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. 2022 Dec 25:10.1111/jcap.12404. Online ahead of print. doi: 10.1111/jcap.12404

Children and adolescents' mental health during the COVID‐19 pandemic: A qualitative study of their experiences

Marjorie Montreuil 1,2,3,✉, Lauranne Gendron‐Cloutier 1, Emilie Laberge‐Perrault 1, Geneviève Piché 4, Christine Genest 5, Jessica Rassy 6, Catherine Malboeuf‐Hurtubise 7, Elsa Gilbert 8, Aline Bogossian 9, Chantal Camden 10, Trinity Mastine 11, Geneveave Barbo 1
PMCID: PMC9880751  PMID: 36566357

Abstract

Topic

Public health measures implemented in response to the COVID‐19 pandemic severely disrupted children and adolescents' (C&A) lives, affecting their sense of structure, predictability, and security.

Purpose

To examine C&A' experiences during the COVID‐19 pandemic to better understand how this context and its associated public health measures affected them and their mental health, and to identify helpful coping strategies.

Sources used

The study was guided by a participatory hermeneutic framework. Semistructured interviews were conducted with 25 C&A aged 6–17 years during the first and second pandemic waves. Participants' interviews were analyzed following a narrative synthesis approach, through which C&A' experiences were contrasted and contextualized to highlight relevant themes.

Conclusions

Participants described a distinct pattern related to their mental health as the pandemic unfolded, which followed the severity of the pandemic in the province. Negative repercussions on their mental health were linked to the loss of social activities, imposed public health measures, transition to online learning, and challenges with family relationships. Certain youth shared positive societal and moral reflections triggered by the pandemic context. Coping strategies reported include: having a variety of hobbies; expressing their emotions; and accessing financial and material resources.

This study highlights the importance of supporting C&A' mental health during crisis situations such as a pandemic. Their perspectives are vital for clinical practice and policy improvement, particularly to find means for social engagement while maintaining safety.

Keywords: adolescent, child, COVID‐19, hermeneutics, mental health, pandemics, physical distancing

1. BACKGROUND

Public health measures implemented in response to the COVID‐19 pandemic disrupted children and adolescents' (C&A) lives, including their education, social relationships, and routines, affecting their sense of structure, predictability, and security (Ramchandani, 2020; Zhang & Lee, 2020). Widespread quarantine and confinement measures have adverse effects for C&A, such as increased incidence of posttraumatic stress, depressive, and anxiety disorders (Douglas et al., 2009; Ellis et al., 2020; Orgilés et al., 2020; Panda et al., 2021; Sprang & Silman, 2013; Zengin et al., 2021). These mental health difficulties increase with greater severity of the crisis and a longer confinement period (Douglas et al., 2009; Panda et al., 2021). These detrimental mental health effects are concerning as the COVID‐19 pandemic has been one of the most widespread public health emergencies in recent times.

Researchers noted increases in distractibility, irritability, nervousness, worries, and feelings of loneliness in C&A (Arunkumar et al., 2019; Jiao et al., 2020; Kayaoğlu & Başcıllar, 2022; Orgilés et al., 2020; Westermann et al., 2013). Although these preliminary studies generate important findings on C&A' mental health during the pandemic, the focus remains on their symptoms and are often reported by parents, which do not provide first‐hand accounts of children's social worlds (Ben‐Arieh, 2005; Kirk, 2007; van de Looij‐Jansen et al., 2011). Studies on children's experiences of the pandemic have been conducted but are limited to their general experiences of the first pandemic wave or conducted through survey questions, which provide limited accounts of C&A' lived experiences throughout the pandemic (Fioretti et al., 2020; Magson et al., 2021; Rogers et al., 2021; Salzano et al., 2021; Stoecklin et al., 2021; Thompson et al., 2021).

In this context, we examined C&A perspectives and experiences during the first and second waves of the COVID‐19 pandemic to better understand how the pandemic affected them and their mental health, as well as to identify helpful coping strategies that assisted C&A to inform healthcare providers and policymakers.

