Canadian Adolescents' Mental Health and Substance Use During the COVID-19 Pandemic: Associations With COVID-19 Stressors

There have been significant concerns regarding the mental health impact of coronavirus disease 2019 (COVID-19) due to isolation, anxiety around the pandemic, and increased conflict in the home. The purpose of this study was to examine the rates of mental health symptoms of clinical concern and substance use, and to assess which COVID-19 related stressors were predictors of these symptoms and substance use in a large Canadian sample of adolescents, with comparisons across genders. Participants (N = 809, M-age = 15.67, SD = 1.37) identified as a girl (56.2%), boy (38.7%), or trans/nonbinary individuals (TNBI; 5.1%) and were recruited via social media to complete an online survey. A high proportion of adolescents reported symptoms of clinical concern for depression (51%), anxiety (39%), and posttraumatic stress disorder (45%). Other mental health problems ranged from 9% to 20%. Adolescents were mainly concerned with the health of family members and vulnerable populations, as well as the increased family stress at home during COVID-19. Rates of substance use were higher than expected, with over 50% of youth engaging in some form of substance use in the past 90 days, and almost 20% engaging in substance use at least once a week. TNBI and girls reported higher rates of mental health problems compared to boys. Family stress due to confinement and violence at home predicted higher mental health symptoms, but not substance use problems. Increased rates of mental health problems and substance use necessitate targeted supports that encourage positive coping amidst the additional stresses of COVID-19. Public Significance Statement The coronavirus disease 2019 (COVID-19) pandemic has put unprecedented stress on Canadian adolescence and their families. This paper found higher than expected clinically concerning number of symptoms of mental health problems including depression, anxiety, PTSD, and substance use in Canadian adolescents. Results also suggest that therapies focused on improving family functioning may help alleviate mental health problems in adolescents during and following the COVID-19 pandemic.