Supporting Adolescent Mental Health During a Pandemic and Back to School

The past 18 months have been challenging for all of us, but they have been particularly hard on adolescents. Some lost family members to COVID-19 and others watched their parents lose jobs. Almost all of them were separated, for some period of time, from their schools, their friends and their routines.

If you’re a parent, you may have read the recent news articles about the growing mental health crisis among adolescents. As the new school year approaches, we need to know more about which teens are most at risk and what we can do to support them.

Investigating Teens’ Mental Health Amid a Pandemic

Nearly all adolescents have been affected by the pandemic, but certain groups are at a higher risk for mental health conditions. To better understand the situation teens have faced, my research team at the Wellesley Centers for Women recently completed a study investigating the factors that made certain teens more vulnerable amid the pandemic.

We conducted an in-person mental health screening for nearly 600 seventh, ninth and 11th-grade students at a public school in a Boston suburb from November 2019 through January 2020 (before the pandemic). Then, in May of 2020 (a few months into the pandemic), we followed up with some of these same students and asked them to complete a second, online assessment.

We found that, on average, teens’ scores on a measure of depressive symptoms were slightly higher during the pandemic relative to their scores before — but overall, teens reported a minimal level of depressive symptoms at both time points. These low levels of symptoms suggest that, although adolescents may have been experiencing more distress during the pandemic, for many, any increase in negative feelings represents a normal reaction to events around them, rather than a significant mental health concern. This should be reassuring to parents who worry that every teen’s mental health will be irreparably damaged by the pandemic. But to be sure, there are certain groups that are struggling.

We found that girls reported significantly more depressive symptoms during the pandemic. Their symptoms fell in the “mild to moderate” range when they were assessed in May 2020. This is consistent with prior research that suggests that adolescent girls are at higher risk than boys of experiencing mental health symptoms in response to adverse life events — and also that girls have experienced higher levels of depressive symptoms during the pandemic than they did before. Our study was limited in scope to a school that was largely white and middle class. But other research suggests that lower educational attainment, financial difficulties, race, and obesity may be associated with more distress during the pandemic.

We found that, among adolescents who were more distressed about the effects of the pandemic, those with a more “negative cognitive style” (i.e., a tendency to draw more negative conclusions about the causes and consequences of negative events and self-characteristics) showed greater increases in depressive symptoms, relative to those with a less negative cognitive style. Such cognitive styles may develop when children are exposed to multiple stressful life events (such as abuse and poverty), dysfunctional parenting or when they imitate the unhealthy cognitive styles of their parents.

For example, a teen with a negative cognitive style, when confronted with a bad grade in a class, may conclude that they lack the intelligence they need to succeed academically. Teens with a healthier cognitive style may assume that the test was unfair or that their strengths lie in other academic areas.

Meanwhile, adolescents who demonstrated greater resilience, as measured by a questionnaire assessing the way they generally manage stressful situations, showed less of an increase in depression, even when they acknowledged feeling distressed about the pandemic.

Meeting Adolescents’ Needs

These findings suggest that the risk for developing depressive symptoms in response to distress caused by negative life events depends on individual vulnerability and protective factors. These factors certainly intersect with gender, racial and economic factors; for example, teens experiencing poverty may develop a more negative cognitive style due to the economic hardship they face. But that doesn’t mean that every single teen experiencing poverty will develop depression. We may be able to support teens’ mental health by helping them minimize factors that make them vulnerable to depression and by increasing their resilience.

Changing teens’ cognitive styles and increasing their resilience does not mean simply telling them to “toughen up” or think more positively, but it is possible to help teens shift the way they think about events in their lives. Cognitive behavioral therapy (CBT) interventions train adolescents to recognize the connections between their thoughts and their feelings. CBT can aid them in identifying their underlying negative beliefs so they can replace them with more positive “counter-thoughts” (i.e., healthier thoughts that oppose their negative beliefs).

Learning CBT strategies can also support teens in becoming more resilient, as they will be better able to manage stress and solve problems that may otherwise lead to negative moods and other depressive symptoms.

Addressing the Back-to-School Transition

As our kids return to school this fall, it is important for parents, family members, teachers, guidance counselors and other school staff to be prepared to support them. This transition, though hopefully positive for many, is likely to present its own challenges.

Some students preferred being at home without the social pressures of school, afterschool activities and social events. We should remember the lessons we learned over the past year and a half about the importance of sleep, time outdoors and time with family. Also, it’s important to prioritize mental health even when focusing on grades, standardized tests and extracurricular activities designed for college admissions.

While these lessons are relevant to all teens, we need to remember that some, who have been more negatively affected by the pandemic, may require special attention. Further research can help us better understand who these adolescents are and what kinds of support they need.

In the meantime, we can focus on providing adolescents with the space to process their experience, opportunities for counseling and access to caring adults who check in on them early and often.

We have an opportunity to turn the tide of mental health issues that was rising even before the pandemic disrupted teens’ lives. With continued research, we can prepare our kids to face the challenges that come their way.

Tracy R. G. Gladstone, Ph.D., is a senior research scientist at the Wellesley Centers for Women, where she leads the Depression Prevention Research Initiative. Her research interests include the development, implementation, evaluation and dissemination of preventive intervention programs for children and adolescents at risk for depression, with a focus on at-risk families.