Articlehybrid2024

COVID-19 and Youth Mental Health Disparities: Intersectional Trends in Depression, Anxiety and Suicide Risk-Related Diagnoses

Laura M. Prichett · Robert H. Yolken · Emily G. Severance · Destini Carmichael · Yong Zeng · Andrea S. Young +1 more

52 citations0/0 files storedAcademic Pediatrics

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COVID-19 and Mental Health Child and Adolescent Psychosocial and Emotional Development Mental Health Treatment and Access

Abstract

OBJECTIVES: Mental health disparities were prevalent among racially and ethnically minoritized youth prior to the COVID-19 pandemic. As complete datasets from 2022 become available, we can estimate the extent to which the pandemic further magnified existing inequities. Our objective was to quantify disparities in trajectories of depression, anxiety, and suicide risk-related diagnoses in youth before and after the start of the COVID-19 pandemic, using an intersectional lens of race, ethnicity and gender. METHODS: Using electronic medical record data from one mid-Atlantic health care system (2015-2022), we evaluated changes in annual rates of depression, anxiety and suicide risk-related diagnoses in 29,117 youths, aged 8-20 years, using graphical analysis, comparison of adjusted mean differences (AMD) and adjusted mixed multilevel logistic regression. RESULTS: Almost all racial and gender subgroups had significantly higher rates of depression and anxiety after the start of COVID-19 compared to the years prior, with the greatest changes observed in Hispanic and Asian females. Suicide risk-related diagnoses significantly increased among all female subgroups, with the largest increase among Asian females (AMD 4.8, 95% CI 0.2-9.3) and Black females (AMD 4.6, 95% CI 2.2-6.9). CONCLUSIONS: Rates of depression, anxiety, and suicidal thoughts and/or behaviors in young people continued to increase in the post-pandemic period. Many pre-existing disparities between subgroups, especially females, significantly widened, highlighting the importance of using an intersectional lens. Urgent action is warranted, including universal screening of pediatric patients for suicide risk, broadening effective treatment and support options in minoritized patients, and increasing support services to patients and families.

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References

2010Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)2018Police killings and their spillover effects on the mental health of black Americans: a population-based, quasi-experimental study 2021STROBE Reporting Guidelines for Observational Studies 2022A systematic review of the mental health changes of children and young people before and during the COVID-19 pandemic 2019Daily multidimensional racial discrimination among Black U.S. American adolescents 2023National Trends in Mental Health–Related Emergency Department Visits Among Youth, 2011-2020 2012A Systematic Review of School-Based Interventions Aimed at Preventing, Treating, and Responding to Suicide- Related Behavior in Young People 2021Black Youth Suicide: Investigation of Current Trends and Precipitating Circumstances

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