‘Maria’, aged 21, rang Kids Helpline because things had been getting a little bit harder lately with the coronavirus situation. She was diagnosed with depression a few years ago and has also attempted suicide a few times. Both her parents are alcoholics and her mum was abusive when she was growing up. She has voices in her head that tell her nobody cares. Usually she will distract herself from these thoughts by spending time with friends or losing herself in work, but with the lockdown she has been unable to do so. 281 (11%) children and young people indicated that COVID-19 and the associated restrictions had affected their pre-existing mental conditions, triggering or increasing the debilitating effects of the conditions. These mental health conditions ranged in severity. However, a large number who mentioned COVID-19 in this context also reported serious mental health conditions during their contact with Kids Helpline. Of the 2567 children and young people who raised COVID-19 overall, as many as 248 (10%) also had suicide-related concerns recorded. For as many as 146 (6%), self-harm/injury had been recorded as a concern. Further, of those who specifically mentioned that COVID-19 had increased their pre-existing condition, • • • • 17% raised suicide 9% raised self-harm 1% raised substance abuse 1% raised body image as one of their concerns when contacting Kids Helpline. It is likely that COVID-19 and its restrictions increased the impact of pre-existing mental health conditions in many more of the contacts to Kids Helpline than is reflected above. However, only those children and young people that specifically mentioned its impact were included in the count. In some cases, a fear of getting COVID-19 was a trigger for an existing mental health condition, but in most cases the restrictions, including the reduced access to usual coping strategies, were cited as the reason for increasing symptoms. For example, children and young people with eating disorders raised concerns that changing routines and limited access to their usual forms of exercise meant that they were unable to cope with their disorder. Concerns about body image and eating disorders during COVID-19 are reflected in data released by ReachOut and the Butterfly Foundation, which shows a sharp spike in the numbers of young people seeking help with body image and eating disorders compared to the same time last year.5 According to June 2020 data, 75% more people visited ReachOut’s content about body image compared to the same time last year (16 March to 30 June 2020 & 2019). There has also been an increase of 48% in the number of people seeking help for an eating disorder via the Butterfly Foundation’s Helpline during the COVID-19 pandemic, compared with the same time last year. Case studies: Triggers or increases in pre-existing mental health condition ‘Lottie’, aged 17, told Kids Helpline her eating disorder had worsened over the past few months because she has been unable to engage in things that would make it okay for her to eat; that is, exercise and netball. She is being medically monitored every fortnight by her GP and speaks to her therapist on the phone because of social distancing. But she doesn’t think the phone sessions help her. She said she has been unable to find a new therapist, because they are either not taking on new clients, or have a long wait time. Impacts of COVID-19 on children and young people who contact Kids Helpline • 2020 • 19