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Not as good as we want, not as bad as we’ve heard: Teen mental health during the COVID-19 pandemic

Is there a mental health crisis among young people, or are worry and sadness to be expected? Pathologizing normal, healthy responses to adverse events promotes misunderstanding about mental illness.

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Although some youth are clearly reporting a negative effect on their social, personal and educational lives during the pandemic, the majority are responding to COVID-19 in ways that are developmentally and psychologically normal. (Canva)

Let’s start with the obvious. Canada’s youth are experiencing disruptions to their lives like few others in recent history. And the present school year has not started off in the direction we had hoped, with unstable COVID-19 numbers, the uncertainty of school safety and the Delta variant.

Headlines declare that isolation has caused youth mental health issues and that children’s mental health is being badly harmed by the pandemic. But are youth being impacted as negatively as the headlines would have us believe? Do we really have the data — past or present — to be making such declarations? What do we know about Canadian youth and their functioning during a global pandemic?

Data past and present

Finding reliable pre-pandemic data on Canadian youth mental health is harder than you think. For decades, we relied on studies like the 1987 Ontario Child Health Study and its finding that one in five youth had psychiatric disorders — a broad statistic still widely touted today. At that time, 18.1 per cent of children ages four to 16 were experiencing one or more disorders.

Jump ahead almost 30 years to the 2014 Ontario Child Health Study and the prevalence numbers for emotional and behavioural disorders are eerily similar. Based on parent reports and self-reports, the prevalence for “any disorder” for youth ages 12-17 is 18.2 per cent and 21.8 per cent, respectively. Though limited to a single province, and while not dismissing the experience of those children with clinical mental disorders (as described in the DSM-V), the available peer-reviewed pre-pandemic data hardly suggest that there has been a dramatic increase in mental disorders for Canadian youth.

Teen boy with his head in his hands.
Canada’s youth are experiencing life disruptions like few others in recent history. (Pixabay)

Now, don’t get me wrong; I share in the discontent with the number of Canadian youth experiencing mental disorders and their lack of access to services. But as a registered psychologist and researcher for over 25 years, I’ve always thought that the one-in-five statistic fails to capture the considerable inequalities inherent in the prevalence rates of youth with mental disorders. For example, a mild specific learning disorder and childhood-onset schizophrenia are not comparable diagnostically, by way of functional impairment or in the intensity of intervention required.

Contributing to the confusion about prevalence, parent or self-report scales often used in survey research reduce complex mental disorders to nonspecific, global ratings or a screening checklist of symptoms that are mistaken for being diagnostic. Summary reports may cite results of broad ratings of youth mental health, and even some peer-reviewed publications equate single-item queries such as “How is your child’s overall mood?” with diagnoses like depression and anxiety. Such studies contribute to the inflammatory rhetoric pervasive in press reports of youth mental health.

Measuring COVID-19’s impact

With this brief historical context in mind, estimating the measured impact of the COVID-19 pandemic on youth mental health becomes even more difficult. Individual and meta-analysis studies are starting to appear in droves, and though helpful and informative, many are pre-prints (not peer-reviewed), very few use Canadian samples and many do not use longitudinal comparison samples before and during COVID-19.

Girl with her face in her hands.
More young people reported stress, worry and sadness during the pandemic. (Pixabay)

Almost nonexistent are peer-reviewed studies that published reliable estimates of pre-COVID-19 youth mental health and used clinically valid measures to do so. However, some notable exceptions include a study with Québec and Ontario adolescents and another with young adults in Québec, both of which found only modest increases in mental disorders like anxiety and depression during COVID-19 compared to pre-COVID estimates.

Our COVID-19 Student Well-being and Resiliency Study of over 1,500 Alberta students ages 12-18 during the last school year confirms and adds to these recent Canadian studies. Students from multiple school divisions completed an online survey at separate times (September and December 2020, March and June 2021) about COVID-19 concerns, their levels of stress, behavioural and adaptive functioning and resiliency.

When schools reopened in September 2020, student functioning in these areas was generally found to be below the threshold of any clinical concern or risk. In short, youth were doing OK, but we wondered how this might change over the school year.

