COVID-19 and Mental Health (CMH) Initiative: Research

Mental Health and Substance Use among Children and Adolescents Amidst COVID-19: A Systematic Review

Key Messages

  • Information is key; children and adolescents need to be educated and informed about the pandemic situations.
  • Effective and rapid communication is essential.
  • Most of the adverse effects come from the school closure, isolation, limited physical activities, social distancing, and imposition of a restriction of liberty.
  • Parents, teachers, health care providers, and public health officials can play an important role in minimizing the impact of pandemic on mental and psychological health.
  • Children and adolescents’ access to mental health services should be improved and should be social-distancing and lockdown friendly.
  • Mental health professionals should use existing evidence-based guidelines and also establish easy operational strategies such as mobile based applications to cope with COVID-19 pandemic-related mental health problems in children and adolescents.

Lay Summary

While COVID-19 continues to affect many communities around the world and fundamentally change how people live, the everyday lives of people are taking a toll on their mental health. During times of uncertainty, it is crucial to focus on mental and emotional well-being to navigate these difficult circumstances in a healthy way. Decisions on how to manage mental health of children and adolescents should be based on the best available evidence. Therefore, we did a systematic review study to identify and evaluate the mental health and substance abuse issues among young children and adolescents. We also evaluated the effectiveness of different interventions employed during previous and current pandemic to promote children and adolescent’s mental health and to prevent substance use; understand the approaches and strategies to successful delivery of mental health and substance use interventions during pandemic; and identify knowledge gaps in those contexts. Of 3377 papers found, 19 were eligible. Of those, one each was qualitative and mixed method, two interventional, and 15 cross-sectional studies. The most reported outcome was the negative impact of pandemic on psychological health which was measured as anxiety, depression, fear, stigma, and post-traumatic stress symptoms (PTSD). These studies reported that pandemics may cause stress, worry, helplessness, and also social and risky behavioral problems among children and adolescents (for e.g. substance abuse, suicide, relationships, academic issues, absenteeism from work etc.). Interventions such as art programs, support services, and nurse led mental health, and psychosocial services are effective in decreasing those issues among children and adolescents. To summarise, mental health care is very important for children and adolescent however, however, very few studies have evaluated the impact of pandemics or crisis on children and adolescent’s mental health. Majority of the intervention-based studies were conducted on population 18 years and above. The early findings from this systematic review (Work in Progress: WIP) shows that the COVID-19 pandemic may worsen existing mental health problems among children and adolescents, hence, it is imperative to focus on children and adolescent mental health. Parents, teachers, community health workers, and public agencies should receive formal training to address the children’s psychological problems, recognise early manifestations of distress, and to provide intervention and referrals as needed. Also, mental health care workers should establish evidence-based guidelines and innovative technologies such as mobile applications to cope with COVID-19 pandemic-related mental health problems. Close attention must be paid to improve the mental health access to care among children and adolescents. Moreover, timely action can help lessen the effects and improve long-term capacities for mental health services for children and adolescents.

Update: During the last two months, we run a repeated search of the additional articles with the help of librarian. We screened 863 articles by title and abstracts. Full text screening of 16 more articles was done and we added 3 additional articles in the review. The 3 more studies are related to COVID 19 that included the children and adolescent’s population. The outcomes observed in the studies are anxiety and depression symptoms, coping mechanism, psychological problems, PTSD, stress, loneliness, and depression. The revised systematic review table has been added as an attachment.


  • Children
  • Adolescents
  • Pandemic
  • COVID-19
  • Mental health
  • Substance abuse
  • Anxiety
  • Depression
  • Isolation
  • Psychological health


  • Nominated Principal Applicant: Dr. Salima Meherali, University of Alberta, Faculty of Nursing
  • Dr. Zohra Lassi, University of Adelaide
  • Jai Das, Aga Khan University Hospital
  • Rehana Abdus Salam, Aga Khan University Hospital
  • Neelam Punjani, University of Alberta, Faculty of Nursing

For more information, please contact: Salima Meherali,

Related Syntheses


Full PDF


People Who Use Drugs (PWUD) and Substance Use, Children, Youth and Families


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