Young People’s Mental Health Changes, Risk, and Resilience During the COVID-19 Pandemic

Abstract

ImportanceAs young people’s mental health difficulties increase, understanding risk and resilience factors under challenging circumstances becomes critical.ObjectiveTo explore the outcomes of the COVID-19 pandemic on secondary school students’ mental health difficulties, as well as the associations with individual, family, friendship, and school characteristics.Design, Setting, and ParticipantsFor this cohort study, follow-up data from the My Resilience in Adolescence (MYRIAD) cluster randomized clinical trial were collected across 2 representative UK cohorts. Mainstream UK secondary schools with a strategy and structure to deliver social-emotional learning, with an appointed head teacher, and that were not rated “inadequate” in their latest official inspection were recruited. A total of 5663 schools were approached, 532 showed interest, and 84 consented. Cohort 1 included 12 schools and 864 students, and cohort 2 included 72 schools and 6386 students. COVID-19 was declared a pandemic after cohort 1 had completed all assessments (September 2018 to January 2020), but cohort 2 had not (September 2019 to June 2021).ExposuresCohort 2 was exposed to the COVID-19 pandemic, including 3 national lockdowns. Associations of individual, family, friendship, and school characteristics with students’ mental health were explored.Main Outcomes and MeasuresChanges in students’ risk for depression (Center for Epidemiological Studies-Depression scale); social, emotional, and behavioral difficulties (Strengths and Difficulties Questionnaire); and mental well-being (Warwick-Edinburgh Mental Well-Being Scale).ResultsOf the 7250 participants included, the mean (SD) age was 13.7 (0.6) years, 3947 (55.4%) identified as female, and 5378 (73.1%) self-reported their race as White. Twelve schools and 769 of the 864 students (89.0%) in cohort 1 and 54 schools and 2958 of the 6386 students (46.3%) in cohort 2 provided data and were analyzed. Mental health difficulties increased in both cohorts but to a greater extent among students exposed to the pandemic, including for risk of depression (adjusted mean difference [AMD], 1.91; 95% CI, 1.07-2.76); social, emotional, and behavioral difficulties (AMD, 0.76; 95% CI, 0.33-1.18); and mental well-being (AMD, −2.08; 95% CI, −2.80 to −1.36). Positive school climate, high home connectedness, and having a friend during lockdown were protective factors during the pandemic. Female gender and initial low risk for mental health difficulties were associated with greater mental health deteriorations. Partial school attendance during lockdown was associated with better adjustment than no attendance when returning to school.Conclusions and RelevanceThis cohort study of secondary school students demonstrated that to promote mental health and adjustment, policy interventions should foster home connectedness, peer friendship, and school climate; avoid full school closures; and consider individual differences.

School closures and prescription medication use among children and adolescents before and during the COVID-19 pandemic in the USA, 2019–2022

“…These findings suggest that the underuse of ADHD medications may be an overlooked contributor to declines in academic performance observed during COVID-19 pandemic lockdown, particularly among children with learning disabilities. 4 5 Furthermore, declines in the use of beta-agonist inhalers extend findings from prior studies that report paediatric emergency room visits and hospitalisations for asthma have substantially declined during the first year of COVID-19 pandemic secondary to school closures. 10 Finally, persistent increases in prescription fills for antidepressants and antianxiety medications are consistent with prior studies of worsening mental health and suicidality during periods of school closure.…”

“…The US public health response to the COVID-19 pandemic included school closures, with nearly all public schools completely closed for in-person instruction by the end of March 2020 for the academic year and not reopening until January 2022. 1 Despite evidence that the COVID-19 pandemic and school closures led to worsening mental health, including suicidality, 2 3 academic performance [4][5][6] and declines in the dispensing of prescription medications for acute infections, in children and adolescents in the USA, 7 the association between school closures and the use of prescription medications, particularly antidepressants and attention deficit hyperactivity disorder (ADHD) medications, is not known. In this study, we analysed changes in the use of prescription medications alongside patterns of school closures in the USA.…”

Evidence linking COVID-19 and the health/well-being of children and adolescents: an umbrella review

“…This suggests that the deterioration of mental health in the younger population during the pandemic may not solely be attributed to indirect impacts during the gradual relaxation of mandatory control measures in many countries. The underlying causes of this phenomenon may vary and encompass financial stressors [ 191 ], social isolation [ 192 ], physical health concerns [ 193 ], and heightened anxiety and fear stemming from the uncertainties of COVID-19 [ 194 ]. Therefore, it is crucial to monitor the negative impact on the mental health of children and adolescents in the future, with dedicated efforts aimed at enhancing their well-being.…”

Development of a Scout Movement-Based Mental Health Literacy Module to Prevent Bullying

“…Since the COVID-19 pandemic, the problem faced by teenagers and school-age children is mental health problems. Learning online and at home becomes a psychosocial problem for school-aged children (Montero-Marin et al, 2023), such as anxiety, depression, stress, social isolation, and even the risk of suicide. Since the COVID-19 pandemic became endemic in Indonesia, mental health problems among teenagers have also increased (Temple et al, 2022).…”