Coronavirus disease 2019 (COVID-19) is caused by a severe acute respiratory syndrome called SARS-CoV-2. [1]] COVID-19 has raged worldwide since it was first declared a pandemic on March 11, 2020, until the emergency order was lifted in the United States on May 11, 2023. [2, 3] To combat the virus, “Stay at Home” orders were sometimes required and encouraged by the US government to slow the spread of the novel virus. In retrospect, well-intentioned mandates contributed to many adverse social and psychological consequences, including increased loneliness, depression, anxiety, and reduced social support. While these interventions were common experiences across the United States, some populations were disproportionately impacted, especially minorities and youth.
Traditionally, as youth mature, they create social relationships and undergo identity formation, all within the school setting, which plays a critical role in their development. Studies have shown that the influence of friendships or romantic relationships in a school setting are sources of social support, identity exploration, and academic resilience that bolster their social competencies and foster protective factors. [4, 5] However, throughout the “Stay at Home” orders, the youth experienced online learning courses that limited their socialization of interaction with their peers. The abrupt loss of communal or ritual celebrations and closures from work, school, and programs severely limited social relationships for the youth as they navigated their critical transition from childhood to adulthood. Furthermore, the cancellation of traditional events or activities, like graduation, prom, birthday parties, sports, and communion has fueled the mental health crisis among the youth due to the loss of socialization opportunities. [6]
Millions of youths across the country are affected by a mental health crisis and an epidemic of loneliness and isolation. [7] Governor Murphy of New Jersey publicly acknowledged the youth mental health crisis, prompting state legislators to debate on how to deliver mental health services to schoolchildren. [8] Due to the pandemic, many students struggled to create or maintain social relationships and a consistent academic schedule. There was little opportunity for students to share how COVID-19 profoundly impacted their lives, such as the challenges of a virtual education or the hurdles imposed by COVID-19 on their life experiences. Studies have shown that loneliness in young adults is associated with negative health behaviors and indicators of poor mental health independent of other risk factors. [9] As per the US Surgeon General’s 2023 report, the mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day and is even greater than the association with obesity and physical inactivity. [7] It is critical to find opportunities to rebuild social connections, capital, and identity so the youth can experience fulfillment, increase educational attainments, and contribute to vibrant, healthy communities.
Notably, school enrollment levels in 2020, when instruction was conducted virtually due to the pandemic, were at their lowest levels in over two decades, translating to over half a million fewer students enrolled in secondary education. [10] This phenomenon not only affects schoolchildren of the United States; approximately 138 other countries also mandated school closures during COVID-19, affecting 80% of children worldwide. [11] The effects of reduced student enrollment directly impact their social determinants of health. Lower educational attainment is associated with financial and housing instability, worse health outcomes, higher unemployment rates and is linked to incarceration. According to the US Department of Health, a protective factor is “a characteristic at the biological, psychological, family, or community... level that is associated with a lower likelihood of problem outcomes or that reduces the negative impact of a risk factor on problem outcomes.” [12] Protective factors like social connectedness are critical for creating a positive environment for students to develop their social-emotional skills, self-efficacy, and self-awareness. Developing and fostering connections during adolescence with supportive parents, family, and the community showed higher levels of social connection and predicted civic engagement outcomes in young adulthood, including a greater likelihood of voting and community involvement. [7]
Few studies focus on the youth during COVID-19, and most data before COVID-19 do not fully assess pre-pandemic youth mental health. The 2021 US Centers for Disease Control High School Risk Behavior Survey (YRBS) highlights the frightening trends among the youth, where more than a third (36.9%) of high school students reported they experienced poor mental health during the COVID-19 pandemic and 42.3% reported they persistently felt sad or hopeless during the past year. Along with the emotional toll, more than half (55%) of youth reported they experienced emotional abuse by a parent or other adult in the home. Additionally, the pandemic rapidly imparted socioeconomic stress on children and their families as more than a quarter (25.4%) reported that a parent or other adult in their home lost a job. [13]
This study seeks to understand the pandemic's psychosocial impact on youth and adolescents is imperative to address their mental health needs while helping foster positive, protective factors that promote resilience and well-being moving forward.