2. METHODOLOGY

2.1. Methodological framework

The study was guided by a participatory hermeneutic framework based on Taylor's hermeneutic philosophy (Montreuil & Carnevale, 2018). As Taylor's conception of hermeneutics is socially based, it allows for the consideration of both personal experiences and participants' sociocultural backgrounds, which was important in the present study to inform on any sociocultural differences in C&A' pandemic experiences. Participatory research is commonly referred to as the active involvement of stakeholders in the study decision‐making process. Within this study, a child was involved in the research process, to be more attuned to children's perspectives and experiences (Montreuil et al., 2021; Shamrova & Cummings, 2017). The child, the daughter of one of the researchers, was 9 years old at the start of her involvement in the study (please note that due to pandemic restrictions, the involvement of a broader network of children was not feasible). She contributed to refine the study question, develop the interview guide, and develop a website to facilitate online recruitment. She was also involved in interpreting the data through an interview‐style discussion while reading the results and discussion, in which she offered contextualizing comments and provided feedback and suggestions, and was involved in deciding who to disseminate the research results with and in which format.

2.2. Recruitment

After receiving research ethics approval from McGill University's Institutional Review Board, online recruitment was conducted to reach the target population. Inclusion criteria were the following: aged between 6 and 17 years old, able to hold a conversation in French or English, self‐declaring as living in the study‐targeted geographical area, and having access to technological means to do an interview online or via phone. To reach participants, a press release was shared with media outlets, tutoring agencies, social media platforms, and researchers' respective networks. Facebook and Instagram were identified as appropriate social media platforms, as they allowed for the recruitment of C&A while targeting either C&A' parents or adolescents themselves (Sloan & Quan‐Haase, 2017). For C&A to sign up to participate, a website specific to this study was created, where they could consent to be contacted by the research team to schedule an interview via the Qualtrics platform. Parental consent was sought for children under the age of 14 (children had to provide assent), and adolescents aged 14 years old and above provided consent independently. The website presented information about the study, as well as mental health resources available to C&A (website now closed). All C&A who completed the consent form and shared their interest for the study were interviewed.

2.3. Data collection

Data were collected through semistructured interviews. Examples of questions included: “What has the COVID‐19 pandemic been like for you? How has the pandemic changed your daily life? Tell me about what a typical day looks like for you these days. What are the hardest things for you during the COVID‐19 pandemic? What activities have you been doing to feel better?” The same interview guide was used for C&A, but the wording was adapted to each participant's level of understanding. Parents could be present during the interview but were asked not to intervene. As approved by the Research Ethics Board, participants were compensated with a $25 gift card from a selection of bookstores, and arts and crafts stores. The use of semistructured interviews allowed for researchers to remain flexible, but also to narrow down into specific topics related to their mental health (Higginbottom et al., 2013). The interviews were carried out by three research assistants via Zoom 5.0 encrypted videoconference or phone calls between September 2020 and February 2021 and lasted between 20 and 60 min each. The number of interviews per participant varied from 1 to 2, depending on the depth and richness of the first interview. Interviews were recorded and transcribed verbatim. During the data collection phase, field notes were taken to document interviewers' reflections (Muecke, 1994; Mulhall, 2003). The process was supervised by an experienced researcher (M. M.) and research coordinator (E. Laberge‐Perrault). For the collection of demographic data, participants were asked following completion of the consent form to indicate their city or town of residence, as well as their age and gender.

2.4. Data analysis

Data collection, synthesis, and analysis occurred concurrently, following the interpretive process detailed in Crist and Tanner (2003) and the narrative synthesis strategy developed by Montreuil and Carnevale (2018). To enhance rigor, the research assistants conducting the interviews created detailed interpretive comments to accompany their field notes within 48 h of conducting each interview. These comments specifically addressed the study aims. Then, for each interview participant, the research assistants prepared a narrative synthesis based on field notes, interview transcripts, and interpretive comments, including excerpts from the raw data. Next, a larger summary of these syntheses was constructed, highlighting similarities and differences in participants' experiences, as well as to identify important themes, contextualize the data, and make meaning of the data, in collaboration with different research team members. Finally, the larger synthesis was refined to clarify the initial interpretations. Throughout this process, exemplars were identified to enhance understanding (Benner, 1994; Crist & Tanner, 2003). Similarities between C&A' experiences are presented jointly in the results, with particularities pertaining to each group highlighted where relevant.

