The Impact of the COVID-19 Pandemic on Adolescent Mental Health and Substance Use

Purpose: The aim of this study is to determine whether COVID-19-induced financial impact, stress, loneliness, and isolation were related to perceived changes in adolescent mental health and substance use. Methods: Data were from Baseline (2018) and Wave 3 (2020; mean age = 14.8; 50% female) of 1,188 adolescents recruited from 12 Texas public middle schools as part of a randomized controlled trial. Participants were primarily Black (23%), Latinx (41%), Asian (11%), and White (9%). We assessed mental health and substance use (Baseline and Wave 3) and pandemic-related physical interaction, loneliness, stress, family conflict, and economic situation (Wave 3). Results: COVID-19-induced stress and loneliness were linked to depression (beta = 0.074, p ≤.001; beta = 0.132, p ≤.001) and anxiety (beta = 0.061, p =.001; beta = 0.088, p ≤.001) among ethnically diverse adolescents. Adolescents who did not limit their physical interactions due to COVID-19 had fewer symptoms of depression (beta = −0.036, p =.03); additionally, adolescents who did not restrict their socializing were substantially more likely to report using a variety of substances (e.g., for episodic heavy drinking; odds ratio = 1.81, p =.001). Increased use of a food bank was linked to depression (beta = 0.063, p ≤.001) and a negative change in financial situation was linked to increased alcohol use (odds ratio = 0.70, p =.04) among adolescents. Discussion: After controlling for prepandemic psychopathology and race/ethnicity, COVID-19 induced isolation, loneliness, stress, and economic challenges were linked to poor mental health and substance misuse. Substantial structural, community, school, and individual level resources are needed to mitigate the impact of the COVID-19 pandemic on adolescent psychosocial health.