CoChat
Sign Up
Cited by 279COVID-19 and Mental HealthChild and Adolescent Psychosocial and Emotional DevelopmentStudent Stress and Coping

Mental Health Impact of COVID-19 among Children and College Students: A Systematic Review

Open access
Elharake, Jad A., Akbar, Faris, Malik, Amyn A., Gilliam, Walter, Omer, Saad B.·2023·Child Psychiatry & Human Development
DOI 10.1007/s10578-021-01297-1PMC PMC8747859
Open this paper in CoChat — free accountOpen PDF

Abstract

The COVID-19 pandemic led to a worldwide lockdown and school closures, which have placed a substantial mental health burden on children and college students. Through a systematic search of the literature on PubMed and Collabovid of studies published January 2020-July 2021, our findings of five studies on children and 16 studies on college students found that both groups reported feeling more anxious, depressed, fatigued, and distressed than prior to the pandemic. Several risk factors such as living in rural areas, low family socioeconomic status, and being a family member or friend to a healthcare worker were strongly associated with worse mental health outcomes. As schools and researchers discuss future strategies on how to combine on-site teaching with online courses, our results indicate the importance of considering social contacts in students' mental health to support students at higher risk of social isolation during the COVID-19 pandemic.

Integrity signals

Registry

Crossref · 10.1007/s10578-021-01297-1

Cites

53 of 53 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 97 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The review identified five studies on children and adolescents.

    “our findings of five studies on children and 16 studies on college students”
    • Also stated in: § Child and Adolescent Studies · plain
      “Five studies remained, which were all cross-sectional studies, conducted in China, and the variables most commonly measured were depression and anxiety [14–18].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [14] Chen F, Zheng D, Liu J, Gong Y, Guan Z, Lou D (2020) Depression and anxiety among adolescents during COVID-19: A cross-sectional study. Brain Behav Immun 88:36–8. https://doi.org/10.1016/j.bbi.2020.05.061 source

      Not checked in the free run.

    • cites [15] Duan L, Shao X, Wang Y, Huang Y, Miao J, Yang X et al (2020) An investigation of mental health status of children and adolescents in china during the outbreak of COVID-19. J Affect Disord. 275:112–8. https://doi.org/10.1016/j.jad.2020.06.029 source

      Not checked in the free run.

    • cites [16] Liang L, Ren H, Cao R, Hu Y, Qin Z, Li C et al (2020) The effect of COVID-19 on youth mental health. Psychiatr Q 91(3):841–852 source

      Not checked in the free run.

    • cites [17] Tang S, Xiang M, Cheung T, Xiang Y-T (2021) Mental health and its correlates among children and adolescents during COVID-19 school closure: The importance of parent-child discussion. J Affect Disord 279:353–360 source

      Not checked in the free run.

    • cites [18] Xie X, Xue Q, Zhou Y, Zhu K, Liu Q, Zhang J et al (2020) Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA Pediatr 174(9):898–900. https://doi.org/10.1001/jamapediatrics.2020.1619 source

      Not checked in the free run.

  • Findingown data

    The review identified 16 studies on college students.

    “our findings of five studies on children and 16 studies on college students”
    • Also stated in: § Sociodemographic Characteristics & Other Factors · plain
      “Of the 16 studies remaining, 15 were cross sectional studies and one was a cohort study [16, 19–33].”
    Quote in the paperSubstantial claim0 of 10 sources checked
    • cites [16] Liang L, Ren H, Cao R, Hu Y, Qin Z, Li C et al (2020) The effect of COVID-19 on youth mental health. Psychiatr Q 91(3):841–852 source

      Not checked in the free run.

    • cites [19] Cao W, Fang Z, Hou G, Han M, Xu X, Dong J et al (2020) The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res 287:112934. https://doi.org/10.1016/j.psychres.2020.112934 source

      Not checked in the free run.

    • cites [20] Chang J, Yuan Y, Wang D (2020) Mental health status and its influencing factors among college students during the epidemic of COVID-19. Nan Fang Yi Ke Da Xue Xue Bao. 40(2):171–6. https://doi.org/10.12122/j.issn.1673-4254.2020.02.06 source

      Not checked in the free run.

