Three years of COVID-19-related school restrictions and children's mental health in Japan

Abstract During the three years of the COVID-19 pandemic, Japanese children had to continue compliance with restrictive mitigation measures at school, such as eating school lunches silently and wearing masks even during physical exercise classes, despite restrictions having been relaxed worldwide. Excursions and other school events were frequently cancelled, especially in 2020 and 2021. This study aimed to understand how the strict mitigation measures affected children's mental health and well-being, and hence, a retrospective survey on school experiences was conducted. Results revealed school excursion cancellation to be associated with higher risk of developing depressive symptoms (odds ratio [OR] 1.655 [95% confidence interval {CI} 1.194–2.293]), and high cancellation rate of other school events to be associated with dissatisfaction in school experience (OR 1.638 [95% CI 1.214–2.221]). Overall, the study demonstrated that persistent strict mitigation measures at schools could have a cumulative negative impact on children’s mental health and psychological well-being.