Youth Mental Health Post-Pandemic: Review Finds Mixed Outcomes After Return to In-Person Schooling

A recent review published in Current Psychiatry Reports evaluates how children and adolescents’ mental health changed following the return to in-person schooling after COVID-19 closures, drawing on studies from multiple countries to assess patterns of improvement, persistence, and variability in outcomes.

Authored by Erika Felix and Jennifer Greif Green, the review highlights that while some youth experienced mental health improvements after resuming in-person learning, others continued to show elevated levels of psychological distress. The findings suggest that post-reopening mental health trajectories are influenced by a range of factors, including age, gender, and contextual variables such as school environment and family dynamics.

The evidence reviewed indicates that improvements were more likely when school environments were perceived as supportive. For example, adolescents in Shanghai reported reductions in anxiety, depression, and anger within three months of returning to school, particularly when academic pressures were manageable and students felt well-oriented. In contrast, a study in Hong Kong found that while preschool-aged children with special educational needs showed some improvements, older children exhibited increased conduct difficulties and declines in quality of life after returning to in-person instruction.

Nationally representative surveys from Finland and the Netherlands indicated that elevated rates of anxiety and depression observed during the pandemic persisted or worsened after schools reopened. Similar patterns were documented in Canada and Australia, where internalizing symptoms remained higher than pre-pandemic baselines even after the return to classrooms.

Age and gender differences were evident across several studies. Adolescents often reported worse outcomes than younger children, although findings varied within age groups. In Finland, depressive and anxiety symptoms increased among girls while social anxiety declined among boys. Transgender youth were found to have higher baseline levels of distress, though some studies noted modest decreases over time.

The review also identifies protective and risk factors associated with post-reopening mental health. Protective factors included regular physical activity, strong relationships with peers and adults, reduced screen time, and lower academic demands. Conversely, family conflict, poor parental mental health, inconsistent discipline, and sleep disturbances were linked with ongoing difficulties.

Changes in school-based mental health service delivery during the pandemic, including those supported by temporary federal funding, may not be sustainable in the long term. The authors emphasize the importance of continued investment in school–mental health partnerships and longitudinal monitoring to better understand the evolving needs of students.

The review concludes that schools play a central role in addressing youth mental health needs but underscores the need for further research to identify which interventions are most effective across diverse populations and settings.