weren’t allowed to go out to do other things, and it was
hard not being able to see your friends because it was very sudden”
8
“it was a bit like stressful with the work and stuff because we had quite a lot of
work to do, and it was like quite hard to keep like concentrated and stuff when
I’m at home because I could easily just go on my phone or like go to my dog
or stuff”
“It was really hard because, because the teachers they...some of them wer-
en’t as supportive, I guess as others. So I would submit some work and some
teachers would get back straight away, and some of them would leave it until
quite a while. I guess that had knocked my condence a bit because I didn’t
know if I was doing it right or wrong. So that was quite hard”
However, some enjoyed being able to work on their own schedule, and enjoyed having
more free time.
“We didn’t have to wake up at a certain time to do it. We could do it any time
that we wanted, so that was absolutely amazing. The work was actually kind of
fun to do on like your laptop and all that instead of like a loud, noisy classroom”
REFERENCES – LIST OF MEASURES
Me and My Feelings (internalising and externalising difculties): Deighton et al. (2013). The Development of a
School-Based Measure of Child Mental Health. Journal of Psychoeducational Assessment
SWEMWBS (wellbeing): Ng Fat et al. (2017). Evaluating and establishing national norms for mental wellbeing
using the short Warwick–Edinburgh Mental Well-being Scale (SWEMWBS): ndings from the Health Survey for
England. Quality of Life Research
General help-seeking questionnaire: Wilson et al. (2005). Measuring help seeking intentions: Properties of the
General Help Seeking Questionnaire. Canadian Journal of Counselling
LOT-R (optimism): Herzberg et al. (2006). Separating Optimism and Pessimism: A Robust Psychometric Analy-
sis of the Revised Life Orientation Test (LOT–R). Psychological Assessment.
CARING FOR YOUR WELLBEING
DURING COVID-19
We asked young people what advice they had for others managing lockdown and
returning to school. Here is what they told us, entirely in their own words...
Make sure you’re
organised. I didnt have a
schedule in lockdown
but I think it would have been
much better if I did.
KEEP IN TOUCH
WITH YOUR FRIENDS SO
YOU DON’T GET LONELY.
People are nding
vaccines every day. So you
should wait it out, follow the
guidelines, and it should go away.
DONT WORRY ABOUT
IT TOO MUCH. THERES NOTHING
YOU CAN REALLY DO, APART FROM BE
CAREFUL. TRY TO STAY FOCUSED
.
Try to make it more
exciting for yourself, it’s a new
experience, try and enjoy it.
Find TV shows or games.
You’ve got family that you can
play games with. Keep yourself
entertained. The second that you start
losing stuff to do, it will get really boring.
If you’re having a bad day,
set your mind on something like
tidying a room, going out, or doing
exercise. Just go out and be active.
MAKE THE MOST
OF LOCKDOWN. HAVE FUN
DURING IT AND DO STUFF
THAT YOU LIKE.
ResearchGate has not been able to resolve any citations for this publication.
Evaluating and establishing national norms for mental wellbeing using the short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): findings from the Health Survey for England. Quality of Life Research General help-seeking questionnaire
  • Deighton
Me and My Feelings (internalising and externalising difficulties): Deighton et al. (2013). The Development of a School-Based Measure of Child Mental Health. Journal of Psychoeducational Assessment SWEMWBS (wellbeing): Ng Fat et al. (2017). Evaluating and establishing national norms for mental wellbeing using the short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): findings from the Health Survey for England. Quality of Life Research General help-seeking questionnaire: Wilson et al. (2005). Measuring help seeking intentions: Properties of the General Help Seeking Questionnaire. Canadian Journal of Counselling