3. RESULTS

3.1. Participant characteristics

A total of 25 participants were included in the study, with 13 (52%) girls and 12 (48%) boys. Thirteen were attending elementary school (referred to as children) and 12 were in high school (referred to as adolescents) (Table 1). Most participants lived in an urban or suburban area, within the province of Québec, Canada.

Table 1.

Participant characteristics

N (%) Mean (std dev)
Age 11.6 (3.70)
Gender
Girl 13 (52)
Boy 12 (48)
Education
Elementary school 13 (52)
Age 6–12 8.09 (1.76)
High school 12 (48)
Age 12–17 14.92 (1.83)
Geographical location
Metropolitan community of Montréal 17 (68)
Island of Montréal 12 (48)
Other location within Québec 8 (32)
Town size (population)
<5000 1 (4)
5001–10,000 1 (4)
10,001–20,000 1 (4)
20,001–50,000 2 (8)
50,000–100,000 0
100,000–500,000 1 (4)
>500,000 19 (76)
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3.2. C&A mental health

Participants described a distinct pattern related to their mental health as the pandemic unfolded, which followed the severity of the pandemic in the province (see Figure 1). While C&A interviewed during the second pandemic wave found the initial shutdown in the spring to be the most distressing, they also highlighted that their experience was increasingly difficult as the pandemic persisted. An overview of C&A' experiences over time is first presented, followed by a thematic analysis based on different spheres of C&A's lives.

Figure 1.

Figure 1

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COVID‐19 timeline in Québec and timing of the interviews [Color figure can be viewed at wileyonlinelibrary.com]

3.2.1. Experiences throughout the first and second waves

C&A reported seeing positively the public health measures initially implemented, which led to an extended spring break due to school closures. As a participant explained: “At the beginning I was like oh cool, we still have another two weeks of vacation, I won't do anything, and I'll relax. Um… but after that since it like, the more it lasted, like the more it, it started to suffocate me and all.” Isolation from peers and extended family, as well as cancellation of extracurricular activities, led most participants to experience the spring period as the most challenging time. Distressing reactions reported include sadness, depressed moods, and feelings of fear, worry, and anxiety (e.g., to be infected or lose friendships). Symptoms of rumination, for example, recurring thoughts about missing one's friends, were frequently reported by adolescents. Many shared experiencing disturbed sleep schedules, motivation difficulties, more listlessness, and feelings of discouragement. As mentioned by a participant: “I feel like I wasn't even happy, I wasn't even sad, it was just like, I feel like I was really just like a wall in my house.” In contrast, some participants' moods had not been negatively affected by the pandemic. They shared playing or performing leisure activities alone or with their siblings, if any.

As certain public health measures were lifted following the first pandemic wave and warm weather allowed for outdoor social interactions, participants shared more positive experiences linked to a greater sense of normalcy: “But after when the, the confinement […] like it loosened and all during the summer, I got to see my friends during the days and all, like we went to the park together, I find that was nice and that it cheered me up.” For many, family vacations such as camping, going to a cottage, and small trips occurred, which helped with their mood. Although there were added restrictions in place when schools reopened in September, many participants expressed that their improved mood was initially maintained, especially since it meant seeing their friends on a regular basis again. One participant, however, shared being worried to see his friends again since he felt that he may have lost his social skills. Another child was worried about the possibility of being infected with the virus and spreading it to others.

As the second wave of COVID‐19 intensified, C&A reported increased feelings of distress. Many knew people who had been infected, which was experienced as stressful and sad. When explaining what he personally knew about the pandemic, a child shared: “Mmm, I know that it kills a lot of people and it stresses quite a lot of kids, because, I had it in my class once. It's been, four weeks I think. […]. I didn't have it, but there were some people who started crying in my class […]. It's really sad.” Both C&A expressed varying levels of hopelessness and discouragement due to the uncertainty and unpredictability of the prolonged nature of the pandemic, negatively affecting their motivation: “I feel like we're never gonna get out of this honestly, so yeah it's a little bit hopeless at this point because I don't know like, yeah I just don't know how we're gonna get out of it… The measures just keep getting stricter with time, they don't loosen at all, they don't loosen so I don't know. Yeah, I'm pretty hopeless.” Some adolescents mentioned that this uncertainty led them to experience panic attacks.