Comparing early to late school year, our Wave 4 data (June 2021) indicate the percentage of students who self-reported their COVID-19 stress reactions in the “above clinical cut-off” range rose to 29.9 per cent from 23.5. Percentage of students’ who self-reported negative affect (feelings like worry and sadness) in the “high risk” range increased to 25.2 per cent from 17.3 per cent. Interestingly, students who were “very” or “extremely” concerned about catching COVID-19 decreased slightly from 38.2 per cent to 34.8 per cent, suggesting the pandemic’s social disruptions were more powerful than the health threat itself.

Line drawing of a young man in a hoodie looking out window
Young people’s resilience support from parents, personal resources and communities remained stable during the pandemic. (Canva)

Important developmental and contextual factors are also often ignored when reporting the overall presentation of youth mental health. In our study, the 15-18 age group reported more stress than the 12-14 age group, females reported higher negative affect than males, and those whose families had experienced income loss and those with previous psychological diagnoses had unique stress and mental health profiles.

However, for all youth in our study — whether in the risk ranges or in the typical ranges of functioning — self-reported resilience support from parents, personal resources and communities remained high and stable.

Normal response vs. mental health crisis

What does this all mean? Although some youth are clearly reporting heightened negative effects of the pandemic on their social, personal and educational lives, in all areas we measured, over seven in 10 youth in our sample are responding to COVID-19 in ways that are developmentally and psychologically normal. This aligns with the Canadian pre-COVID longitudinal studies above. In other words, contrary to the alarming headlines, the majority of youth are doing as well as they can!

Young person with neutral expression, between pictures of the same youth with sad expression and happy expression.
Most young people are responding to the pandemic in ways that are psychologically and developmentally normal. (Pixabay)

But what about the other 30 per cent? Do their self-reported symptoms mean we have a shadow pandemic of youth mental health? Part of the answer might come in the language we use to understand mental disorders (part of mental health literacy). Put directly, feeling sad or lonely is not depression; worry or nervous feelings is not anxiety. Literature that leads us to believe otherwise is unethical at best and clinically damaging at worst.

Pathologizing normal, healthy responses to adverse experiences promotes misunderstanding about mental illness, and communicating to children that their COVID-19-related thoughts and feelings are akin to mental disorders might reignite a stigma that we have worked so hard to dismantle. Many factors have to be ruled out before we can reliably diagnose a mental disorder. And although a pandemic might certainly exacerbate symptoms consistent with or contributing to a mental disorder, it is not a direct, causal line.

Resiliency happens when children experience adversity in the context of available and accessible personal and social resources. When youth hear constant messages that their sadness, frustration or worry are being interpreted as a mental disorder, this compromises the unique opportunity for youth to learn how to adapt and even thrive in the middle of a pandemic.

For those youth who need it, let’s get evidence-based help to them as quickly as we can and as close to their communities as possible, such as school-based services. But for the majority of youth, qualifying their lived experiences as clinically disordered only adds to their already heavy load of coping with COVID-19.

Our challenge moving forward will be to accept the honesty of their sadness and worry and to nurture their strengths of perseverance and resolve. In doing so, we can start to envision and build the changes in youth mental health promotion, prevention and intervention that are so desperately needed. And that is a headline we all can agree on.

Kelly Dean Schwartz receives funding from Canadian Institutes of Health Research, Human Development, Child and Youth Health (CIHR IHDCYH). He is affiliated with the Alberta Children's Hospital Research Institute (ACHRI), the Owerko Centre, the Hotchkiss Brain Institute (HBI), and the Mathison Centre for Mental Health Research & Education.

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Huge Dock Worker Protests In Italy, Fears Of Disruption, As Covid ‘Green Pass’ Takes Effect

Huge Dock Worker Protests In Italy, Fears Of Disruption, As Covid ‘Green Pass’ Takes Effect

Following Israel across the Mediterranean being the first country in the world to implement an internal Covid passport allowing only vaccinated citize

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Huge Dock Worker Protests In Italy, Fears Of Disruption, As Covid 'Green Pass' Takes Effect

Following Israel across the Mediterranean being the first country in the world to implement an internal Covid passport allowing only vaccinated citizens to engage in all public activity, Italy on Friday implemented its own 'Green Pass' in the strictest and first such move for Europe

The fully mandatory for every Italian citizen health pass "allows" entry into work spaces or activities like going to restaurants and bars, based on one of the following three conditions that must be met: 

  • proof of at least one dose of Covid-19 vaccine

  • or proof of recent recovery from an infection

  • or a negative test within the past 48 hours

Via AFP

It's already being recognized in multiple media reports as among "the world's strictest anti-COVID measures" for workers. First approved by Italian Prime Minister Mario Draghi's cabinet a month ago, it has now become mandatory on Oct.15.

