Navigating adolescence through COVID-19: a multi-system view on mental health in the Chilean context

Abstract

The COVID-19 pandemic challenged mental health worldwide. Although its emotional effects were widespread, adolescents were an especially vulnerable group. Chile was the OECD country with the most school days lost due to closures during the crisis, resulting in severe disruptions to adolescents’ social life, routines, and recreation, creating additional challenges for their mental health. This dissertation sheds light on the associations between pandemic‑related stressors and the mental health of Chilean adolescents, exploring social determinants that may help explain individual differences in their emotional functioning during and after the crisis.

Two studies were conducted: one during the acute phase of the pandemic (late 2020) and another several months after the return to in-person schooling (late 2022). In study 1, 65 adolescents and 219 parents completed online surveys assessing pandemic hardship, mental health, coping strategies (adolescents), disaster exposure (parents) and family resilience (parents). The study examined how pandemic-related hassles and negative changes related to mental health difficulties in a population previously exposed to varying levels of disaster hardship, and their interplay with individual (i.e., adolescent coping) and family functioning factors (i.e., family resilience). Study 2 used a mixed-methods approach to 1) identify correlates from family and school social environments influencing adolescents’ adjustment during the first year back to face-to-face education, and 2) document adolescents’ unique experiences with their mental health during and after the health crisis. A total of 419 high-school adolescents completed a survey about mental health, pandemic hardship and SSN experiences in the family and school settings. Additionally, 19 adolescents and 16 school staff members shared their perspectives on adolescent mental health and school responses to the crisis during a semi-structured interview.

The findings show negative effects of pandemic‑related stressors on adolescent mental health, primarily through depressive and anxiety complaints. Furthermore, factors at different layers of the context in which adolescents develop were related to risk of mental health problems. At the individual level, coping strategies such as cognitive restructuring were associated with better mental health, while maladaptive coping (e.g., withdrawal or self‑criticism) was linked to worse outcomes, making these promising targets for intervention. The quality of immediate social environments (i.e., family, school, peer relationships) constituted another key factor for individual well-being. Disruptions to the functioning of these social environments appeared to fuel adolescents’ emotional complaints. Family resilience and safe and nurturing relationships at home and at school were identified as promoting factors for mental health. In particular, targeting students’ well‑being through school SSN (mainly safety and nurturance) may represent an effective and scalable strategy. Finally, stressors occurring at the chronosystem level (i.e., pandemic hardship, past disaster hardship) were associated with the emotional functioning among family members. Taken together, adolescent resilience in times of COVID‑19 appeared to be a multisystem affair. This dissertation highlights the need to prioritize adolescents’ developmental needs and to pay close attention to potential disruptions in supportive social environments when designing crisis‑management strategies in order to promote resilience.