Research confirms that children and adolescents are experiencing significant anxiety and depression during the coronavirus disease 2019 pandemic. Adolescents may be at greater risk, particularly females. Social isolation, loneliness, lack of physical exercise, and family stress may contribute to these problems. Children who feel unsafe with regards to coronavirus disease 2019 may be more likely to experience somatic symptoms, depression, and anxiety. Parental stress and mental health problems may put children at an increased risk for maltreatment. Medical and behavioral health professionals should routinely screen for depression and anxiety. Increased access to mental health services will be critical.

Key points

  • Research is ongoing regarding mental health effects of the coronavirus disease 2019 pandemic on children and adolescents.
  • Early studies show children and adolescents experiencing increased anxiety and depression.
  • Isolation, loneliness, lack of physical activity, family stress, and racism may contribute to the effects of the coronavirus disease 2019 pandemic on child and adolescent mental health.


Coronavirus disease 2019 (COVID-19) has created unimaginable challenges for children, adolescents, and their families around the world. This virus, which was first identified in Wuhan, China, in December 2019,1 has led to 23,440,774 cases of COVID-19 in the United States (as of January 16, 2021) and has caused more than 390,938 total US deaths.2 Pandemic-related school and business closings and community lockdowns have had significant effects on families. The earliest world-wide lockdowns that started in China around January 23, 2020,3 included restrictions on schools and gatherings, and resulted in children being transitioned to online school. In the United States, many school districts began transitioning to online school in March 2020 in conjunction with community closures.4 Since then, individual communities and states within the United States have continued to impose and lift restrictions in response to COVID-19 outbreaks. This situation has been and continues to be a constantly changing situation, with new stressors occurring constantly.

COVID-19–related sources of stress for children and adolescents

Everyday life for children and adolescents has been significantly disrupted by the COVID-19 pandemic. Potential stressors for children and adolescents during this challenging time could include:

• Increased social isolation
• Heightened concerns over safety and health
• Increased stress of parents and caregivers owing to work, financial, or other impacts
• Increased family conflict, parent–child conflict, and/or child abuse
• Placements with friends or relatives owing to parent work situation
• Loss of prosocial activities (school, sports, social activities, hobbies)
• Adjustment to online schooling processes and demands
• Increased screen time and sedentary behaviors
• Decreased access to medical and mental health care, including exacerbated health disparities

Added effects of sociopolitical events

In addition to the pandemic-related changes discussed, co-occurring sociopolitical stressors during this time also likely impact the mental health of children and adolescents. Given that the first cases of COVID-19 were identified China,1 some American politicians began referring to it as the “Wuhan virus” or the “Chinese virus,” which led to reports of a racism pandemic against Asian Americans in the United States.5 Early research on this topic demonstrated that nearly one-half of Chinese American parents and their children ages 10 to 18 who were surveyed reported being targeted by or witnessing COVID-19 racial discrimination.6

Additional racial-based stressors occurred in the United States beginning May 25 with the death of George Floyd at the hands of the police.7 Through media coverage and a video of his death, many children were exposed to examples of violence and/or racism. Outrage over police violence focused the country on issues of racial justice and resulted in months of protests and demonstrations, peaking in June 2020.8 It is difficult to disentangle the effects of the COVID-19 pandemic stressors from these sociopolitical events in the United States.

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