14th July 2023 Blog

The mental health of children and young people before and during the COVID-19 pandemic

COVID-19 • Young people •

A new study found significant changes in the mental health of young people during the pandemic – we share what it says and recommendations moving forward.

Carolyn Chew-Graham & Pearl Mok

It’s no secret the pandemic had an impact on the UK’s mental health – and that young people were affected in ways that haven’t been fully realised yet. While some impacts won’t become clear for, potentially, years, we wanted a clearer picture of how they’d been affected in the first two years.

Researchers from the University of Manchester, Keele University, University of Exeter, and the McPin Foundation have been working together to investigate the mental health of children and young people during the COVID-19 pandemic.

Using anonymised patient data from GP practices across the UK, we worked with an advisory group of young people and parents/carers, as well as professionals from the health, social care, education, and third sectors.

We included data from children and young people aged 10-24 years, and looked at:

  • Diagnoses of: depression, anxiety disorders, eating disorders, attention deficit hyperactivity disorders (ADHD), autism spectrum disorder, personality disorders, and substance misuse.
  • Incidences of self-harm
  • Prescriptions for psychotropic medicines, e.g. for depression, anxiety, and ADHD
  • Referrals to further treatment (e.g. mental health services)

We presented some of the key findings at a webinar in May 2023. You can read more about it in The Mental Health of Children and Young People Before and During the COVID-19 Pandemic webinar – a summary in pictures

There has been a large increase in numbers of eating disorder diagnoses and self-harm episodes among teenage girls. There is therefore an urgent need for intervention.

Large reduction in all mental health diagnoses at start of ‘lockdown’

One of the findings that stood out the most was around a reduction in diagnoses at the start of the lockdown period.

Reasons for these reductions were thought to be related to the public health messages to ‘stay at home’ and the request to ‘protect the NHS’.

Since school might be an important stressor for children and young people, not being in school during lockdown could have meant not being exposed to a key stressor.


A graphic of some key findings from the study. Illustration of a boy looking worried and a sign saying 'save lives, stay at home'. Text reads: Reductions in diagnoses... surely to do with COVID and people not going to GP.

Two years since the onset of the pandemic, numbers of psychiatric diagnoses were still largely below what we expect, especially in males.

Key findings of CHOOSE. Illustration of young person reading news and looking distressed. Text reads: The data doesn't reflect the narrative...is it that people aren't accessing support?

However, there has been a large increase in numbers of eating disorder diagnoses and self-harm episodes among teenage girls. There is therefore an urgent need for intervention.

Key findings of CHOOSE: Diagnoses. Illustrations of young people looking worried. A graph pointing upwards next to a girl, text reads: Increases in females eating disorders, self-harm, ADHD. Arrow on graph next to boy goes down, text reads: Largest reduction in males.

There has also been a large rise in the number of females being diagnosed with ADHD or prescribed ADHD medications.

Illustration of pills and a graph pointing down labelled: Less substantial decrease. Text reads: Prescriptions, but an increase in ADHD medication for females.

Key messages for children and young people

As well as information for services and schools, the study also provided some useful takeaways for young people struggling with their mental health.

  • If you feel upset, do talk to someone – whether your parents, a family member, a trusted friend, or a teacher.
  • Be honest about how you feel – you’re not ‘bad’ or ‘broken’ for feeling the way you do.
  • See what help is available at your school/college.
  • Look at online support/apps, although be aware of the sources of information – trusted websites and apps like the NHS are a good place to start.
  • Reach out to third sector organisations such as young people’s mental health charities – they often have chat or text options if you don’t feel comfortable calling.
  • If the feelings continue it’s a really good idea to speak to your GP (general practitioner), who can discuss how best to help you.

The importance of working with people with lived experience in research

A vital part of our study was the valuable contributions made by our advisory group of young people and parents/carers. They helped shaped our study, giving us an ‘insider’ perspective, and providing possible explanations of our findings.

The importance of involving people with lived experience in research was summarised by our young people advisory group member Lauren during our webinar.

Young people, parents and carers. Illustration of young person with older person looking unhappy, saying
Young people, parents & carers advisory group. Illustration of girl looking in mirror and not seeing anything - text reads

Lauren also emphasised the need to ensure that patient advisory groups include people from diverse background so that their voices are heard.

The views of people involved. Illustrations of diverse young people smiling and talking. Text reads: A diverse mix of voices is essential.

Further information and next steps

Our findings on eating disorders and self-harm were recently published in the Lancet Child & Adolescent Health.

Over the next few months, we will disseminate other findings and key messages in infographics, videos, as well as further academic papers. Please sign up to the McPin newsletter to stay up to date on the study.

Carolyn Chew-Graham is a GP, Manchester and Professor of General Practice Research, Keele University. Pearl Mok is a Research Fellow.