Protests have been quick to pop up across various parts of the country, particularly as workers who don't comply can be fined 1,500 euros ($1,760); and alternately workers can be forced to take unpaid leave for refusing the jab. CNN notes that it triggered "protests at key ports and fears of disruption" on Friday, detailing further:

The largest demonstrations were at the major northeastern port of Trieste, where labor groups had threatened to block operations and around 6,000 protesters, some chanting and carrying flares, gathered outside the gates.

    Around 40% of Trieste's port workers are not vaccinated, said Stefano Puzzer, a local trade union official, a far higher proportion than in the general Italian population.

    Workers at the large port of Trieste have effectively blocked access to the key transport hub...

    As The Hill notes, anyone wishing to travel to Italy anytime soon will have to obtain the green pass: "The pass is already required in Italy for both tourists and nationals to enter museums, theatres, gyms and indoor restaurants, as well as to board trains, buses and domestic flights."

    The prime minister had earlier promoted the pass as a way to ensure no more lockdowns in already hard hit Italy, which has had an estimated 130,000 Covid-related deaths since the start of the pandemic.

    Meanwhile, the requirement of what's essentially a domestic Covid passport is practically catching on in other parts of Europe as well, with it already being required to enter certain hospitality settings in German and Greece, for example. Some towns in Germany have reportedly begun requiring vaccination proof just to enter stores. So likely the Italy model will soon be enacted in Western Europe as well.

    Tyler Durden Sat, 10/16/2021 - 07:35

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    China Coal Prices Soar To Record As Winter Freeze Spreads Cross The Country

    China Coal Prices Soar To Record As Winter Freeze Spreads Cross The Country

    One week ago we discussed why the "worst case" scenario for China’s property crisis is gradually emerging; to this we can now add that China’s worst case energy crisi

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    China Coal Prices Soar To Record As Winter Freeze Spreads Cross The Country

    One week ago we discussed why the "worst case" scenario for China's property crisis is gradually emerging; to this we can now add that China's worst case energy crisis scenario is also about to be unleashed as cold weather swept into much of the country and power plants scrambled to stock up on coal, sending prices of the fuel to record highs.

    Electricity demand to heat homes and offices is expected to soar this week as strong cold winds move down from northern China, according to Reuters with forecasters predicting average temperatures in some central and eastern regions could fall by as much as 16 degrees Celsius in the next 2-3 days.

    Shortages of coal, high fuel prices and booming post-pandemic industrial demand have sparked widespread power shortages in the world's second-largest economy. Rationing has already been in place in at least 17 of mainland China's more than 30 regions since September, forcing some factories to suspend production and further disrupting already broken supply chains.

    On Friday, the most-active January Zhengzhou thermal coal futures closed at a record high of 2,226 per tonne early. The contract has risen almost 200% year to date.

    China's three northeastern provinces of Jilin, Heilongjiang and Liaoning - also among the worst hit by the power shortages last month - as well as several regions in northern China including Inner Mongolia and Gansu have started winter heating, which is mainly fuelled by coal, to cope with the colder-than-normal weather.

    Meanwhile, even though Beijing has taken a slew of measures to contain coal price rises including raising domestic coal output and cutting power to power-hungry industries and some factories during periods of peak demand, so far all measures have failed with coal surging by 40% in just the past three days. Beijing has also repeatedly assured users that energy supplies will be secured for the winter heating season, and went so far as to order energy firms to "secure supplies at all costs." Well, the energy firms heard it, because on that day, thermal coal closed at 1,436 yuan. Two weeks later it is some 800 yuan higher.

    Unfortunately for Beijing, the power shortages are expected to continue into early next year, with analysts and traders forecasting a 12% drop in industrial power consumption in the fourth quarter as coal supplies fall short and local governments give priority to residential users.

    Earlier this week, we reported that China undertook its boldest step in a decades-long power sector reform when it allowed coal-fired power prices to fluctuate by up to 20% from base levels from Oct. 15, enabling power plants to pass on more of the high costs of generation to commercial and industrial end-users. read more

    Steel, aluminium, cement and chemical producers are expected to face higher and more volatile power costs under the new policy, pressuring profit margins.