    • cites [21] Chi X, Becker B, Yu Q, Willeit P, Jiao C, Huang L et al (2020) Prevalence and psychosocial correlates of mental health outcomes among chinese college students during the coronavirus disease (COVID-19) pandemic. Front Psychiatry. 11:803. https://doi.org/10.3389/fpsyt.2020.00803 source

      Not checked in the free run.

    • cites [22] Naser AY, Dahmash EZ, Al-Rousan R, Alwafi H, Alrawashdeh HM, Ghoul I et al (2020) Mental health status of the general population, healthcare professionals, and university students during 2019 coronavirus disease outbreak in Jordan: A cross-sectional study. Brain Behav 10(8):e01730. https://doi.org/10.1002/brb3.1730 source

      Not checked in the free run.

    • cites [23] Ojewale LY. Psychological state, family functioning and coping strategies among students of the University of Ibadan, Nigeria, during the COVID -19 lockdown. medRxiv. 2020:2020.07.09.20149997. Doi:https://doi.org/10.1101/2020.07.09.20149997. source

      Not checked in the free run.

    • cites [24] Son C, Hegde S, Smith A, Wang X, Sasangohar F (2020) Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study. J Med Internet Res. 22(9):e21279. https://doi.org/10.2196/21279 source

      Not checked in the free run.

    • cites [25] Sun S, Goldberg SB, Lin D, Qiao S, Operario D (2021) Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China. Global Health 17(1):15. https://doi.org/10.1186/s12992-021-00663-x source

      Not checked in the free run.

    • cites [26] Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F (2020) Investigating mental health of US college students during the COVID-19 pandemic: cross-sectional survey study. J Med Internet Res. 22(9):e22817. https://doi.org/10.2196/22817 source

      Not checked in the free run.

    • cites [27] Wang ZH, Yang HL, Yang YQ, Liu D, Li ZH, Zhang XR et al (2020) Prevalence of anxiety and depression symptom, and the demands for psychological knowledge and interventions in college students during COVID-19 epidemic: A large cross-sectional study. J Affect Disord 275:188–93. https://doi.org/10.1016/j.jad.2020.06.034 source

      Not checked in the free run.

  • Findingown data

    The 16 college student studies included 15 cross-sectional studies and one cohort study.

    “Of the 16 studies remaining, 15 were cross sectional studies and one was a cohort study [16, 19–33].”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [16] Liang L, Ren H, Cao R, Hu Y, Qin Z, Li C et al (2020) The effect of COVID-19 on youth mental health. Psychiatr Q 91(3):841–852 source

      Not checked in the free run.

    • cites [19] Cao W, Fang Z, Hou G, Han M, Xu X, Dong J et al (2020) The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res 287:112934. https://doi.org/10.1016/j.psychres.2020.112934 source

      Not checked in the free run.

    • cites [20] Chang J, Yuan Y, Wang D (2020) Mental health status and its influencing factors among college students during the epidemic of COVID-19. Nan Fang Yi Ke Da Xue Xue Bao. 40(2):171–6. https://doi.org/10.12122/j.issn.1673-4254.2020.02.06 source

      Not checked in the free run.

    • cites [21] Chi X, Becker B, Yu Q, Willeit P, Jiao C, Huang L et al (2020) Prevalence and psychosocial correlates of mental health outcomes among chinese college students during the coronavirus disease (COVID-19) pandemic. Front Psychiatry. 11:803. https://doi.org/10.3389/fpsyt.2020.00803 source

      Not checked in the free run.

    • cites [22] Naser AY, Dahmash EZ, Al-Rousan R, Alwafi H, Alrawashdeh HM, Ghoul I et al (2020) Mental health status of the general population, healthcare professionals, and university students during 2019 coronavirus disease outbreak in Jordan: A cross-sectional study. Brain Behav 10(8):e01730. https://doi.org/10.1002/brb3.1730 source

      Not checked in the free run.

    • cites [23] Ojewale LY. Psychological state, family functioning and coping strategies among students of the University of Ibadan, Nigeria, during the COVID -19 lockdown. medRxiv. 2020:2020.07.09.20149997. Doi:https://doi.org/10.1101/2020.07.09.20149997. source

      Not checked in the free run.

    • cites [24] Son C, Hegde S, Smith A, Wang X, Sasangohar F (2020) Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study. J Med Internet Res. 22(9):e21279. https://doi.org/10.2196/21279 source

      Not checked in the free run.