3.2.2. Repercussions on different spheres of C&A' lives

C&A' pandemic experiences and its mental health repercussions were linked to different spheres of their lives, such as extra‐familial social activities, schooling, and family life.

Social activities

The loss of extra‐familial social activities such as birthday parties, sleepovers, going to the park, extracurricular activities, and organized team sports was experienced as distressing and sad, as C&A longed to spend time with their friends. The loss of social activities meant for many adolescents that they were missing out on shared experiences with peers that could contribute to develop their identities: “But I think that I'm going to miss something […] there's the fact that I can't discover new things, like experiment with my friends.” Other participants expressed feeling that they were missing out on their lives and could not live their teenage years fully, as they were prevented from engaging in important social rituals like graduation. Younger children also expressed missing their friends, with one child mentioning the following about being at home: “Uhm, it's different, it's like I'm losing friends.” These examples of social restrictions related to the school context were often expressed spontaneously by children when asked about what the pandemic had been like for them.

School

Children considered online learning more boring and less motivating than in‐person classes, describing it as “not fun,” with one child stating: “I absolutely didn't want to participate.” Adolescents' experiences were mixed. Most described disliking online classes due to greater difficulty concentrating and poor adaptation of class content to an online format. Restrictions for interactive engagement with peers and teachers were considered as a major downside. Many adolescents described being less comfortable asking questions online, which led to an increase in lecture speed and decreased understanding, enhancing anxiety. Some explained feeling stressed as their workload felt greater than in previous years. On the other hand, certain adolescents indicated appreciating online learning, since it is a more autonomous and adaptable learning format than in‐person classes.

Public health measures implemented for in‐person classes were said to remove some of the fun usually present at school, such as extracurricular and social activities. One child shared: “Because for example, at school, we aren't really allowed to say hi to others. We always have to distance ourselves. For example, the class in front of my class, well, we aren't allowed to talk to each other.” Certain measures were deemed maladapted, illogical, confusing, and not clearly explained. For instance, a child explained that in the hallway, he had to maintain a 2‐m distance with his classmates, but this requirement was lifted once they were in the gym. Similarly, one adolescent described: “I mean, to me the rules, they kind of feel random and also at school, the rules, like we don't really know what the rules are. There's no like book that tells you the rules. So like sometimes the teachers, they contradict each other or the personnel of the school. So we don't really know what's the rules.” Some C&A stated that school staff had become stricter to reinforce these new rules, which affected their morale: “They're always like screaming at us when we're trying to like, talk to each other, which it, makes it really sad because it's like, basically school is just for educational purposes right now, and not socializing. So it's like, you might as well just be alone, which really sucks.” In relation to wearing masks for extended periods of time, most mentioned having become accustomed to it.

Family

Confinement measures forced families to spend more time at home, leading to positive and negative experiences for C&A. Almost all participants shared that it offered the opportunity for their family to develop closer bonds: “[…] something positive that came with COVID is that, I spent, I got to know my family better on like a more meaningful level.” Additionally, many participants indicated that their parents and siblings had become their primary sources of support, entertainment, activities, and happiness. Some C&A felt very lucky and appreciative for the time spent with their family: “Being with my family […] it helps a lot, I feel like it's not that bad, because at least I have a family that, that I love and that, and that I'm close enough with, and so that, yes, that helps a lot”. Despite the benefits expressed by C&A associated with spending more time with family, some also expressed downsides, such as having more instances in which they annoyed each other. Because of this, some participants, particularly adolescents, described experiencing more arguments and outbursts of anger at home. Yet, for C&A who had siblings with whom they got along, they expressed appreciating their presence as it allowed them to have playmates or peers they could easily talk with about what they were experiencing. For participants who did not have siblings, they expressed that not being able to spend time with other C&A greatly affected their mood, as they felt particularly lonely.

C&A mentioned struggling with suddenly not being able to see their extended family due to confinement and traveling restrictions, especially during the Christmas holidays which was generally a time when they would get together and celebrate. Most participants, C&A alike, particularly avoided seeing their grandparents due to the fear of endangering their health. Many participants also mentioned that they felt sad and worried as they saw the negative mental health effects of the pandemic on their loved ones.

3.3. Helpful coping strategies

Numerous strategies were described by C&A to maintain a stable mood, feel better, and/or distract themselves from the pandemic's negative mental health repercussions.

