Impact of the COVID-19 Pandemic on Children's Mental Health in Taiwan: 2021-2022, Two-Year Follow-up Study

Background: According to the most comprehensive mental health report in the past two decades by the World Health Organization, nearly one billion people experienced mental health issues prior to the coronavirus disease 2019 (COVID-19) pandemic. Following its outbreak in 2021, the rates of depression and anxiety increased by 25%, which highlights its impact on mental health at the global scale. This study aims to elucidate the impact of the COVID-19 pandemic on children’s mental health and to raise awareness among various stakeholders, including educators and governments. Methods: To analyze and evaluate the indicators of mental health in children, we used a structured questionnaire that was previously designed with good reliability and validity. We focused on assessing six major categories related to children’s mental health in 2021 and 2022. We collected 1,000 valid responses from parents and their children for in-depth analysis (men: 538; women: 462). Results: The average total indices of children’s mental health were 66.50 and 63.83 in 2021 and 2022, respectively. The results of the six indices for both years were as follows: “Personal Life”: 68 and 66; “Family Life”: 70 and 70; “Peer Relationship”: 77 and 73; “School Life”: 68 and 68; “Online Social Interaction”: 60 and 55; and “Epidemic Life”: 56 and 51, respectively. During the COVID-19 pandemic, the top three activities of children aside from attending online classes were watching TV (66.0%), browsing the Internet (62.0%), and playing video games (50.7%). Conclusion: Children reported challenges with online exposure and academic pressure. The COVID-19 pandemic significantly affected their mental health, which impacted learning, socializing, and family dynamics. Specifically, family dynamics and environment emerged as significant influencing factors on the overall well-being of the children during these times. Consequently, collaborative effort among schools, communities, and governments is essential for improving or maintaining the mental health of children. Keywords COVID-19; Children mental health; Questionnaire