    Meanwhile, the latest Chinese "data" on Thursday showed factory-gate inflation in September hit a record high; but since thermal coal is the one commodity that correlates the closest to PPI, absent a sharp drop in coal prices in the next few weeks, expect the next PPI print to be far higher. Meanwhile as the power crisis leads to further shutdowns in domestic production, some banks - such as Nomura - have gone so far to predict that China's GDP is set to shrink in coming quarters.

    China, which laughably aims to be "carbon neutral" by 2060 even as its president announced he will skip the COP26 UN Climate Change Conference in Glasgow, has been "trying" to reduce its reliance on polluting coal power in favor of cleaner wind, solar and hydro. But coal remains the source for some 70% of China's electricity needs.

    Of course, China is not the only nation struggling with power supplies, which has led to fuel shortages and blackouts in many European countries. and threatens to send US heating bills up as much as 50% this winter. he crisis has highlighted the difficulty in cutting the global economy's dependency on fossil fuels as world leaders seek to revive efforts to tackle climate change at talks next month in Glasgow.

    China will strive to achieve carbon peaks by 2030, Vice Premier Han Zheng said in a video message at the Russian Energy Week International Forum, according to state-run news agency Xinhua late on Thursday. He also said that China and Russia are important forces leading the energy transition and they should cooperate and ensure smooth progress of major oil and gas pipeline and nuclear power projects.

    Translation: Russia better save that nat gas and not ship it to Europe as China will soon be needed even BCF Russia an provide. As for China

     

    Tyler Durden Fri, 10/15/2021 - 22:50

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    Retail And Food Sales: If It’s Not Inflation, And It’s Not, Then What Is It?

    OK, so we went through the ways and reasons consumer price increases are not inflation, cannot be inflation, are nowhere near actual inflation, and what all that really means. The rate they’ve gone up hasn’t been due to an overactive Federal Reserve,…

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    OK, so we went through the ways and reasons consumer price increases are not inflation, cannot be inflation, are nowhere near actual inflation, and what all that really means. The rate they’ve gone up hasn’t been due to an overactive Federal Reserve, so it has to be something else. This is why, though the bulge has been painful, it’s already beginning to normalize. Without a persistent monetary component (in reality, not what’s in the media) the economy will adjust eventually.

    It already has. Several times, and that’s part of the problem.



    If not money, and it’s not, then what is behind the camel humps? No surprise, Uncle Sam’s ill-timed drops along with reasonable rigidities in the supply chain.

    An Economist might call this an accordion effect. One recently did:

    The closures and reopenings of different industries, coupled with the surges and lags in consumer purchasing during the pandemic, have caused an “accordion effect,” says Shelby Swain Myers, an economist for American Farm Bureau Federation, with lots of industries playing catch-up even as they see higher consumer demand.

    Not just surges and lags, but structural changes that have been forced onto the supply chain from them. With the Census Bureau reporting US retail sales today, no better time than now and no better place than food sales to illustrate the non-economics responsible for the current “inflation” problem.

    When governments panicked in early 2020, they shut down without thinking any farther than “two weeks to slow the spread.” This is, after all, any government’s modus operandi; unintended consequences is what they do.

    The food supply chain had for decades been increasingly adapted to meeting the needs of two very different methods of distributing food products; X amount of capacity was dedicated to the at-home grocery model, while Y had been set up for the growing penchant for eating out (among the increasingly fewer able to afford it). Essentially, two separate supply chains which don’t easily mix; if at all.

    Not only that, food distributors can’t simply switch from one to the other. And even if they could, the costs of doing so, and the anticipated payback when undertaking this, were and are massive considerations. McKinsey calculated these trade-offs in the middle of last year, sobering hurdles for an already stretched situation back then:

    Moreover, many food-service producers have already invested in equipment and facilities to produce and package food in large multi-serving formats for complex prepared-, processed-, frozen-, canned-, and packaged-food value chains. It would be highly inefficient to reconfigure those investments to single service sizes.

    And if anyone had reconfigured or would because they felt this economic shift might be more permanent:

    For food-service producers, the dilemma is around the two- to five-year payback period of new packaging lines. Reinvesting and rebalancing a food-service network for retail is not a straightforward decision. Companies making new investments would be facing a 40 percent or more decline in revenue. And any number of issues could extend the payback period or make investments unrecoverable. Forecasts are uncertain, for example, about the duration of pandemic-related demand shifts, the recovery of the food-service economy, and the timeline of returning to full employment.