    • cites [25] Sun S, Goldberg SB, Lin D, Qiao S, Operario D (2021) Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China. Global Health 17(1):15. https://doi.org/10.1186/s12992-021-00663-x source

      Not checked in the free run.

    • cites [26] Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F (2020) Investigating mental health of US college students during the COVID-19 pandemic: cross-sectional survey study. J Med Internet Res. 22(9):e22817. https://doi.org/10.2196/22817 source

      Not checked in the free run.

    • cites [27] Wang ZH, Yang HL, Yang YQ, Liu D, Li ZH, Zhang XR et al (2020) Prevalence of anxiety and depression symptom, and the demands for psychological knowledge and interventions in college students during COVID-19 epidemic: A large cross-sectional study. J Affect Disord 275:188–93. https://doi.org/10.1016/j.jad.2020.06.034 source

      Not checked in the free run.

  • Findingcitation

    In the Sun et al. college student study, family financial stress due to COVID-19 consistently predicted psychiatric symptoms.

    “family financial stress due to COVID-19 consistently predicted psychiatric symptoms.”
    Quote in the paperNot a substantial claim
  • Findingcitation

    In the Chen et al. child and adolescent study, lower parental educational attainment was associated with increased risk of depression among children.

    “lower parents’ educational attainment is associated with increased risk of depression among the children.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 19
  • The quote only partly states this claim. 1
  • Classified as probably not a substantial claim. 21

  • May combine two claims.

    Findingown data

    The five child and adolescent studies were all cross-sectional and conducted in China.

    “Five studies remained, which were all cross-sectional studies, conducted in China, and the variables most commonly measured were depression and anxiety [14–18].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [14] Chen F, Zheng D, Liu J, Gong Y, Guan Z, Lou D (2020) Depression and anxiety among adolescents during COVID-19: A cross-sectional study. Brain Behav Immun 88:36–8. https://doi.org/10.1016/j.bbi.2020.05.061 source

      Not checked in the free run.

    • cites [15] Duan L, Shao X, Wang Y, Huang Y, Miao J, Yang X et al (2020) An investigation of mental health status of children and adolescents in china during the outbreak of COVID-19. J Affect Disord. 275:112–8. https://doi.org/10.1016/j.jad.2020.06.029 source

      Not checked in the free run.

    • cites [16] Liang L, Ren H, Cao R, Hu Y, Qin Z, Li C et al (2020) The effect of COVID-19 on youth mental health. Psychiatr Q 91(3):841–852 source

      Not checked in the free run.

    • cites [17] Tang S, Xiang M, Cheung T, Xiang Y-T (2021) Mental health and its correlates among children and adolescents during COVID-19 school closure: The importance of parent-child discussion. J Affect Disord 279:353–360 source

      Not checked in the free run.

    • cites [18] Xie X, Xue Q, Zhou Y, Zhu K, Liu Q, Zhang J et al (2020) Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA Pediatr 174(9):898–900. https://doi.org/10.1001/jamapediatrics.2020.1619 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In the Duan et al. child and adolescent study, the anxiety score was 23.87 ± 15.79 for children and 29.27 ± 19.70 for adolescents.

    “anxiety score for children was 23.87 ± 15.79, while the anxiety score for adolescents was 29.27 ± 19.70.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Children and college students reported feeling more anxious, depressed, fatigued, and distressed than before the pandemic.

    “our findings of five studies on children and 16 studies on college students found that both groups reported feeling more anxious, depressed, fatigued, and distressed than prior to the pandemic.”
    • Also stated in: § Discussion · plain
      “Children and college students reported feeling more anxious, depressed, fatigued, and distressed than prior to the pandemic.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    In the Moghe et al. college student study, over 75% of the sample felt fatigued and over 80% felt sad and empty due to COVID-19.

    “over 75% of its sample felt fatigued and over 80% of individuals felt sad and empty due to the COVID-19 pandemic.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In the Cao et al. college student study, low family income, having relatives or friends infected with COVID-19, and living in rural areas were risk factors for increased anxiety and worse mental well-being.

    “low family income, having relatives or friends infected with COVID-19, and living in rural areas were risk factors for increased levels of anxiety among college students and overall worse mental well-being.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Several risk factors, including living in rural areas, low family socioeconomic status, being a family member or friend to a healthcare worker, and knowing someone infected with COVID-19, were strongly associated with worse mental health outcomes among children and college students.

