The present study aimed to identify the individual, social, environmental, and COVID-19 specific protective factors associated with better mental health outcomes (namely internalising and externalising difficulties, and wellbeing) for 11–14 year olds following the first UK lockdown. Results indicated that higher participant-rated lockdown experience (perceptions of the extent to which it was fun, easy, and good) and higher levels of optimism were protective factors for all three outcomes of interest. Greater adherence to Government guidance was also a protective factor for internalising difficulties and general wellbeing. Stronger family connection was a protective factor for externalising difficulties only, while stronger peer connection was a protective factor for general wellbeing only.
It is particularly noteworthy that despite the significant impact COVID-19 has had on the daily lives of adolescents, mean scores for lockdown experience ratings (i.e., the extent to which they thought it was good, fun, and easy) were approximately three out of five, indicating that, generally, adolescents in this study did not find it to be a completely negative experience; a potentially reassuring sign. Indeed, research conducted during the COVID-19 pandemic suggests that on average there has been wide spread resilience in response to the pandemic (60). However, it is important to bear in mind that this score is the average, and some young people in this study reported a very challenging lockdown. Given that lockdown experience was a protective factor across all three aspects of mental health and wellbeing, this is particularly concerning. Thus, it is vital that, moving forward, young people who experienced a difficult lockdown are identified, and receive appropriate intervention and support (32). Furthermore, should any further lockdowns be required, it will be of upmost importance that these adolescents are appropriately supported, and their lockdown experience improved as far as possible.
Schools are typically considered to be a valuable location for the early identification of children experiencing mental health difficulties and the implementation of mental health interventions (e.g., promoting mental health literacy, social and emotional wellbeing, coping skills; Caan et al., 2015; Vostanis et al., 2013). It is now recognised that all schools have a responsibility for supporting the mental health of their pupils, particularly following the recent Government Green Paper recommending that all English schools appoint a designated mental health lead (63). However, prioritising mental health conflicts with more recent Governmental concerns regarding pupils’ academic progress, which places schools under considerable pressure to ensure their pupils ‘catch up’ following the school closures (e.g., (64)). Thus, schools may find themselves in a position where they are in a conundrum regarding whether to reach targets for academic progress, or prioritise ensuring the mental wellbeing of their pupils. Nevertheless, given the importance of peer support to adolescents’ general wellbeing identified in the present study (and in previous research e.g., (9)) it appears that, particularly for those who have had a difficult lockdown, allowing time in school for adolescents to socialise with their friends and build relationships may be invaluable in counteracting the negative experiences of lockdown. In case any further lockdowns occur, it will also be vital that, as far as possible, schools help to ensure their pupils’ experiences of learning in lockdown are positive; for instance, through the provision of pastoral support and frequent contact with teachers. Qualitative research highlights the importance of teachers, with adolescents emphasising the value of having access to teachers for their learning and wellbeing during school closures (65).
More broadly, Government policy must prioritise the provision of effective support and resources for young people who are experiencing, or who have previously experienced, difficult lockdowns. This may be in the form of strategies that can directly improve a young person’s lockdown (e.g., providing support to families experiencing poverty, or technology for adolescents to access schoolwork), or the availability of resources and support services (e.g., adolescent mental health services) that can help to mitigate the longer-term impact of any negative experiences. Findings from the Mental Health Foundation’s (60) research echo this need, calling on the Government to speed up the roll out of evidence-informed psychotherapeutic digital mental health interventions, implement trauma-informed therapies, and provide safe places for social connection and interaction in the community.
Regarding optimism, greater levels of optimism predicted greater wellbeing, and less internal and externalising difficulties. These findings highlight optimism as a personality trait which is associated with resilience and wellbeing, often in the face of a lack of personal control, where dispositional optimism is considered a stress buffer on mental health in adolescents (66). The COVID-19 pandemic, and in particular the first lockdown phase considered in the current study, presented a time of uncertainty, and results suggest that those adolescents who have a more optimistic stance are more likely to experience fewer psychological difficulties and greater wellbeing, thus potentially mitigating the psychological impact of COVID-19 (67). This is consistent with findings that suggest optimism mediates the relationship between stress related to COVID-19 and psychological difficulties (68, 69). Whilst in this study dispositional optimism is explored, learned optimism can also be applied as a useful intervention in enhancing wellbeing and a movement towards flourishing for the individual (70).
Another noteworthy finding from the present study is the importance of relationships; specifically, the association between strong family connection and lower levels of externalising difficulties, and strong peer connection and improved wellbeing. This finding is consistent with qualitative research with older adolescents that suggests family disputes and tension could be a source of difficulty during lockdowns, whereas keeping in touch with peers was considered beneficial (43). The impact of family relationships on adolescents’ mental health is perhaps unsurprising given that the vast majority of participants were likely solely with their family for prolonged periods during lockdown, and the existing evidence highlighting the important role of family relationships. For instance, even in the absence of risk, well-structured home environments and warm relationships within the family are important for positive development (55), but having a supportive family has been found to be particularly valuable for children trying to cope with stressful experiences (71, 72), as is the case at present for many young people.