    So, for some the accordion of shuttered restaurants squeezed food distributors far more toward the grocery and take-home way of doing their food businesses. And it may have seemed like a great bet, or less disastrous, as “two weeks to slow the spread” morphed to other always-shifting government mandates which appeared to make these non-economics of the pandemic a permanent impress.

    More grocery, less dining. Forever after.

    In one famous example, Heinz Ketchup responded to what some called the Great Ketchup/Catsup? Shortage by rearranging eight, yes, eight production lines to spit out their tomato paste in individual servings rather than bottles. CEO Miguel Patricio told Time Magazine back in June (2021) there hadn’t actually been any shortage of product, just the wrong packaging for it:

    It’s not that we don’t have ketchup. We have ketchup, but in different packages. The strain on demand started when people stopped going to restaurants and they were ordering takeout and home delivery. There would be a lot of packets in the takeout orders. So we have bottles; we don’t have enough pouches. There were pouches being sold on eBay.

    But then…vaccines. Suddenly, after over a year of the above, by April 2021 the doors were flung back open, stir-crazy Americans flew back to their local pubs and establishments (see: below) and within months, according to retail sales, it was almost back to normal again. Meaning pre-COVID.



    The accordion had expanded back out but how much of the food services supply chain had been converted to serve the eat-at-home way which many companies had understandably been led to believe was going to be a lasting transformation?

    Do they undertake even more costly and wasted investments to go back? Maybe they resist, just shipping what they have even if not fully suited in the way it had been before all this began.

    Does Heinz spend the money to reconfigure those same eight production lines so as to revert to producing their ketchup in bottles? Almost certainly, but equally certain they’re going to take their sweet time doing it; milking every last ounce of efficiency – limiting their losses, really – they can out of what may prove to have been a bad decision (again, you can’t really fault Mr. Patricio for being unable to predict pandemic politics).

    Rancher Greg Newhall of Windy N Ranch in Washington likewise told NPR that he has the animals, beef, pork, lamb, chicken, goat, but distributors are caught in the accordion (Newhall didn’t use that term):

    NEWHALL: People don’t understand how unstable and insecure the supply chain is. That isn’t to say that people are going to starve, but they may be eating alternate meats or peanut butter rather than ground beef.

    GARCIA-NAVARRO: Newhall says he hasn’t had any issues raising his animals. It’s the processing and shipping that’s the bottleneck, as the industry’s biggest players pay top dollar to secure their own supply chains.

    The usual credentialed Economist NPR asked for comment first tried to blame LABOR SHORTAGE!!! issues, including those the mainstream had associated with the pandemic (closed schools forcing parents to stay home, or workers somehow deathly afraid of working in close proximity with others) before then admitting:

    CHRIS BARRETT: And there’s also the readjustment of the manufacturing process. As restaurants are quickly opening back up, the food manufacturers and processors have to retool to begin to supply again the bulk-packaged products that are being used by institutional food service providers.

    With US retail sales continuing at an elevated rate, the pressures on the goods sector are going to remain intense.


    Because, however, this is not inflation – there’s no monetary reasons behind the price gouge – the economy given enough time will adjust. And it has adjusted in some ways, very painful ways.

    Painful in the sense beyond just hyped-up food prices and what we pay for gasoline lately, the services sector has instead born the brunt of this ongoing adjustment. Consumers have bought up goods (in retail sales) at the expense of what they aren’t buying in services (not in retail sales); better pricing for sparsely available goods stuck in supply chains, seeming never-ending recession for service providers.

    According to the BEA’s last figures, overall services spending remains substantially lower than when the recession began last year. And it shows in services prices which had been temporarily boosted by Uncle Sam’s helicopter only to quickly, far more speedily and noticeably fall back in line with the prior, pre-existing disinflationary trend following a much smaller second camel hump.



    Once the supply and other non-economic issues get sorted out, we would expect the same thing in goods, too. It is already shaping up this way, though bottlenecks and inefficiencies are sure to remain impediments and drags well into next year.

    Those include other factors beyond food or domestic logistical nightmares. Port problems, foreign sourcing, etc. The accordion has played the entire global economy, and in one sense it has created the illusion of recovery and inflation out of a situation which in reality is nothing like either.

    That’s the literal downside of transitory. We can see what the price bulge(s) had really been, and therefore what it never was.

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