    “Several risk factors such as living in rural areas, low family socioeconomic status, and being a family member or friend to a healthcare worker were strongly associated with worse mental health outcomes.”
    • Also stated in: § Discussion · boosted
      “Additionally, several risk factors such as living in rural areas, low family socioeconomic status, being a family member or friend to a healthcare worker, and knowing someone who was infected with COVID-19 were strongly associated with worse mental health outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The college student studies most commonly measured depression and anxiety, and some also measured stress and suicidal thoughts.

    “The variables most commonly measured in these studies were depression and anxiety, and some studies included other variables such as stress and suicidal thoughts.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingcitation

    In the Liang et al. study, 14% of the population aged 14 to 35 reported PTSD symptoms.

    “Overall, 14% of the population, which included individuals from 14 to 35 years old, reported having PTSD symptoms.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The systematic review of five studies on children and 16 studies on college students found that children and college students reported more anxiety, depression, fatigue, and distress than before the pandemic.

    “In summary, our systematic review of five studies on children and 16 studies on college students found that children and college students reported feeling more anxious, depressed, fatigued, and distressed than prior to the pandemic.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Rural areas are economically and educationally under-resourced.

    “This is not surprising as rural areas, as opposed to urban areas, often have limited mental health services, lacking access to adequate healthcare, being economically and educationally under-resourced, and usually consisting of elder populations with worse health outcomes—making those living in these communities even more vulnerable to COVID-19 [49–51].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [49] Ranscombe P (2020) Rural areas at risk during COVID-19 pandemic. Lancet Infect Dis 20(5):545. https://doi.org/10.1016/s1473-3099(20)30301-7 source

      Not checked in the free run.

    • cites [50] Human J, Wasem C (1991) Rural mental health in America. Am Psychol 46(3):232–9. https://doi.org/10.1037//0003-066x.46.3.232 source

      Not checked in the free run.

    • cites [51] CDC. Rural Communities CDC2021 [cited 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/rural-communities.html.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    By May 2020, 138 countries had implemented national school closures due to COVID-19, affecting more than one billion children and young adults, about 80% of the global student population.

    “138 countries had implemented national school closures due to COVID-19 by May 2020, which impacted more than one billion children and young adults—approximately 80% of the global student population [37].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] UNESCO. Education: From disruption to recovery: UNESCO; 2021 [cited 2021]. Available from: https://en.unesco.org/covid19/educationresponse.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Similar psychological effects have been found from wars and previous disease outbreaks.

    “Similar psychological effects have been found from wars and previous disease outbreaks [10–13].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [10] Morina N, von Lersner U, Prigerson HG (2011) War and bereavement: consequences for mental and physical distress. PLoS One 6(7):e22140. https://doi.org/10.1371/journal.pone.0022140 source

      Not checked in the free run.

    • cites [11] Thabet A, Tawahina AA, Sarraj E, Vostanis P (2013) Death anxiety, PTSD, trauma, grief, and mental health of Palestinians victims of War on Gaza. Health Care: Curr Rev. https://doi.org/10.4172/hccr.1000112 source

      Not checked in the free run.

    • cites [12] Van Bortel T, Basnayake A, Wurie F, Jambai M, Koroma AS, Muana AT et al (2016) Psychosocial effects of an Ebola outbreak at individual, community and international levels. Bull World Health Organ 94(3):210–4. https://doi.org/10.2471/blt.15.158543 source

      Not checked in the free run.

    • cites [13] Tucci V, Moukaddam N, Meadows J, Shah S, Galwankar SC, Kapur GB (2017) The forgotten plague: psychiatric manifestations of Ebola, Zika, and emerging infectious diseases. J Glob Infect Dis 9(4):151–6. https://doi.org/10.4103/jgid.jgid_66_17 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Similar mental health effects were seen in past containment efforts during SARS in 2003, the 2009 swine flu pandemic, and the 2014-2016 Ebola epidemic.

    “similar mental health effects were seen in past containment efforts during infectious disease outbreaks, such as the severe acute respiratory syndrome (SARS) in 2003 [2, 3], the 2009 swine flu pandemic [4, 5], and the 2014–2016 Ebola epidemic [6].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [2] Peng EY, Lee MB, Tsai ST, Yang CC, Morisky DE, Tsai LT et al (2010) Population-based post-crisis psychological distress: an example from the SARS outbreak in Taiwan. J Formos Med Assoc 109(7):524–32. https://doi.org/10.1016/s0929-6646(10)60087-3 source

      Not checked in the free run.

