School closures largely explain the deterioration of youth mental health over the first pandemic wave

During the Coronavirus Disease 2019 (COVID-19) pandemic, youth mental health problems have increased manifold. The contribution of school closures to this problem has been heavily debated but is largely unknown.

A new Science Advances study aimed to address this issue by combining data on variation in school closures and reopening across states in Germany with high-frequency data from the largest crisis helpline and survey data on youth mental health.

Study: The youth mental health crisis: Quasi-experimental evidence on the role of school closures. Image Credit: eldarnurkovic/Shutterstock.com

Background

The pandemic and the related public health measures have massively affected people’s lives and mental health. During childhood and adolescence, the negative psychological consequences were particularly pronounced.

Mental health problems among children and adolescents are at all-time highs, and recent research has suggested a doubling of anxiety and depression levels in this age group during the pandemic compared to pre-pandemic levels. Despite this, studies on the role played by the pandemic are rare and of correlational nature.

Most studies find it difficult to disentangle the effects of the pandemic itself and the multiple public health measures. An exception is a Swedish study that revealed a lowering in mental health care demand among students who switched to remote learning at the start of the pandemic.

Despite the improvement compared to prior research, this study did not clarify whether the reduction in healthcare demand stemmed from an actual change in mental health or hid the rising number of unnoticed mental health problems, conveying a false all-clear signal.

About this study

The current study analyzed the potential costs and risks of school closures. It relied on unique German survey data on adolescents’ mental health, collected between the 26th of May and the 10th of June 2020.

This was supplemented with data between August 2015 and November 2017, i.e., before the pandemic, to serve as control. Additionally, high-frequency data from the largest German crisis helpline was obtained from January 2019 until December 2020.

To isolate the overall strain imposed by the various pandemic measures and the pandemic, quasi-experimental variation in the length of school closures was used. The variation resulted from state-specific regulations for the different grade levels and school tracks.

To provide causal estimates, all state-specific corona protection ordinances were processed. A dataset was compiled, which enabled the assignment of each individual in the dataset with the respective mandatory weeks of school access restriction and causal estimation of the effect on mental health.

Key findings

It was observed that school closures significantly contributed to the recently observed aggravation of youth mental health problems. The crisis helplines’ data helped understand that the youth were mainly struggling with family problems. It was highlighted that adolescents who experienced longer school closures struggled with these problems more and for prolonged periods.

Analysis of subgroups revealed that younger children struggled most, while the effects weakened monotonically with age. 11-year-olds were the youngest in the sample and experienced marked losses in their quality of life and behavioral and emotional problems.

Effects faded out and lost precision by mid-adolescence. Regarding gender heterogeneity, boys were seen to cope worse than girls.

Further, to understand the effect of living conditions at home, the living space available per school-aged child was considered. It was observed that adolescents suffered most from the burden if they resided in homes with limited living space.

The results documented here likely reflect only the tip of the iceberg. Only the short-run effects of prolonged school closures were explored in this study. More specifically, the estimates only correspond to the impact of school closures lasting between 4.7 and 10.1 weeks.

Subsequently, 25 or more additional weeks of school closure followed in Germany. The effects documented here are not expected to accumulate weekly because many adolescents could have learned to live with the altered situation.

Conclusions

The current study revealed that prolonged school closure led to a significant deterioration in the quality of life of youth, which stemmed from the development of early signs of mental health problems.

Compared to girls, this effect was more prominent in boys and younger adolescents. School closures were a significant reason behind the youth’s mental health deterioration during the first COVID-19 wave.

In the future, more research must be conducted to formulate a better coping strategy to protect students from the negative effects of school closure.

These studies must focus on understanding the nature of student-teacher relationships and the quality of homeschooling that can alleviate the adverse effects of school closures.