Children on the Brink: Risks for Child Protection, Sexual Abuse, and Related Mental Health Problems in the COVID-19 Pandemic

By Ramaswamy, Sheila; Seshadri, Shekhar | Indian Journal of Psychiatry, September 2020 | Go to article overview

Children on the Brink: Risks for Child Protection, Sexual Abuse, and Related Mental Health Problems in the COVID-19 Pandemic


Ramaswamy, Sheila, Seshadri, Shekhar, Indian Journal of Psychiatry


Byline: Sheila. Ramaswamy, Shekhar. Seshadri

In developing contexts such as India, children in adversity form a high-risk group, one that cannot be subsumed under the general category of children, who are generally considered as a vulnerable group in disaster and crisis situations. Child mental health issues in contexts of protection risks and childhood adversity tend to be over-looked in such crises. This article focuses on examining the impact of the COVID-19 pandemic and its socio-economic consequences on children in adversity, describing the increased child protection and psychosocial risks they are placed at, during and in the immediate aftermath of the COVID-19 crisis and its lockdown situation. It specifically links the lockdown and the ensuing economic issues to sexuality and abuse-related risks, as occur in contexts of child labour, child sex work and trafficking, child marriage and child sexual abuse, and that result in immediate and long-term mental health problems in children. It proposes a disaster risk reduction lens to offer recommendations to address the emerging child protection, psychosocial and mental health concerns.

Introduction

Although the COVID-19 pandemic is a recent phenomenon, there is already an emerging literature on its adverse protection, psychosocial, and mental health effects on children.[1],[2],[3],[4],[5] While the perspectives presented thus far are useful, it is imperative, as in any crisis, to examine its impact on the most vulnerable populations. It is also well-established that neither all population groups are impacted equally by a given disaster, nor are access to disaster assistance and mitigation services and resources[6],[7] - so, because some are less 'equal than others,' they are more severely impacted, in ways that have long-term life consequences.

In developing contexts such as India, children in adversity form a high-risk group - one that cannot be subsumed under the general category of children, who are generally considered as a vulnerable group in disaster and crisis situations. This article focuses on examining the impact of the COVID-19 pandemic and its socioeconomic consequences on children in adversity, describing the increased child protection and psychosocial risks they are placed at, during and in the immediate aftermath of the COVID-19 crisis and its lockdown situation. It specifically links the lockdown and the ensuing economic issues to sexuality and abuse-related risks, aspects that often tend to be over-looked in such crises, and the consequent mental health problems; it proposes a disaster risk reduction lens to offer recommendations to address the emerging child protection and 'psychosocial' and mental health concerns.

COVID-19 context in India vis-à-vis children

Disease and mortality in children

The health and mortality impact of COVID on children is varied, and age-dependent. The largest study to date of children and the virus[8] has found that most develop mild or moderate symptoms, and only a small percentage, especially babies and preschoolers, can become seriously ill. The study, which included over 2000 children, found that about half of them had mild symptoms, such as fever, fatigue, cough, congestion, and possibly nausea or diarrhea, over a third of them became moderately sick, with additional symptoms including pneumonia or lung problems, but with no obvious shortness of breath; that only about 6% developed very serious illness (these were the very young children) and that only one child died. The researchers concluded therefore that while children may become infected like adults, the severity of the illness is considerably less, with only a handful of (young) children requiring aggressive treatment.[8]

Thus, most children, especially those who are above the age of 5 years, are probably not at serious risk of severe health impacts and mortality due to COVID. Consequently, (older) children, while they must follow social distancing and other precautions, because they constitute a risk for transmission, may not need to be prioritized as a vulnerable group from a health and mortality perspective. …

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