Child Mental Health in the COVID-19 Context

Last Updated: July 29, 2020

No Results Found 0/0
Please note that at this time, the content on this page is not being regularly updated.

Now more than ever it is important for your patients to look after their health and receive care from you as their healthcare provider. It’s essential that patients continue to seek out care that they need.

This tool has been developed to support primary care providers in navigating and providing patient care in a world where COVID-19 is the ‘new normal’. While how care is delivered has changed, efforts should be made to ensure that the quality has not. As always, when treating your patients, continue to use your clinical judgement and follow standards of care, best practices, evidence and guidelines.

Click on the sections below to get started:

How to talk to children about COVID-19

Parents and caregivers should ensure children receive honest and accurate information during the COVID-19 pandemic (SickKids, March 31, 2020).

Talking tips:

  • Share ‘need to know’ information with children, using age appropriate language.
  • Answer questions directly and honestly, and do not make false promises.
  • It’s okay if you don’t know all the answers. Focus on the short-term plan for the whole family.
  • If children are distressed, let them know that it is ok and understandable to have these feelings.
  • Model healthy coping skills and attend to your own physical and mental health.
  • Consider seeking out additional resources and supports for children with special needs or who are having trouble coping. For a list of local mental health services for families, children and youth, see Local Services > Mental health services.

Given the Pfizer vaccine has been approved for use in children age 12 and older, children and their parents may have questions regarding COVID-19 vaccination in children. See COVID-19 Vaccines for Ontario Youth (Kids Health First, 2021) for answers to frequently asked questions, as well as other resources for parents, youth and providers.

Preparing children for reopening

Reopening is presenting kids with a different set of anxieties and challenges. Doing the following, parents and caregivers can help children adapt and prepare for the changes resulting from COVID-19:

Agree on ground rules

Establishing clear family rules for socializing will give kids a sense of control. Empathize with their fears, but encourage them to think of ways that your family will work together to help everyone stay safe and healthy.

Take it step-by-step

Emphasizing that reopening is a gradual process can help kids manage their behaviour and feel more confidence. Steps to start with might include maintaining physical distancing or wearing a mask while with friends, or limiting the number of friends your child can see. Discuss what other steps might come down the road so kids know you’re planning ahead even if they can’t do everything they want just yet.

Prepare children by coping ahead

Other families might follow different rules, which could result in uncomfortable moments for kids. Work with kids to anticipate unsafe situations they might encounter so they feel more comfortable and can make better decisions when the time comes.

Recognizing the signs of mental health distress

Changes in behaviour or emotions can indicate that a child needs more support (CPS, March 2020; SickKids, April 14, 2020; School Mental Health Ontario, 2020; Child Mind Institute, 2020).

Look out for:

  • Changes in behaviour or emotions that seem out of proportion even with the current circumstances (e.g. angry outbursts, depressed mood, sense of panic).
  • Problems sleeping; shifts in sleep patterns.
  • Appetite changes; changes in weight.
  • Headaches, stomach aches/nausea and fatigue.
  • Infantile behaviours that aren’t common anymore for the child (bedwetting, thumb sucking, being afraid of the dark, wanting to be held).
  • Loss of interest in activities they enjoy; reduced feelings of anticipation.
  • Worry and/or fear of leaving the home.
  • Increased rebellion and/or complaining about schoolwork or chores.
  • Increased aggression towards others.
  • More frequent outward expression of emotions.
  • Harsh self-assessment.

If a child expresses thoughts of hurting themself or engages in suicidal behaviour, seek help from a mental health professional immediately. For a list of local mental health services for families, children and youth, see Local Services > Mental health services.

Managing depression

Managing stress and anxiety

Use the CARD System (Comfort, Ask, Relax, Distract) to help children cope
  • Comfort: help the child accept negative thoughts and feelings.
  • Ask: listen and talk to each other.
  • Relax: model relaxation for the child.
  • Distract: try to keep normal routines and limit the amount of time the child focuses on whatever is making them anxious.


Children experiencing the death of someone close to them are particularly vulnerable (Canadian Virtual Hospice, 2019). They need time to process their thoughts and feelings and to ask questions. Willingness to discuss difficult topics teaches children that hard conversations can happen safely, and that they can talk with you about difficult things (Canadian Virtual Hospice, 2019).

Talking to a child about the loss of a loved one:

  • Have the conversation in a safe, comfortable place where you won’t be interrupted.
  • Get down to eye level.
  • Tell them that you may be upset or cry while you talk because you’re feeling many emotions, and that this is natural and okay.
  • Explain that they may have strong feelings too and it’s okay to express them.
  • Start with what the child already knows and build from there.
  • Give the information in a straightforward way, using words they can understand.
  • Let them know their questions are welcome. Praise them for asking questions and sharing their thoughts and feelings.
  • Be gentle and sensitive, giving the information they ask for and need.
  • Watch for cues to guide you around pacing the conversation, signs that will help you gauge how much information to provide and when the child is ready to hear it.


These supporting materials and resources are hosted by external organizations. The accuracy and accessibility of their links are not guaranteed. CEP will make every effort to keep these links up to date.