3.3.1. Having a variety of hobbies

Participants who had a variety of hobbies they could do alone described the most well‐being, whether they performed these activities before the pandemic or started in response to the confinement measures. C&A spoke passionately about them, highlighting how they were beneficial for their mood, with one adolescent stating: “I know that exercise, it's a, it helps to be in a good mood and all that. And I really loved it so I was always working out. So I think that this, this would be a piece of advice I'd give a lot of people, to like try a sport that you like, like dancing, do something because, like it doesn't seem like it, but even fifteen minutes a day and then like, your day, it's better.” Other hobbies shared included arts and crafts, reading, cooking, spending time with pets, and technology‐related activities, such as playing video games and watching television. However, a subset of participants highlighted that only engaging in screen‐related activities was not helpful for their mood. Outdoor individual hobbies (e.g., walking, performing outdoor yard activities, and biking), were described as helpful to alleviate the impression of being imprisoned, especially for C&A who didn't have access to a backyard.

Participants who had fewer individual hobbies or who had lost important group hobbies reported experiencing more mental health difficulties. Remaining in contact with one's peers and having group hobbies that were similar to those practiced before the pandemic, but in accordance with the measures in place, was described as helpful for C&A to maintain a positive mood. For example, playing online group video games, riding their bikes with friends, or engaging in virtual workout classes and games were particularly beneficial.

3.3.2. Expressing emotions

Having opportunities to express their emotions and feeling understood were described as highly beneficial: “I think my mom and I, […] like when we have deep meaningful conversations, I just – I feel better because it just makes me feel like someone understands me, and like… and she gives me really good advice.” Many adolescents expressed that being able to talk about what they were going through with peers their age was especially helpful. Having an outlet to express one's difficult emotions was also described as beneficial. For example, an adolescent who had experienced a lot of frustration during the pandemic began making rap music to express these feelings to prevent himself from having anger outbursts: “Now [with rap], […] I really see that it really helps me, to free myself more. […] Like I keep a lot of things inside. But [rap], it really helps me to, to breathe a bit, to have fun, especially with school, […] and now, like you can see I have my mic, I can rap at home and, it's good, it's stress relief.”

3.3.3. Accessing financial and material resources

Participants who stated having access to “adequate” financial and material resources shared that it protected them from many distressing consequences of the pandemic: “For me, it isn't so bad because […] my parents, they still work so we don't really have any financial problems and yeah, it's going pretty well.” For some, this also meant having access to a large backyard and a pool, which was helpful to engage in outdoor activities that aided their mental health: “I'm okay with COVID. Like I have a big yard, I have a pool, I have brothers I can play with. But there are other people who have like, they don't have [that] so for them, it must be harder.” Two participants who lived in the countryside or had the opportunity to visit the countryside also found that this environment was beneficial for their mental health: “I'm actually lucky because […] at least I had some things to do, and like some of my friends live in [the city] where like they can't go outside because they have like a little property and they couldn't do much. But I live on a farm so like at least I had like something to do because we have a big property so if anything, they were probably more sad than me.”

3.4. Societal and moral reflections triggered by the pandemic context

Some participants described that being faced with adversity and spending more time alone brought them to wisely consider their priorities, values, and global awareness. For example, some began to feel less worried about what others think of them and their appearance: “Everything was about your image for so long and like, living without that for a long time just kind of made me realize, like, why is it so important? Why do we care about that? And so, I think that my mindset on things just kind of changed and I realized like, I realized that's not really what's important.” Others also shared having realized who their true friends were based on their shared values and how seriously they applied the public health measures. Certain adolescents noticed that people around them developed a greater awareness of world issues since, as a society, we are facing a common threat with the COVID‐19 pandemic. A few children also described having come to the realization, through their experience with the pandemic, that there are not always rapid solutions to important societal problems.

