Experts in Germany are voicing their growing concern over the stress caused by the COVID-19 pandemic is leading to a mental health crisis among children. 

The social restrictions brought about by the outbreak has led to schools closing across Germany, isolating the country's 13.7 million children from education and their friends. 

"We don't have any long-term studies yet, but there's lots of anecdotal evidence of a crisis-driven rise in hospitalizations and overflowing psychologists' practices," Julia Asbrand, a professor of child and youth psychology at Berlin's Humboldt University, told AP News.

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A recent survey by the University Medical Center Hamburg-Eppendorf found that about one child in three is suffering from pandemic-related anxiety or depression, or is exhibiting psychosomatic symptoms like headaches or stomach aches. Children from poorer and immigrant families are disproportionately affected, according to the survey.

Lack of structure and company 

Pollina Dinner returned to school in Berlin for the first time this week after two months of lockdown. The nine-year-old was thrilled to see her classmates and teachers again, but frets about the coronavirus pandemic's effect on her life.

"I'm not afraid of the coronavirus, I'm afraid that everything will continue like this – that my school will close again, I won't be able to see my friends, and that I can't go to the movies with my family," the girl told AP. "And wearing this mask is even worse than all the shops being closed."

Pollina, who immigrated from Russia with her family in 2019, worries about forgetting German as she speaks Russian at home. She's one of 150 youngsters from underprivileged families who, before the pandemic, regularly spent time after school at a youth support program on the eastern outskirts of the German capital.

Arche – Ark in English – is based in Berlin's Hellersdorf district. Some children are still allowed to come in person, but only once every two weeks. The rest of the time, Arche's workers keep in contact with the kids using video chats, helping their young clients with remote learning.

"Many have completely withdrawn and don't want to get out of their rooms anymore. They've gained a lot of weight, are playing online games nonstop and don't have any more structure in their everyday lives," Arche founder Bernd Siggelkow said.

Rising need for psychiatric treatment

The second major lockdown in Germany started before Christmas. Students in grades 1-3 were allowed to return to classrooms this week with reduced class sizes and limited lessons. The government hopes to ease further restrictions in coming weeks and has said that the re-opening of all schools is a top priority.

However, there's concern the country is slipping into a third wave of infections due to more contagious variants of the virus. Virologists have repeatedly said it is still unclear to what extent the virus spreads from children attending school into homes and communities. 

Even though children are not at as much risk of severe COVID-19 complications as older adults, they may be more vulnerable to the collateral mental health effects of the pandemic, according to experts.

Analysis by German health insurer DAK regarding youth psychological issues confirms the first-person observations of the staff at Arche.

The evaluation, which was obtained by German news agency dpa, showed that the number of children and teenagers hospitalized for psychiatric treatment in Berlin almost doubled during the first half of 2020, when schools were closed for over two months during the country's first lockdown, compared with the first six months of 2019.

'Tip of the iceberg'

The statistic underscores the psychological strain the pandemic is putting on young people but does not illustrate the scope of the problem, Christoph Correll, the director of child and youth psychiatry at Berlin's Charite hospital, told dpa.

"Hospitalizations are the tip of the iceberg," Correll told AP.

Teenagers, especially girls, are more prone to eating disorders and self-harming, and many children's psychological problems are going undetected while parents are overwhelmed and teachers, social workers and paediatricians don't have regular contact with students, clients and patients, experts warn.

Psychology professor Asbrand worries that the mental health of children and teenagers has not gotten enough attention during the pandemic. 

Together with other professionals in the field, she wrote an open letter to the government this month to push for youth needs to get better addressed in the ongoing health crisis and prioritized when society reopens.

An immediate action government authorities could take to help mitigate possible problems would be to allow groups to gather for school and youth sports, in line with hygiene and distancing precautions.

"We all don't know yet how this is going to develop long-term, but we must focus on youth mental health now," she said.