Middle schoolers with mental health problems pre-pandemic showed reduction in symptoms during early stages of pandemic
A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that middle schoolers from a predominantly Latinx community, with elevated levels of mental health problems, showed a reduction in symptoms during the early stages of the pandemic.
"While the negative impact of the COVID pandemic on mental health is widespread, our study found that COVID-19 stay-at-home measures may have offered some protective effects for youth mental health early in the pandemic," said study coordinator Francesca Penner, MA, University of Mississippi Medical Center, Mississippi, MA, USA. "These may be related to increased time with family, fewer social and academic pressures, more flexible routines, factors related to Latinx culture and the socio-emotional learning program that students were engaged in throughout the study period."
The findings are based on the Identity Development in Typical Adolescents Study, a US-based ongoing longitudinal project tracking identity development in adolescence, that began in January 2020, prior to the onset of the pandemic.
A sample of 322 young adolescents (Mage = 11.99, 55% female), with a racial/ethnic composition of 72.7% Hispanic/Latinx; 9.3% Black or African American; 5.9% Multiple Races; 5.0% Asian; 1.6% White; and 1.2% American Indian, completed a mental health screening measure prior to the COVID-19 pandemic and at three bi-weekly time points starting one month into stay-at-home orders (mid-April, early May, late May, 2020). A subsample also completed a survey about their experience at home during COVID-19.
For youth who had elevated levels of mental health problems pre-pandemic, symptoms were significantly reduced across domains during the pandemic. Reductions in internalizing, externalizing and overall problems were clinically significant. For youth without notable pre-pandemic mental health problems, there were statistically significant reductions in internalizing and overall problems, and no change in attention or externalizing problems. Further analyses revealed that better family functioning was consistently related to lower mental health symptoms in youth during the bi-weekly follow-ups.
"These results have important clinical implications," said senior author Carla Sharp, Ph.D., who led the study, and is a professor in the Department of Psychology, University of Houston, Texas. "First, promoting family functioning during COVID-19 may have helped protect or improve youth mental health during the pandemic. Further, it is important to consider cultural factors, such as familism and collectivism in Latinx communities that may buffer the early effects of disasters on mental health to COVID-19 stress.
"It also points to the need to determine specific features of stay-at-home measures that may be protective for youth mental health: for example ongoing socio-emotional learning programs in schools that can pivot to support mental health during crises, increased family time, changes in school structure, addressing middle school peer stress, more sleep, and more flexible routines."
It is of course possible that the negative impact of stay-at-home orders began to take effect after the study period ended in May 2020. Assessments were completed while the academic year was still in session and the COVID-19 outbreak worsened in the school's region after that time. Mental health may have declined later as the spread increased in the area or as stay-at-home measures continued.
The window when this study was conducted may present a unique "natural experiment" with the combination of increased time at home while stress related to COVID-19 in this region was not yet at its peak. Related, families who were financially impacted by COVID-19 may have had worsening stress that had not yet manifested during follow-up points. Further analysis indicated that in families where job loss occurred due to the pandemic, children did not experience the same level of reduction in total mental health problems at the first follow-up, compared to children in families where no job loss occurred.
"Our findings underline the importance of the family environment and Latinx collectivist values of community connection for promoting child resilience and brings into stark focus the possibility that school environments may exacerbate mental health difficulties," said co-author, Jessica Hernandez Ortiz, a graduate student working with Dr. Sharp, who is currently leading the follow-up of the sample to assess more long-term effects of COVID-19 on adolescent mental health outcomes. "Removal from that context into a less pressured environment immediately and positively impacts mental health."