4. DISCUSSION

The repercussions of social isolation were central to C&A' shared experiences. They stated experiencing loneliness and a longing to be with their peers, which was often reported to be linked with feelings of sadness and anxiety. These results are similar to those of other studies examining C&A' mental health during the COVID‐19 pandemic, which showed that the loss of in‐person social interactions was strongly associated with C&A' mental health deterioration (Cost et al., 2021; Larsen et al., 2021). The prolonged pandemic duration was particularly distressing for C&A, which is associated with negative mental health symptoms such as depression and anxiety (Loades et al., 2020). These results also align with conceptual work on human isolation—which define this concept as encompassing social isolation and confinement—that identified anxiety, anger, loneliness, depression, and mood disturbances as consequences of isolation (Gilmartin et al., 2013).

These mental health difficulties were especially evident for adolescents, consistent with findings from Larsen and colleagues (2021). In the province where the study was conducted, elementary school children received online schooling during the springtime and in‐person schooling was reestablished in the fall, giving them the opportunity to rekindle their friendships at school, while adolescents sustained prolonged online schooling (every other day) throughout the second and third waves of the pandemic. Considering the importance of peer interactions for many adolescents, they may be particularly vulnerable to experiences of social isolation (Jones et al., 2014; Sawyer et al., 2018). Being unable to see one's friends was one of the greatest concerns for adolescents in other studies conducted during the pandemic, which has been identified as a stressor impeding autonomy development (Magson et al., 2021; Salzano et al., 2021). Certain participants in our study however described positive repercussions of experiencing a period of isolation, such as developing closer family ties (for both C&A), having time to reflect more deeply on their values, and acquiring a greater understanding of societal issues. These positive repercussions have rarely been reported in the media and literature (Cost et al., 2021), but were also identified in another study on C&A' experiences of the pandemic (Stoecklin et al., 2021). Future studies could be conducted to examine how to foster these positive experiences.

C&A in this study described negative school experiences during the pandemic due to a focus on academic tasks, which is consistent with findings from Fioretti et al. (2020). While school is foremost a place of academic learning, it should also serve as a place for development and socialization (Brown & Larson, 2009). This situation contributed to the feeling of isolation many C&A experienced.

The general family climate was also highlighted as particularly important to support C&A's mental health during the pandemic. For example, C&A indicated that having opportunities to express their emotions with family members was beneficial for their mood, especially when their emotions were acknowledged and supported by their family members. Validating C&A' emotional responses is linked to positive affect and mood (Lennarz et al., 2019; Zeman et al., 2002). For C&A who did not have the opportunity to express their emotions in a supportive home environment, fostering relationships with compassionate adults and peers they could contact while maintaining a physical distance, as well as facilitating access to mental health and counseling services can be beneficial (Chevance et al., 2020; Fegert et al., 2020).

4.1. Recommendations

Considering the likely reoccurrence of crisis situations, including pandemics and natural disasters (Barbour et al., 2020), adaptations can be put in place by nurses and other healthcare providers to mitigate the possible negative repercussions of populational measures, while ensuring safety.

To help alleviate the distress caused by social isolation throughout the pandemic, most C&A shared that practicing a variety of hobbies was particularly helpful, as recommended in the literature (Hiremath et al., 2020; Moore et al., 2020). Distraction through play, exercise, sports, cooking, or crafts is an important component of psychosocial care, especially during confinement, as it can protect against, or reduce, the negative repercussions on C&A' mental health (Kang et al., 2020; Koller et al., 2010; Singh et al., 2020; Yeasmin et al., 2020). Taking part in activities that call upon C&A' imagination (e.g., artistic activities and play) can foster a feeling of well‐being by opening up a space for creativity and distraction (Bateson, 2015; Jensen & Bonde, 2018; Malboeuf‐Hurtubise et al., 2021, Nijhof et al., 2018). Outdoor activities were described as particularly beneficial for their mental health. Participating in outdoor group activities while adopting preventative distancing measures could have a doubly positive effect, due to the studied benefits of nature on overall mental health and stress reduction, coupled with the benefits of social activities (Cost et al., 2021; Jones et al., 2014; Tillmann et al., 2018). While many authors recommend maintaining routines to reduce or limit the psychological impact of social isolation during the pandemic (Imran et al., 2020), many C&A explained that their routines actually led to greater boredom and distress since they had few positive and exciting activities to look forward to. These results emphasize the importance to have a routine that includes an array of stimulating activities that C&A personally enjoy.

