Remote Education and Adolescent Depression: An Analysis of Mental Health Outcomes during the COVID-19 Pandemic

Background: The COVID pandemic resulted in unprecedented mental, physical, academic, and social impacts on children and adolescents. While prior research indicates that adolescents exhibited increased psychological distress and diminished academic outcomes, little is known about school format and rates of depression throughout the pandemic. Longitudinal research is needed to improve our understanding of: 1) the enduring impact of the pandemic on adolescent mental health; and 2) whether stay-at-home orders and remote learning affected adolescent health. We used 6 waves of longitudinal data gathered before, during, and after the pandemic on a large cohort of high school students (starting from 8^th to post- high school) to examine adolescent depression in conjunction with school format.

Methods: Participants (n=2,031) were 54% female and racially and ethnically diverse. Data were drawn from 6 waves (2019- 2023) of an ongoing cluster, randomized controlled trial from 24 schools in a large urban area in a Southwestern state. We collected baseline and wave 2 data via a paper/pencil survey, while we fielded all other waves online. We asked participants about COVID stressors (e.g., whether they had COVID; household adult lost a job), remote learning experiences (e.g., “my education suffered due to the disruption from COVID”), and depressive symptoms (i.e., 10-item Center for Epidemiologic Studies Depression scale). To generate a picture of participants’ personal, school experiences, school settings, and rates of depression before, during, and after COVID, data analysis consisted of descriptive statistics.

Results: Eighty-four percent of students attended school in-person in spring 2019 prior to COVID-19. After the lockdown period in 2020, only 15% attended in-person while over three-fourths attended school remotely. Rates of adolescents meeting criteria for depression rose from 31% to over 37% during this time. Forty-six percent of participants still attended school remotely and over 50% attended in a hybrid setting in the spring of 2021, while the depression rate reached a height of 47%. Ninety-one percent returned to school in-person in the 2022-2023 school year, and 38% met criteria for depression. Over 70% of participants felt that they learned better while in a physical classroom and only 17% preferred online over in-person learning. Almost one-quarter reported that a friend or relative died from COVID.

Conclusions: Our findings indicate that rates of depression among this community sample increased during the pandemic, and, though rates decreased from their height during 2021, adolescent depression remained higher than pre-pandemic levels in 2023. Higher rates of remote learning for longer time periods also coincided with higher rates of depression, aligning with prior research on the importance of peer social connection and the detriments of adolescent loneliness and increased screen time. Given the increased likelihood for adolescent depression to negatively affect long-term outcomes, including suicide rates, the persistence of higher rates of adolescent depression compared to pre-pandemic levels signals a critical need for social workers and aligned professionals to design and implement policies and practices to support and increase wide-scale access to school- and community-based youth mental health services and programs.