At the onset of the COVID-19 pandemic, health professionals hypothesized that a shadow pandemic of mental illness was imminent. Mental health issues among adolescents have been increasing steadily in Canada since 2011. Concerns regarding the impact on adolescent mental health of school closures and limiting in-person contact with peers were warranted. Research indicates that adolescents were among the populations whose mental health has suffered the most during COVID.[4-8] Developmental resilience science provides insight for supporting youth mental well-being during this challenging time; more than 5 decades of evidence has demonstrated that positive experiences with families, with peers, in schools, and in communities act as protective and promotive factors for youth mental health.
Data collected through the Youth Development Instrument (YDI) offer insight into pandemic-era adolescent mental health and well-being in BC. The YDI is an annual self-reported survey administered in BC secondary schools that asks youth ages 15 to 17 about their mental health and well-being. The YDI also measures risk and protective factors for mental health and well-being in individual, family, peer, school, and community domains. The YDI was piloted in the spring of 2020, and youth participation has increased each year since its inception. To date, YDI participation has included approximately 26 000 youth from 33 school districts and 28 independent schools across all five health regions in BC [Table 1]. Here we highlight key mental health and well-being challenges and opportunities elucidated by YDI research during the pandemic.
BC adolescent subjective mental well-being appears to have declined since the onset of the pandemic [Figure]. As well, in our latest wave of data collected from January to March 2023, 38% of youth screened positive for moderate to severe symptoms of depression, and 38% of youth screened positive for generalized anxiety disorder [Table 1]. YDI results suggest that some populations of youth in BC are experiencing poorer mental health and well-being than others. Analyses of 2022 YDI data indicated that youth with pre-existing mental health issues, those who report lower family affluence, and those living in rural areas of BC have poorer mental health and well-being compared with their peers [Table 2]. LGBTQIA2S+ youth and those identifying as female or nonbinary reported poorer mental health and well-being than those who identify as heterosexual or male. Similar to 2022 data, preliminary analyses of 2023 YDI data identified youth with pre-existing mental health conditions as having the poorest mental health and well-being of YDI participants. These findings align with extant research that suggests these groups have been experiencing poorer mental health and well-being prior to and during the COVID pandemic. Thus, addressing social and structural inequities is paramount to population mental health.
A motivating factor for creating the YDI was to identify malleable protective and promotive factors for youth mental health and well-being. In our analyses of 2021 YDI data, important correlates of mental health and well-being for BC adolescents included sleep, positive home experiences (e.g., supportive adults at home, positive communication with family), supportive peers, positive school experiences (e.g., school belonging, school safety), and social and emotional competencies, such as self-concept and optimism, after controlling for demographics such as racial identity, gender identity, sexual orientation, and family affluence. YDI results for 2022 were similar: positive childhood experiences, such as having supportive families, peers, and teachers, were linked to significantly greater mental well-being and life satisfaction and significantly lower symptoms of depression and anxiety among youth. Moreover, we found that having six or more positive childhood experiences protected youth with adverse childhood experiences, such as neglect or abuse, against poor mental health and well-being. Thus, finding ways to increase positive experiences at home, among peers, at school, and in the community may serve as an important population-level strategy for promoting mental well-being and preventing mental illness among youth. Similar to extant research conducted among adults, we observed that positive childhood experiences are additive: the more of them that youth experience, the better their self-reported mental health and well-being on the YDI.
Implementing evidence-based policies and programs that promote positive childhood experiences has been shown to lead to better mental health and well-being outcomes—for example, whole-school social and emotional learning programs that include student, teacher, parent/guardian, and community components. Furthermore, addressing social determinants of health, such as poverty and discrimination, may lead to more positive childhood experiences and reduce the number of adverse childhood experiences, thus positively influencing mental health and well-being among youth. Many of these initiatives are already underway in BC schools (e.g., the Mental Health in Schools Strategy, the sexual orientation and gender identity curriculum, the K-12 Anti-Racism Action Plan). Similar initiatives for supporting families and communities and in health care are necessary to promote mental health and well-being at a population level.
—Jacqueline Maloney, PhD
Postdoctoral Fellow, Faculty of Health Sciences, Simon Fraser University
—David Long, MD
Child and Youth Psychiatrist
Senior Data Analyst, Faculty of Health Sciences, SFU
—Jenna Whitehead, PhD
YDI Implementation Coordinator, Faculty of Health Sciences, SFU
—Judy Wu, MPH
Doctoral Student, Faculty of Health Sciences, SFU
—Julia Kaufmann, BSc
Master of Public Health Student, Faculty of Health Sciences, SFU
—Jillian Herring, MPH
Research Assistant, Faculty of Health Sciences, SFU
—Rachel Correia, MPH
Research Assistant, Faculty of Health Sciences, SFU
—Hasina Samji, PhD
Senior Scientist in Population Mental Well-Being, BC Centre for Disease Control
Assistant Professor, Faculty of Health Sciences, SFU
This article is the opinion of the BC Centre for Disease Control and has not been peer reviewed by the BCMJ Editorial Board.
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11. Samji H, Long D, Wu J, et al. The Youth Development Instrument: A population level survey of adolescent mental health and well-being indicators. Poster presented at the Banff International Conferences on Behavioural Science, Banff, AB, 20 March 2023.
13. Samji H, del Casal M, Kaufmann J, et al. Youth mental health and protective factors during the COVID-19 pandemic. Poster presented at the Banff International Conferences on Behavioural Science, Banff, AB, 20 March 2023.
14. Samji H, Long D, Correia R, et al. Positive childhood experiences as protective and promotive factors for mental health. Poster presented at the Frayme Learning Institute, Vancouver, BC, 22 February 2023.
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