It was widely anticipated that Covid-19 and the lockdowns it engendered would have a devastating effect on the mental health of our young (Gruber et al, 2020).
Indeed, the numbers of youth suffering depression and other miseries has increased through the pandemic (Deng et al, 2021). But the impact has been more variable than was expected: while depression increased for many, some were not affected, and some even enjoyed improved mental health (Deng et al, 2021; Hutchinson et al, 2021).
A special issue of the Journal of Research in Adolescence (volume 31, issue 3) presents a collection of studies exploring risk and protective factors for mental health in adolescents in the pandemic. This article summarises the key findings of those studies and the practical implications for schools and staff.
The usual suspects: Social disadvantage and vulnerability
We have long known that low socio-economic status, financial difficulty in the family, ethnic minority discrimination, poor support from family or peers are all generally associated with poorer outcomes whatever the issue.
And these factors were predictably associated with greater vulnerability to mental health problems through the pandemic (Deng et al, 2021; Hussong et al, 2021; Hutchinson et al, 2021). Alas, these risk factors often co-occur, presenting a cascade of effects that multiply disadvantage.
By contrast teenagers from more affluent backgrounds with supportive families and friends were more likely to cope well with the pandemic, more likely to experience reductions in anxiety and other emotional issues and to experience overall improvements in mental health (Deng et al, 2021; Hussong et al, 2021; Hutchinson et al, 2021). Again, these protective factors tend to co-occur, creating a multiplying cascade of advantage.
It is not hard to understand the impact of factors associated with vulnerability. Low socio-economic status, financial difficulty, parents who lost their jobs or had to take the risks of working outside the home and might be unable, for those reasons alone, to offer much support to the young, which could easily lead to a depressing situation.
The improvements in mental health seem more surprising. The probability is that for some, being out of the school environment through lockdowns reduced both academic and social stresses (a thing we need to ponder on).
For some, particularly those from families of higher socio-economic status, without financial challenges, lockdowns increased quality time in the family, and might also have provided more access to new activities and hobbies, again factors likely to boost wellbeing.
The practical implications
Resources to support the young through and after the pandemic should be focused on those most at risk of damage to mental health. Unaddressed, these vulnerabilities may lead to long-term negative consequences for mental health (Hussong et al, 2021), a fact which should concern government (pandemic or not).
It is not rocket science! But the results here also suggest that we need to be more nuanced, less stereotyped in identifying risk. For example, not all teenagers from lower socio-economic status backgrounds are in families with financial difficulties or which lack emotional support.
Nor are all teenagers from higher socio-economic status backgrounds necessarily enjoying protective factors: there may be no financial difficulty, but not all affluent families offer supportive parenting. Tensions between teenager and parent (and abuse) can occur in any socio-economic status group.
Risk assessment of vulnerability needs to be multi-factorial. Equally, the support a vulnerable individual might need is not uniform: for example, financial difficulty might be addressed by providing access to the internet, or in severe cases, food and heating, whereas vulnerability from poor family support would need a very different intervention.
And while support should be targeted toward specific issues, we should be alert to the fact that many individuals will suffer multiple risk factors, and hence need support across many different areas.
Loneliness
Loneliness emerges as a major risk for poor mental health outcomes (Hussong et al, 2021). The pandemic greatly reduced peer interaction among the young, and this in itself created loneliness (Cauberghe et al, 2021).
Interestingly, whereas extraversion normally protects mental health, in the pandemic it was a liability (Alt et al, 2021), associated with increased loneliness and depression.
Many teenagers lost the support of their peers through the pandemic just when they needed it most (Alt et al, 2021; Bernasco et al, 2021; Hutchinson et al, 2021). Sometimes this loss was as a direct consequence of their distress: sometimes friends found empathising with a friend’s distress so overwhelming that they withdrew rather than offering support (Sabato et al, 2021).
As social interaction moved online, some were excluded through lack of internet access, but others by poor quality interactions (Bernasco et al, 2021).
Overall, it is quality not quantity of interaction that is crucial (Maheux et al, 2021). The poorer the quality of interaction with peers, the greater the loneliness, and the greater the risk to mental health. Positive interactions online mitigated feelings of isolation and loneliness (Magis-Weinberg et al. 2021).
Positive interactions were characterised in two ways: as sharing jokes, and playing games together online (Cauberghe et al, 2021), and as meaningful rather than trivial interactions (Maheux et al, 2021). Maheux identified gratitude, defined as a positive outlook (living in blessings) as a crucial factor supporting meaningful interactions and protecting mental health.
Loneliness was also affected by quality of relationship with siblings and parents (Campione-Barr et al,2021; Janssens et al, 2021) in the obvious ways. Parental involvement and direct support was a crucial protective (Campione-Barr et al, 2021; Klootwijk et al, 2021; Maiya et al, 2021; Shi & Wang, 2021). Alas, adolescence is not a period of life notoriously associated with good parent-child relationships, which may be a factor fuelling mental health issues across the family as a whole. And tragically, the pandemic left some vulnerable youth trapped at home with abusers.
The practical implications
This is a challenging area for schools. How far can we, should we, intervene in peer relationships and family dynamics? There is a clear duty to protect against domestic abuse, but there are complex moral and political issues when it comes to the quality of relationships between family or friends.