Conversely, the relationship between stronger family connection and lower levels of externalising difficulties specifically is interesting. Previous research has found similar results with family functioning, suggesting children’s externalising difficulties are more strongly associated with poorer family functioning than internalising difficulties (73). However, a longitudinal study by Mastrotheodoros et al. (74) indicated that adolescents (aged 15) with higher levels of externalising difficulties tended to be those who later experienced worse family functioning, but not vice versa, suggesting that higher externalising difficulties in children cause poorer family functioning. Thus, it may be that the relationship between externalising difficulties and family connection found in the present study was a result of pre-existing difficulties (or the absence thereof). Unfortunately, the cross-sectional nature of the current study does not allow for an identification of the direction of these relationships. However, previous studies have focused on family functioning; less research has looked at family connection, and so the direction of the relationship remains unclear.
Nevertheless, the findings from the current study, combined with existing evidence, still highlight the importance of fostering good relationships with family members, in order to effectively promote adolescents’ mental health during the pandemic. Various strategies exist, such as family support programs, which aim to improve parent wellbeing and parenting, and in turn improve adolescent mental and behavioural health (75), or the provision of family support workers (FSWs) for those identified as at-risk. FSWs can help to strengthen parents’ and children’s social supports and coping skills through the provision of a range of behavioural and parent-training interventions, in order to prevent the escalation of more severe difficulties (76). Alternatively, parenting classes may provide a less resource-intensive and more readily available option that can be implemented in the community, while still strengthening family connections (77).
Outside of the family, peer connection was associated with higher levels of general wellbeing. Early adolescence is a crucial period of social development; young people spend more time building relationships outside of the family, and peers become increasingly important in terms of identity formation, fostering independence, and the development of social skills (78). Thus, given the circumstances of lockdown, whereby young people could not socialise with their peers face-to-face, maintaining strong peer connection may have been more important than ever for promoting adolescents’ wellbeing. Furthermore, early adolescence is a time where peers are increasingly relied upon for social support (10). Previous research in the field of help-seeking suggests that young people have a preference for informal sources of support, such as peers, if they are experiencing mental health difficulties (79, 80), which may also explain why stronger peer connections protected against poorer wellbeing during the coronavirus lockdowns.
Other research has highlighted similar concerns regarding adolescents’ peer groups, with young people reporting they found maintaining relationships during lockdown difficult (43, 65), and 41% of 8–24 year olds saying they are lonelier than pre-pandemic (81). As mentioned previously, allowing young people to spend time with peers and develop their relationships on their return to school will be of upmost importance. Indeed, a panel of child mental health experts have already written to the Government, urging them to prioritise children’s social and emotional wellbeing when re-opening schools, and emphasising the importance of play (82). Strategies such as peer support initiatives may also be beneficial in schools. These can include approaches such as peer tutoring or mentoring, peer counselling, befriending, or buddy systems. Previous research suggests peer support initiatives cannot only promote wellbeing and positive mental health, but also facilitate appropriate and quality access to help and signposting for further support (83). Given adolescent’s tendency to seek help from peers first, these initiatives may be particularly valuable for this age group.
Finally, it is worth noting that only one COVID-19 specific predictor, adherence to Government guidance, was identified as a significant protective factor for both internalising difficulties and wellbeing. While the reason for this is unclear, there is a potential that the families who adhered to the guidance were those who were more accepting and/or understanding of the COVID-19 pandemic, resulting in children feeling less anxiety or stress during this time. Interestingly, no other COVID-19 specific factors, such as having a parent who was shielding or a keyworker, were significantly associated with children’s mental health outcomes. Thus, although largely null results were identified regarding these predictors, the absence of significant negative mental health outcomes for these groups of children could be considered a good sign, and still contributes to the evidence base regarding the COVID-19 related factors that are (or are not) a cause for concern.
There are several limitations of the present study that should be noted. In terms of the sample size, there were a relatively small number of participants (n = 290) limited to one regional area in England (the North West). Secondly, participants were also self-selecting, as the survey was sent home via their school, and they were free to choose whether to participate. Thus, there is potential that the findings were not representative of the experiences of this age group nationally. However, participant demographics were broadly reflective of national averages (46) in terms of the proportion of young people eligible for FSM and those belonging to a BAME background. Third, the proportion of missing data was relatively high (12.8%). To account for this, an EM algorithm was used, in order to reduce bias (49), and so this was not considered to be problematic. Furthermore, it was not possible to include all possible candidate protective factors in the present study, and so some significant contributors to adolescent mental health outcomes may have been missed. Finally, the cross-sectional nature of this study limits the extent to which causation can be inferred. Thus, the direction of the relationships between the predictor and outcome variables cannot be confirmed.
It is also worth highlighting potential issues with the use of the term ‘protective factors’ in the present study. There is some contention in the resilience literature regarding the use of the terms protective and promotive factors; some suggest the use of the term ‘protective factors’ is only appropriate when examining the interaction term or moderating effect of factors on the relationship between risk factors and poorer mental health outcomes. Conversely, ‘promotive’ should be used for factors that are directly associated with positive outcomes, regardless of risk status (84). As risk factors or interaction terms were not directly explored in the present study, there may be some question over whether protective factors were truly identified. However, Luthar et al. (19) have suggested that the importance of interaction effects should not detract from the significance of main-effect associations, and the term ‘protective’ should be used in a broader sense, referring to all constructs linked with positive adaptation in at-risk groups. Arguably the COVID-19 pandemic has been a risk factor for all adolescents in terms of their mental health and wellbeing and, although they have not all had equal experiences, emerging evidence suggests that as a group they are at increased risk of developing mental health difficulties as a result of the pandemic (e.g., (45)). Nevertheless, in time, future research should seek to explore longitudinally the distinct promotive and protective factors that contributed to the onset of adolescent mental health difficulties for at-risk groups, as a direct consequence of the pandemic.