Adolescent Mental Health Service Use During Extended Lockdowns
Keywords:
Adolescent mental health, service utilization, lockdown effects, telehealth, accessibility, stigma,Adolescent mental health, Mental health service utilization, Prolonged lockdowns, COVID-19 pandemic impact,Tele-mental health services, Access to mental health care, psychological distress in adolescents, Health-seeking behavior, Barriers to mental health services, Youth coping and resilience.Abstract
Adolescent mental health has become a pressing public health concern, especially during the coronavirus disease 2019 pandemic, in light of prolonged lockdowns. A body of research has documented increased rates of depression and anxiety, and their evolution during subsequent lockdown periods. Notably, many studies indicate that few adolescents seek professional help during these distressing times. In line with health services utilization theory, these findings suggest a disconnect between expressed need and help-seeking behavior. Such research provides a wealth of information concerning the availability, accessibility, and effectiveness of mental health services during the pandemic. Perspectives on adolescents’ mental health service utilization—that is, whether and when to access services—have, however, remained marginal. By integrating information from multiple sources, these utilization patterns can be better understood. The present abstract aims to provide an overview of the determinants of adolescents’ mental health service seeking during prolonged periods of lockdown. The discussion focuses on issues within the adolescent’s life context and perceived needs, along with important influences originating from parents, the broader social environment, and the health system.
Service utilization trends can shed light on whether adolescents sought care when required, and the reasons that might explain patterns. Evidence suggests an overall increase in the need for psychological care during lockdown periods, reflected in rising demand from both adolescents and their parents. However, adolescents appear to prefer communicating their emotional distress with family members or friends instead of professionals. Most adolescents experiencing risk factors for depression and anxiety do not seek help, even though those with higher levels of perceived need are likelier to do so. Help-seeking behavior is influenced by multiple factors, including age, gender, ethnicity, socio-economic status, stigma, and accessibility. Survey results indicate that stigma represents one of the main barriers to seeking help.
References
1. Leeb, R. T., Bitsko, R. H., Radhakrishnan, L., Martinez, P., Njai, R., & Holland, K. M. (2020). Mental health-related emergency department visits among children aged <18 years during the COVID-19 pandemic—United States, January 1–October 17, 2020. Morbidity and Mortality Weekly Report, 69(45), 1675–1680.
2. Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., Brigden, A., Linney, C., McManus, M. N., Borwick, C., & Crawley, E. (2020). Rapid systematic review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. Journal of the American Academy of Child & Adolescent Psychiatry, 59(11), 1218–1239.e3.
3. Racine, N., Cooke, J. E., Eirich, R., Korczak, D. J., McArthur, B., & Madigan, S. (2020). Child and adolescent mental illness during COVID-19: A rapid review. Psychiatry Research, 292, 113307.
4. Leff, R. A., Setzer, E., Cicero, M. X., & Auerbach, M. A. (2021). Changes in pediatric emergency department visits for mental health during the COVID-19 pandemic: A cross-sectional study. Clinical Child Psychology and Psychiatry, 26(1), 33–38.
5. Moorman, L. K., & Hensley, L. (2021). COVID-19 pandemic-related transition to telehealth in child and adolescent mental health. Family Relations, 71(1), 7–17.
6. Mangalampalli, B. M., & Kolla, S. K. (2025). Large Language Models for Automated Healthcare Data Dictionary Generation and Maintenance. Vascular and Endovascular Review, 8(20s), 363-375.
7. Radhakrishnan, L., Leeb, R. T., Bitsko, R. H., Carey, K., Gates, A., Holland, K. M., Hartnett, K. P., Kite-Powell, A., DeVies, J., Smith, A. R., van Santen, K. L., Crossen, S., Sheppard, M., Wotiz, S., Lane, R. I., Njai, R., Johnson, A. G., Winn, A., Kirking, H. L., Rodgers, L., Thomas, C. W., Soetebier, K., Adjemian, J., & Anderson, K. N. (2022). Pediatric emergency department visits associated with mental health conditions before and during the COVID-19 pandemic—United States, January 2019–January 2022. Morbidity and Mortality Weekly Report, 71(8), 319–324.
8. Adams, S. H., Schaub, J. P., Nagata, J. M., Park, M. J., & Brindis, C. D. (2022). Young adult anxiety or depressive symptoms and mental health service utilization during the COVID-19 pandemic. Journal of Adolescent Health, 70(6), 985–988.
9. Hernández-Calle, D., Andreo-Jover, J., Curto-Ramos, J., García Martínez, D., Vicente Valor, L., Juárez, G., Alcamí, M., Ortiz, A., Iglesias, N., Bravo-Ortiz, M. F., Rodríguez Vega, B., & Martínez-Alés, G. (2022). Pediatric mental health emergency visits during the COVID-19 pandemic. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 10, 53–57.
10. Samji, H., Wu, J., Ladak, A., Vossen, C., Stewart, E., Dove, N., Long, D., & Snell, G. (2022). Review: Mental health impacts of the COVID-19 pandemic on children and youth—A systematic review. Child and Adolescent Mental Health, 27(2), 173–189.
11. Viner, R. M., Russell, S. J., Croker, H., Packer, J., Ward, J., Stansfield, C., Mytton, O., Bonell, C., & Booy, R. (2022). School closure and management practices during coronavirus outbreaks including COVID-19: A rapid systematic review. The Lancet Child & Adolescent Health, 4(5), 397–404.
12. Moen, E., & colleagues. (2022). Mental health service use among children and adolescents during the COVID-19 pandemic: A systematic review. Child and Adolescent Psychiatry and Mental Health, 16, 1–15.