    • cites [3] Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R (2004) SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis 10(7):1206–12. https://doi.org/10.3201/eid1007.030703 source

      Not checked in the free run.

    • cites [4] Yeung NCY, Lau JTF, Choi KC, Griffiths S (2017) Population responses during the pandemic phase of the influenza A(H1N1)pdm09 epidemic, Hong Kong, China. Emerg Infect Dis 23(5):813–5. https://doi.org/10.3201/eid2305.160768 source

      Not checked in the free run.

    • cites [5] Taha SA, Matheson K, Anisman H (2014) H1N1 was not all that scary: uncertainty and stressor appraisals predict anxiety related to a coming viral threat. Stress Health 30(2):149–57. https://doi.org/10.1002/smi.2505 source

      Not checked in the free run.

    • cites [6] Jalloh MF, Li W, Bunnell RE, Ethier KA, O’Leary A, Hageman KM et al (2018) Impact of Ebola experiences and risk perceptions on mental health in Sierra Leone, July 2015. BMJ Glob Health 3(2):e000471. https://doi.org/10.1136/bmjgh-2017-000471 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    ECMHC is a preventive intervention that places mental health consultants in early childcare settings and pairs them with families to address a child's individual needs and improve social and emotional health.

    “ECMHC is a preventative intervention that places mental health consultants in early childcare settings and pairs these consultants with families to address a child’s individual needs and increase their social and emotional health [42, 45, 46].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [42] Cohen E, Kaufmann RK. Early childhood mental health consultation: National Technical Assistance Center for Children's Mental Health; 2000.

      Not checked in the free run.

    • cites [45] Zero to Three. Early Childhood Mental Health Consultation: Policies and Practices to Foster the Social-Emotional Development of Young Children Zero to Three2016 [cited 2021 October]. Available from: https://www.zerotothree.org/resources/1694-early-childhood-mental-health-consultation-policies-and-practices-to-foster-the-social-emotional-development-of-young-children.

      Not checked in the free run.

    • cites [46] Duran F, Hepburn K, Irvine M, Kaufmann R, Anthony B, Horenn N et al (2009) What works? A study of effective early childhood mental health consultation programs. Georgetown University. Center for Child and Human Development, Washington, DC

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Rural areas often have limited mental health services and lack access to adequate healthcare.

    “This is not surprising as rural areas, as opposed to urban areas, often have limited mental health services, lacking access to adequate healthcare, being economically and educationally under-resourced, and usually consisting of elder populations with worse health outcomes—making those living in these communities even more vulnerable to COVID-19 [49–51].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [49] Ranscombe P (2020) Rural areas at risk during COVID-19 pandemic. Lancet Infect Dis 20(5):545. https://doi.org/10.1016/s1473-3099(20)30301-7 source

      Not checked in the free run.

    • cites [50] Human J, Wasem C (1991) Rural mental health in America. Am Psychol 46(3):232–9. https://doi.org/10.1037//0003-066x.46.3.232 source

      Not checked in the free run.

    • cites [51] CDC. Rural Communities CDC2021 [cited 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/rural-communities.html.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    During quarantine, one-third of adolescents reported high levels of loneliness and almost half of young adults reported being lonely.

    “one-third of adolescents reported high levels of loneliness and almost half of young adults reported being lonely while quarantining [38–40].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [38] Lim M. Achieving resilience during COVID-19: psycho-social risk & protective factors amidst a pandemic in adolescents: Mental Health Research Matters; 2020 [cited 2021]. Available from: http://mentalhealthresearchmatters.org.uk/achieving-resilience-during-covid-19-psycho-social-risk-protective-factors-amidst-a-pandemic-in-adolescents/.

      Not checked in the free run.

    • cites [39] Young Minds. Coronavirus: Impact on young people with mental health needs 2020 [cited 2021]. Available from: https://youngminds.org.uk/media/3708/coronavirus-report_march2020.pdf.

      Not checked in the free run.

    • cites [40] Mental Health Foundation. Loneliness during coronavirus. MentalHealth. 2020.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two authors independently extracted data on demographic characteristics and mental health measurements.

