Objective: The COVID-19 pandemic has heightened children's and adolescents' risk of experiencing longterm mental health problems and a decline in subjective well-being. To better understand the longitudinal impact of COVID-19, this study explored the role of demographic variables and the potential moderating effects of social support and daily routines as resilience factors. Method: A nationally representative, longitudinal cohort of 5,217 Israeli children and adolescents aged 10-15 at baseline completed measures of mental health symptoms, life satisfaction, positive and negative emotions, gratitude, social support, and daily routines. Data were collected in school at four measurement points: September 2019 (before the outbreak of COVID-19; N = 5,127), May 2020 (after the first lockdown; N = 4,698), May 2021 (after the third wave lockdown; N = 4,813), and May 2022 (after the fourth and fifth waves of the pandemic; N = 4,897). The data were analyzed using multilevel mixed models. Results: Significant increases in depression, anxiety, and panic along with decreases in psychological well-being were found as a function of time. These effects were moderated by age and gender. Participants with high social support and structured daily routines reported smaller increases in mental health symptoms than students with low social support or irregular daily routines. Conclusion: There is a critical need for clinical and educational interventions for young people during this period to promote the resilience factors that can moderate well-being and counter the decline in mental health.
Clinical Impact StatementThe COVID-19 pandemic has exacted a heavy mental health toll on children and adolescents that has been shown to persist beyond the peak periods and continues to this day. This longitudinal study documented the declines in mental health in Israeli 10-to 15-year-olds over a 3-year period from before the pandemic to May 2022. The findings strongly indicate that prevention programs and clinical interventions for all students based on promoting social support, regular daily routines, and well-being factors are likely to significantly reduce the mental health symptoms associated with the crisis and its aftermath.