School or public health nurses may be in the best position to mitigate the negative repercussions experienced by C&A during pandemics. They can not only assist in applying preventative measures in schools (e.g., screening and immunization), but also monitor students' mental health and well‐being (Buduhan & Woodgate, 2021; Williams et al., 2021). Online care support or hybrid models can be used to check‐in on students periodically during pandemics (Williams et al., 2021), particularly during school closures, as our findings suggest these are the times C&A' mental health was most affected. Ensuring a positive nurse–student relationship during school closures may allow for students to feel more emotionally supported and connected, reducing their risk of developing mental health disorders (Williams et al., 2021). Virtual platforms may also be utilized to educate students about the mechanisms of the virus, preventative measures, mental health literacy, and strategies to cope during the pandemic (Williams et al., 2021). Through the implementation of mental health promotion in schools, long‐term and serious mental health difficulties may be avoided (Williams et al., 2021).

4.2. Limitations

Most study participants lived in urban or suburban areas and belonged to the ethnic majority group, which offers a particular perspective that is context specific. Access to a computer and an internet connection (or a phone) was necessary to participate, which meant that C&A without these resources could not be included in the study. Technical difficulties sometimes occurred, which hindered the quality of certain interviews. Having the possibility to conduct two interviews contributed to mitigate this limitation. The absence of direct contact may have impeded the possibility of creating an interview environment in which participants felt more at ease to share their experiences. The videoconferencing format may also have affected participant recruitment, as many C&A shared being tired of screen use. Since the interviews were carried out during a 6‐month timeframe, the pandemic and related public health measures evolved, which affected the themes raised by participants. This evolution, however, allowed for the collection of data that informed on the lasting nature of the pandemic and permitted participants to reflect on their experiences through time.

5. CONCLUSION

This study highlights the importance of being attentive to C&A's experiences and perspectives to help them cope with the widespread changes the COVID‐19 pandemic has created in their lives. Their perspectives are vital for practice and policy improvement, particularly in the context of remote schooling and in finding creative means for social engagement while ensuring safety. Other benefits of engaging C&A include helping them to express their feelings, allowing them to participate in community life, and providing insights for parents and caregivers, which could help better align healthcare practice to C&A' experiences and perspectives (Murray, 2019; Pascal & Bertram, 2021). While this pandemic was brought upon us as an emergency, planning is critical and crucial if future global adverse events were to occur.

Future research could focus on children's pandemic experiences from different socioeconomic backgrounds, to ensure vulnerable populations and minority groups are considered. Additional studies related to the benefits of coping strategies shared by study participants like play and outdoor activities on C&A' mental health—with or without prior mental health issues—would also be warranted.

AUTHOR CONTRIBUTIONS

Marjorie Montreuil Centre de recherche de l'Institut universitaire en santé mentale de Montréal; Centre de recherche de l'Institut universitaire en santé mentale Douglas. Christine Genest, Centre d'étude sur le trauma du Centre de recherche de l'Institut universitaire en santé mentale de Montréal et le Centre de recherche et d'intervention sur le suicide, les enjeux éthiques et pratiques de fin de vie. CatherineMalboeuf‐Hurtubise, Centre de recherche du CHUS.

CONFLICT OF INTEREST

The authors declare no conflict of interest.

ACKNOWLEDGMENT

Fanny Ouellet who was involved as child‐partner. Victoria Gilmore and Kadiam Al‐Roubaie for their work as research assistants. This research was funded by Canadian Institutes of Health Research (FRN: 171715); McGill University's Faculty of Medicine and Health Sciences; VOICE (Views on Interdisciplinary Childhood Ethics); and Fonds de recherche du Québec—Santé, in collaboration with Unité de soutien SSA Québec (Marjorie Montreuil is the recipient of a junior 1 career award).

Montreuil, M. , Gendron‐Cloutier, L. , Laberge‐Perrault, E. , Piché, G. , Genest, C. , Rassy, J. , Malboeuf‐Hurtubise, C. , Gilbert, E. , Bogossian, A. , Camden, C. , Mastine, T. , & Barbo, G. (2022). Children and adolescents' mental health during the COVID‐19 pandemic: A qualitative study of their experiences. Journal of Child and Adolescent Psychiatric Nursing, 1–10. 10.1111/jcap.12404

Lauranne Gendron‐Cloutier and Emilie Laberge‐Perrault authors are both considered as second author.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Associated Data

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Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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