13. Tedja, M. G., Perera, S., & Middeldorp, C. M. (2023). COVID-19 and its impact on child and youth mental health service demand in the community and emergency department. Child and Adolescent Mental Health, 28(1), 91–94.
14. Ferro, V., Averna, R., Murciano, M., Raucci, U., Cristaldi, S., Musolino, A. M. C., Pontillo, M., Della Vecchia, N., Labonia, M., Raponi, M., & colleagues. (2023). Has anything changed in the frequency of emergency department visits and the profile of the adolescent seeking emergency mental care during the COVID-19 pandemic? Children, 10(3), 578.
15. Burrell, T. D., Kim, S., Mohadikar, K., & colleagues. (2023). Family structure and adolescent mental health service utilization during the COVID-19 pandemic. Journal of Adolescent Health, 73(4), 693–700.
16. Anderson, K. N., Johns, D., Holland, K. M., Chen, Y., Vivolo-Kantor, A. M., Trinh, E., Bitsko, R. H., Leeb, R. T., Radhakrishnan, L., Bacon, S., & Jones, C. M. (2023). Emergency department visits involving mental health conditions, suicide-related behaviors, and drug overdoses among adolescents—United States, January 2019–February 2023. Morbidity and Mortality Weekly Report, 72(19), 502–512.
17. Meda, R. (2025). Integrated Sales Performance Management Platforms: Leveraging AI for Quota Allocation, Demand Forecasting, and Zone-Based Sales Optimization. Advances in Consumer Research, 2(4), 461.
18. Kalmin, M. M., Cantor, J. H., Bravata, D. M., Ho, P.-C., Whaley, C., & McBain, R. K. (2023). Utilization and spending on mental health services among children and youths with commercial insurance. JAMA Network Open, 6(10), e2336979.
19. Tiwari, S., Kaur, P., & colleagues. (2023). Pattern of psychiatric emergencies in children and adolescents at a tertiary care centre after onset of COVID-19 pandemic. Indian Journal of Psychological Medicine, 45(1), 49–54.
20. Patrick, S. W., Henkhaus, L. E., Zickafoose, J. S., Lovell, K., Halvorson, A., Loch, S., Letterie, M., & Davis, M. M. (2020). Well-being of parents and children during the COVID-19 pandemic: A national survey. Pediatrics, 146(4), e2020016824.
21. Jones, E. A. K., Mitra, A. K., & Bhuiyan, A. R. (2021). Impact of COVID-19 on mental health in adolescents: A systematic review. International Journal of Environmental Research and Public Health, 18(5), 2470.
22. Racine, N., McArthur, B. A., Cooke, J. E., Eirich, R., Zhu, J., & Madigan, S. (2021). Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: A meta-analysis. JAMA Pediatrics, 175(11), 1142–1150.
23. Panchal, U., Salazar de Pablo, G., Franco, M., Moreno, C., Parellada, M., Arango, C., & Fusar-Poli, P. (2023). The impact of COVID-19 lockdown on child and adolescent mental health: Systematic review and meta-analysis. European Child & Adolescent Psychiatry, 32, 1197–1214.
24. Tsiachristas, A., Holland, J., Guo, B., Chitsabesan, P., Sayal, K., & Abdul Pari, A. A. (2024). The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: Interrupted time-series analysis of national patient records. BJPsych Open, 10(2), e69.
25. Burstein, B., Agostino, H., & Greenfield, B. (2024). Effect of COVID-19 on youth mental health services and emergency presentations: A population-based analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 63(2), 210–221.
26. Endo, F., Hiramatsu, Y., & Ide, H. (2025). Impact of the COVID-19 pandemic on utilization of mental health services among children and adolescents using an interrupted time series analysis. Scientific Reports, 15, 2411.
27. Tan, S. C., Hunt, K., & Shelton, B. (2025). Disparities in mental health service utilization among adolescents with depression: Results from a 2022 U.S. National Survey. PLOS Mental Health, 2(8), e0000388.
28. De Caro, E. F., Delvecchio, E., Pagano, L. P., Garofalo, C., Orgilés, M., & Mazzeschi, C. (2025). Child and adolescent mental health during the COVID-19 pandemic. Journal of Applied Developmental Psychology, 99, 101811.
29. Mangalampalli, B. M., Kolla, S. K., Bandi, V. D. V. K., Yandamuri, U. S., & Rani, P. S. (2025). Designing Intelligent Healthcare Ecosystems through Adaptive Data Integration and Autonomous Learning Systems. Vascular and Endovascular Review, 8(20s), 330-347.
30. Tedja, M. G., Middeldorp, C. M., & colleagues. (2023). Child and youth mental health service utilization during the COVID-19 pandemic: Changes in demand and service delivery. Child and Adolescent Mental Health, 28(1), 85–94.
31. Fegert, J. M., Vitiello, B., Plener, P. L., & Clemens, V. (2020). Challenges and burden of the coronavirus 2019 pandemic for child and adolescent mental health: A narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child and Adolescent Psychiatry and Mental Health, 14, 20.
32. Meherali, S., Punjani, N., Louie-Poon, S., Abdul Rahim, K., Das, J. K., & Salam, R. A. (2021). Mental health of children and adolescents amidst COVID-19 and past pandemics: A rapid systematic review. International Journal of Environmental Research and Public Health, 18(7), 3432.
33. Singh, S., Roy, D., Sinha, K., Parveen, S., Sharma, G., & Joshi, G. (2020). Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations. Psychiatry Research, 293, 113429.
