The pandemic and its effects have taken a heavy toll on the mental health of millions. For children and adolescents, however, it's been particularly grim.
Long periods away from school and friends, with children forced to learn at home and relate to their peer groups only online, have resulted in an explosion of demand for mental health support.
A new investigation by the Telegraph newspaper has found that the number of children attending A&E with 'serious' mental health issues, including self-harm and suicidal thinking, has leapt by more than 50% since the beginning of the COVID pandemic.
Over 2,240 children in England alone were referred to mental health care professionals via A&E in May 2021, compared with 1,428 in May 2020.
Meanwhile, NHS figures show that around 27 000 children a month, largely teenagers, are now prescribed anti-depressants, with over 1000 under 11 years old. Waiting lists for Child and Adolescent mental health services have also shot up, while eating disorder hospital admissions have more than doubled.
Watch: 'I did it to control my feelings': Study reveals 'desperate' situation of self harm amongst teenagers
Mind, the mental health charity, has called on the governmet for extra funding, urging them not to “betray the next generation”.
"The uptick has been driven mainly by the extra pressures that the pandemic and resulting lockdown have put on young people and their families," says Zoe Clews, a PTSD, trauma and anxiety mental health specialist.
"Inevitably, the question many people are asking is: why is this happening? But really the most obvious question is: why wouldn’t it be?" she goes on.
"In pre-pandemic life, most kids were kept in a protective bubble by parents who tried as much as possible not to burden their children with their own everyday financial and emotional pressures.
"Eighteen months plus of lockdown have not only torn those shields apart – it’s much harder to hide the impact of your own problems when you’re living on top of your children 24/7 – but also saddled children with their own pressures, stresses and anxieties."
At any age, she adds, children’s minds are like sponges – "thirsty for knowledge and gaining context and learning from their daily life experiences. In turn, the impact of traumatic experiences and exposure to chronic stress has a catastrophic effect on the subconscious and its ability to achieve emotional balance."
There has also been the immense impact of enforced isolation, she goes on.
"For too many, their lockdown experience has been one of social isolation, absence of expected routines, denial of interaction and the loss of development of self-identity that only comes from ‘normal’ life.
"It’s not difficult to see how poor mental health in children has become a pandemic in its own right."
She acknowledges that while waiting times are long and private help is beyond the reach of many families, there are steps that parents can take to help ease the mental load on their children.
"Parents can support their children by encouraging them to keep talking about how they feel and by reassuring them that they are not alone," says Clews.
"The biggest problem in a decline in mental health is the sense that the negative or destructive feelings we have are never ending.
Parents need to explain that their child is not alone and that, with support and ongoing dialogue, the way they feel can be transient and temporary."
Of course, if there are 'red flags' in their behaviour, including, "withdrawal, lack of ‘normal’ engagement in family life or addictive activities such as gaming – and if your child is reluctant to talk to you," she says, "encourage them to speak to other members of the family or to trusted adult friends who will be non-judgemental and impartial."
Don't ignore the existence of charities and helplines either, Clews adds. "There is no shame in your child reaching out to them to talk about things they may not want to discuss with their parents.
"And, of course, parents need to ensure they look after their own mental health when offering support to a child – because it’s impossible to pour from an empty cup."
Therapist Navi Schechter, who works with parents, agrees that caring for yourself is vital when you're supporting unhappy children.
"It can be very hard to see your child struggling and also to be on the receiving end of their bad moods. It's really important that you take care of yourself and get the support you need so that rather than taking responsibility for their feelings or taking it personally, you can do your best to understand and be there to support them through the rough patches."
Here are Schechter's tips to help your child through a tough period
1 Create an environment of open communication
Your child or teenager is unlikely to feel comfortable opening up about their feelings if they haven't felt close to you for a while.
Working on developing and maintaining your connection with your teenager over time; by taking an interest in their life, supporting their interests, giving them your time and attention and doing your best to be responsive to their needs can help them be more open about the personal things happening in their life.
2 Pick your moment carefully
Picking the right time to have your conversation is important. Talking to your teenager when they're feeling calm and more relaxed will likely go better than if you're trying to talk to them when they're already feeling worked up and overwhelmed.
Carving out time to go for a coffee together or chatting in the car can give you the chance to talk on neutral ground.
3 Listen and validate
Let your child do the talking. Asking open questions and taking a back seat, listening to what they have to say will help them to feel heard.
Validating your child's feelings, based on the thoughts they've been having, can help them to feel understood and accepted.
Try, "I can understand why you feel frustrated, given that there's so much you've missed out on this year" instead of "stop shouting all the time, I've had enough, I don't want to hear another word."
4 Don't judge
Adolescence is a time where your child will be exploring their individuality and independence and they may start to develop beliefs that no longer fit with yours. Try and be open to understanding your teenagers viewpoint even if you don't agree with it.
If your child feels judged or rejected because of what they shared, it will feel harder for them to open up to you next time.
Watch: Adolescent mental health takes a dive during COVID-19 pandemic
5 Don't try and fix it
Your teenager may be experiencing intense emotions and what may seem exaggerated responses to situations.
Giving them a chance to offload their thoughts and feelings, without needing to offer solutions or to "fix" anything can allow them to process their feelings and move on from them - and may also make them more likely to open up to you again in the future.