A Social Determinants Perspective on Adolescent Mental Health during the COVID-19 Pandemic
Abstract
:1. Introduction
1.1. Background
1.2. Purpose and Research Questions
2. Materials and Methods
2.1. Study Design and Setting
2.2. SDoH Framework
2.3. Sampling and Recruitment
2.4. Data Collection
2.5. Participant Characteristics
2.6. Data Analysis
3. Findings
3.1. Education: “The One That Hit the Hardest”
3.2. Access to Health Services: “Everything Was Shut Down”
Such experiences of inability to access needed health services were upsetting for some participants, calling into question perceptions of basic rights to care. Reflecting on his experience, Steven (age 19, Edmonton) added, “it was terrible, [everything] was shut down … I was thinking that this is not the Canada that I would choose or that I’d want to choose. So it really affected me in a very big way”.I couldn’t get the normal medical routine I used to … I was trying to get treatment, [but] everywhere was shut down. So I couldn’t get the treatment I was supposed to get. The injury started getting serious because everywhere was locked down.(Steven, age 19, Edmonton)
For Amanda, long wait times to receive mental health support during the pandemic, coupled with the transition to online or virtual delivery of mental health services, made it even more difficult to access mental health services.At that time there wasn’t always the resources to help you … because everything was shut down. Even if you did [access mental health services], it’d be so long to wait to talk to someone. And things were always virtual which I didn’t, I don’t necessarily love. At the time I hated it.(Amanda, age 18, Grove County)
3.3. Employment and Income: “How Am I Going to Cope with My Basic Needs?”
Now that my mom is at home [unemployed], we don’t have really enough [financial] resources to stay online all the time. So sometimes when I’ll miss my classes, that will make me feel so sad because when I’m trying to read it on my own, I don’t really understand. Just feeling like this is now the end of me, like I don’t have any friends to ask the questions.(Mary, age 18, Edmonton)
Melissa (age 18, Edmonton) primarily attributed income insecurity during the pandemic to her diminished mental wellness: “My main difficulty was my financial help. How will I be financially capable of taking care of my needs? That really had a negative impact on me and I wasn’t stable for the early few months of the pandemic”. The lack of financial security that accompanied PHMs for Melissa introduced additional worry, with mental health impacts.When I heard that my work was canceled and I wasn’t going to work, I was like, “How am I going to cope with my basic needs or providing for myself?” … I was just shattered. How am I going to do financially? Because this was the main source of my income. How am I going to compensate?(Melissa, age 18, Edmonton)
Although most adolescents experienced stress and worry as workplaces closed and income insecurity increased, the PHMs also contributed to greater financial stability for others as their schedules became more flexible. Changes to employment and income, including for adolescents and their families, subsequently affected some participants’ educational experiences and social support as well, with mental health consequences.I felt really blessed to be able to go from a 15-h workweek to like 30 h a week, so I was able to make more money than what I was before … Not only was I available to work more, I could manage school and work at the same time.(Kyle, age 18, Grove County)
3.4. Social Support: “I Almost Lost My Mind”
For Ava, social isolation began to breed more social isolation, compounding the mental health difficulties they encountered during the pandemic.I started [to] not enjoy talking to people. Before Covid hit, I really loved talking to people … But once I got that separation, it just became hard to even consider planning socially distanced meetups. I just didn’t want to go through the trouble of it, it just wasn’t worth going out there. I just lost my social connection, and not having that really hurt my mental health.(Ava, age 16, Grove County)
When Cory (age 16, Grove County) experienced the death of a close friend during the pandemic, separation from his peers only magnified the negative effect on his mental health. In becoming disconnected from their friends and peers, participants expressed that they had lost a significant aspect of their social support networks.Before Covid, if I had [something] eating me up, I could just talk it over with someone. I used to rather talk [about] it with someone one on one. During [the pandemic] and all those restrictions that came with it, people that I interacted with [were] just my family members, and those things I can’t talk [about] with my family.(Reggie, age 18, Edmonton)
4. Discussion
4.1. Implications and Areas for Further Study
4.2. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demographic Categories | N (33) | Percentage (100%) |
---|---|---|
Residence during pandemic | ||
Grove County | 16 | 48.5 |
Edmonton | 17 | 51.5 |
Gender identity at time of interview | ||
Identify as a young woman | 18 | 54.5 |
Identify as a young man | 12 | 36.4 |
Identify as other | 2 | 6.1 |
Undisclosed | 1 | 3.0 |
Age at time of interview | ||
14 | 1 | 3.0 |
15 | 2 | 6.1 |
16 | 5 | 15.15 |
17 | 5 | 15.15 |
18 | 12 | 36.4 |
19 | 8 | 24.2 |
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Taylor, M.; Hilario, C.T.; Ben-David, S.; Dimitropoulos, G. A Social Determinants Perspective on Adolescent Mental Health during the COVID-19 Pandemic. COVID 2024, 4, 1561-1577. https://doi.org/10.3390/covid4100108
Taylor M, Hilario CT, Ben-David S, Dimitropoulos G. A Social Determinants Perspective on Adolescent Mental Health during the COVID-19 Pandemic. COVID. 2024; 4(10):1561-1577. https://doi.org/10.3390/covid4100108
Chicago/Turabian StyleTaylor, Mischa, Carla T. Hilario, Shelly Ben-David, and Gina Dimitropoulos. 2024. "A Social Determinants Perspective on Adolescent Mental Health during the COVID-19 Pandemic" COVID 4, no. 10: 1561-1577. https://doi.org/10.3390/covid4100108