However: there is nothing to stop schools checking how lonely a teenager feels, what contacts they have (or don’t have). There is nothing to stop schools finding ways to discuss how the young might develop better, more protective relationships online, and in family.
Emotional stability
Predictably, those who had mental health problems before the pandemic were more vulnerable to further damage. Beyond that, this research identifies the ability to regulate emotions effectively as a key factor in risk or protection.
Those who had poor emotional regulation prior to the pandemic were most at risk of mental health damage (Hussong et al, 2021; Romm et al, 2021), and are most at risk of long-term damage (Van Loon et al, 2021).
The practical implications
Are there ways that we can foster the skills of emotional regulation? Encouraging something like “counting to 10” before reacting; encouraging “deep breaths”, which induce calm; encouraging reflective strategies to manage stress? Emotional regulation skills often reflect parental attitudes and practices. Parents suffer from stress too. Deng et al (2021) suggest that interventions subtly and sensitively aimed at parents will not only help those parents, but also their children.
Existential resilience
The pandemic has seen a rise in despair, and “deaths of despair” through suicide, drug addiction, and self-harm in the vulnerable (Steinhoff et al 2021). This has fed recent research interest in existential orientation and existential development.
Our species has lived through many previous pandemics – and wars, and climate disasters. Such situations foster two different existential strategies: live fast, breed soon, accept a risk of dying young, versus live slow, self-care, manage the risks, defer reproduction to plan for survival through adversity, try to live old.
Chang et al (2021) looked at the current pandemic through this lens: as we have long known, adversity, perhaps particularly in childhood, pushes us toward “live fast”. But through human history, and also in this pandemic, “live slow” is the more successful strategy.
The practical implications
We in the West have lived through an unprecedented “bubble” of safety, security, health for many decades. With the pandemic, the war in Ukraine, climate change, that seems to be over. In summarising the research in this special issue, Hussong et al (2021) argue that what we must do now is to help the young to develop in new ways that accept this more dangerous world – and find constructive ways to deal with it.
In other words, we need to help them develop a more robust orientation to existential threats to life and death. In this sense, it may be worth considering the advice in my previous SecEd series on (re)building hope in the young (Thornton, 2022).
- Dr Stephanie Thornton is a chartered psychologist, author and lecturer in psychology and child development. She is the co-author of Understanding Developmental Psychology (Macmillan International/Red Globe, 2021). To read her previous articles for SecEd, visit http://bit.ly/seced-thornton
SecEd Summer Edition 2022
This article first appeared in SecEd's Summer Edition 2022. This edition was sent free of charge to every secondary school in the country. A digital edition is also available via www.sec-ed.co.uk/digital-editions/
Journal of Research on Adolescence
Research papers cited from the Journal of Research on Adolescence (Volume 31, Issue 3), September 2021: https://bit.ly/3JgxJyY
- Alt et al: Fall from grace: Increased loneliness and depressiveness among extraverted youth during the German Covid-19 lockdown.
- Bernasco et al: Friend support and internalizing symptoms in adolescence during Covid-19.
- Campione-Barr et al: Adolescent adjustment during Covid-19: The role of close relationships and Covid-19-related stress.
- Chang et al: Slow life history strategies and increases in externalizing and internalizing problems during the Covid-19 pandemic.
- Deng et al: Predicting negative and positive affect during Covid-19: A daily diary study in youths.
- Hussong et al: Adolescence amid a pandemic: Short-and long-term implications.
- Hutchinson et al: Adolescent and maternal anxiety symptoms decreased but depressive symptoms increased before to during Covid-19 lockdown.
- Janssens et al: The impact of Covid-19 on adolescents’ daily lives: The role of parent-child relationship quality.
- Klootwijk et al: Parental support and positive mood buffer adolescents’ academic motivation during the Covid-19 pandemic.
- Magis-Weinberg et al: Positive and negative online experiences and loneliness during the Covid-19 lockdown in Peruvian adolescents.
- Maheux et al: Grateful: Longitudinal associations between adolescent’s social media use and gratitude during the Covid-19 pandemic .
- Maiya et al: Longitudinal changes in adolescents’ school bonding during the Covid-19 pandemic: Individual, parenting, and family correlates.
- Romm et al: Risk and protective factors for changes in adolescent psychosocial adjustment during Covid-19.
- Sabato et al: Too lonely to help: Early adolescent’s social connections and willingness to help during Covid-19 lockdown.
- Shi & Wang: Chinese adolescent’s coping with Covid-19: Relationships with emotional maladjustment and parental reactions to negative emotions.
- Steinhoff et al: Self-Injury and domestic violence in young adults during the Covid-19 pandemic: Trajectories, precursors, and correlates.
- Van Loon et al: Prepandemic risk factors of Covid-19-related concerns in adolescents during the Covid-19 pandemic.
Other references
- Cauberghe et al: How adolescents use social media to cope with feelings of loneliness and anxiety during Covid-19 lockdown, Cyberpsychology, Behavior, and Social Networking (24), 2021.
- Gruber et al: Mental health and clinical psychological science in the time of Covid-19: Challenges, opportunities, and a call to action, The American Psychologist (76), 2020.
- Thornton: Rebuilding hope post-Covid, SecEd Series, June 2021: https://bit.ly/35TtzMa