Masks, Mental Health, and Children

Coming into increased focus over the past several months is a disturbing picture of children and teens struggling with mental health issues in the COVID-19 era. Last week, the American Academy of Pediatrics (AAP), American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association issued a declaration on the “soaring rates of mental health challenges among children, adolescents, and their families,” calling this “worsening crisis” a national emergency. Sadly, the AAP has aided the crisis with its strong endorsement of masking children, which will only lead to tragedy for children and their families.

While it is true that depression and anxiety among children were increasing even before March 2020, it’s clear that COVID-19 panic has aggravated the trend. Taken together, the available data strongly suggest depression and suicidal ideation have increased among adolescents during the panic that has followed the emergence of the virus. These data command our attention as a cost and a consequence of our shortsightedness, which has always gone hand in hand with fear and panic. If Americans are honest, we can already see the headlines and feel the grief: an upswell of anxiety and depression cases, suicides, and school shootings. These are outcomes to dread, and they’re horrible to discuss, but pretending we don’t know how this story ends doesn’t help anyone. We can come to grips with what we’ve done to the COVID-19 kids then or now.

Some have cited a lack of studies on the connection between masks and depression and anxiety among children, but this seems ridiculous when considered in context: it’s no surprise that we don’t have very much good science on these questions. How could we have studied the mental and emotional impact of masks on children except by putting masks on them, their parents, friends, teachers, siblings, etc.? There are, after all, ethical constraints on our experimental designs for a reason. The truth is that scientists have no way of knowing what the long-term mental health consequences of forcing children to wear face masks will be, but we can use what we do know to hypothesize.

What we do know is a fact that was never controversial until now: the ability to recognize and produce “facial expressions is an important skill that allows children to share and adapt emotions with their relatives and peers during social interactions.” We know the human brain takes faces very seriously, and that’s because we are unique among all living things in the way we use our faces to communicate with one another; on our faces, we wear our happiness, sadness, confusion, anger, and fear. There is much greater variability among faces in humans than in other living things, and we’re able to make a much wider range of facial expressions than other animals. And we’re finally beginning to understand why: “Recent evidence suggests that evolution has contributed to increased diversity and complexity in human facial morphology, presumably due to the role of the face as a primary medium of individual identification and recognition.” So evolution made each of us quite unique -- and it also made each of us really good at recognizing the tiny details that make us unique.

Discussing his study on the evolution of facial identity, Michael Sheehan said, “Humans are phenomenally good at recognizing faces; there is a part of the brain specialized for that.” There’s a lesson here, whatever one thinks about masks. When anyone on any side of any issue starts to claim the authority of science, we must ask whether it’s science as an attitude focused on a good-faith desire to understand the nature of reality; that is, science in context -- subtle, big-picture science that carefully accounts for and synthesizes our existing body of knowledge -- or the politicized science-of-the-cultural moment science; that is, science wielded cynically to get your political way.

Both political teams do this frequently, both with varying degrees of artfulness and technical sophistication. If we’re going to respond to this crisis in a measured, appropriate way, rather than in mindless panic, the relative merits of mask use must be considered alongside other scientific facts, such as the fact that even a newborn baby “will quickly lock on to any faces in the environment,” or the fact that wearing masks is known to strongly confuse and “disturb emotion reading from facial expression,” or the fact that the human face is at the center of how our children learn about language, emotions, and social life.

It is fascinating to observe supposedly data-centric mental health experts insist that masks present no concern, even as they acknowledge a clear mental health crisis falling hardest on our children. While we will never be able to sort out how much of this crisis can fairly be blamed on masks, we likewise don’t have a clear idea of what we hope to accomplish by masking children. As is now well-known, children are “extremely unlikely to suffer from severe illness or death if infected,” and any evidence we do have on mask use tells a story much too tenuous to inflict this practice on children.

We’re finally talking more about privilege these days, and it’s a healthy thing for American society. There may be no wider historical privilege divide than the one that separates children from adults. In pretending that children are tough and resilient, we’re showing our capacity for self-deception, shamelessly excusing our abusive behavior. With all of our causes and coalitions, with all of our awareness and activism, we still can’t seem to stand up for children -- and their weakness means that we don’t have to, that we can get away with our dereliction of duty. If we want to be scientific, we have to stop pretending the tools we’re using to fight the pandemic don’t themselves have life-threatening consequences. Parents should be deciding whether their children wear masks, not politicians, or health bureaucrats, or school administrators.

David S. D’Amato is an attorney and adjunct law professor and is on the Board of Policy Advisors for The Heartland Institute.

Image: Pixabay

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