    “Two authors of this review independently extracted data on basic demographic characteristics and mental health measurements”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two authors independently retrieved studies from the searches.

    “Two authors of this review independently retrieved studies from the searches using terms relevant to the impact of COVID-19 on the mental health of children”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    ECMHC is effective and is used in child care centers, Head Start/Early Head Start centers, home visiting programs, primary care settings, elementary schools from kindergarten through third grade, and community outreach programs.

    “Studies have shown that ECMHC is effective and being used across child care centers, Head Start/Early Head Start centers, home visiting programs, primary care settings, elementary schools (kindergarten through third grade), and community outreach programs [41, 45, 46, 48].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [41] Gilliam WS, Maupin AN, Reyes CR (2016) Early Childhood Mental Health Consultation: Results of a Statewide Random-Controlled Evaluation. J Am Acad Child Adolesc Psychiatry. 55(9):754–61. https://doi.org/10.1016/j.jaac.2016.06.006 source

      Not checked in the free run.

    • cites [45] Zero to Three. Early Childhood Mental Health Consultation: Policies and Practices to Foster the Social-Emotional Development of Young Children Zero to Three2016 [cited 2021 October]. Available from: https://www.zerotothree.org/resources/1694-early-childhood-mental-health-consultation-policies-and-practices-to-foster-the-social-emotional-development-of-young-children.

      Not checked in the free run.

    • cites [46] Duran F, Hepburn K, Irvine M, Kaufmann R, Anthony B, Horenn N et al (2009) What works? A study of effective early childhood mental health consultation programs. Georgetown University. Center for Child and Human Development, Washington, DC

      Not checked in the free run.

    • cites [48] Hoffmann E, Ewen D. 2007 Supporting families, nurturing young children: Early Head Start programs in 2006. CLASP Policy Brief (Head Start Series). 9.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    When COVID-19 social distancing measures were imposed, many businesses were forced to shut down, leaving many adults unemployed for several months.

    “When COVID-19 social distancing measures were imposed, many businesses were forced to shut down—leaving many adults unemployed for several months [56].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [56] Parker K, Minkin R, Bennett J. 2020 Economic fallout from COVID-19 continues to hit lower-income Americans the hardest. Pew Research Center. 21.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Higher rates of mental illness occur in groups with lower socioeconomic status.

    “The relationship between income status and mental health has been well-documented as there are higher rates of mental illness in groups with lower socioeconomic status [53–55].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [53] Warren JR (2009) Socioeconomic status and health across the life course: a test of the social causation and health selection hypotheses. Soc Forces. 87(4):2125–53. https://doi.org/10.1353/sof.0.0219 source

      Not checked in the free run.

    • cites [54] Perry MJ (1996) The relationship between social class and mental disorder. J Prim Prev 17(1):17–30. https://doi.org/10.1007/bf02262736 source

      Not checked in the free run.

    • cites [55] Wang H, Yang XY, Yang T, Cottrell RR, Yu L, Feng X et al (2015) Socioeconomic inequalities and mental stress in individual and regional level: a twenty one cities study in China. Int J Equity Health 14:25. https://doi.org/10.1186/s12939-015-0152-4 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Black/African American, Latinx, and Native American populations are at increased risk of contracting COVID-19 and having severe illness because of inequities in social determinants of health.

    “In the U.S., specifically, rural areas are becoming more racially and ethnically diverse, with more Black/African American, Latinx, and Native American populations—groups who are at increased risk of contracting COVID-19 and having severe illness due to inequities in social determinants of health—migrating to rural communities [51, 52].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [51] CDC. Rural Communities CDC2021 [cited 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/rural-communities.html.

      Not checked in the free run.

    • cites [52] CDC. Health Equity Considerations and Racial and Ethnic Minority Groups CDC2020 [cited 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fracial-ethnic-minorities.html.

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The review is focused on COVID-19.

    “Some strengths of our review are it answers a more expansive question (as opposed to other similar reviews [62–65]), it is focused on COVID-19, and covers a large date range, which makes our review one of the first systematic reviews to have these qualities.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The review covers a large date range.

    “Some strengths of our review are it answers a more expansive question (as opposed to other similar reviews [62–65]), it is focused on COVID-19, and covers a large date range, which makes our review one of the first systematic reviews to have these qualities.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    School lunch is associated with high educational attainment.

    “Studies show that food insecurity is associated with low educational performance, while school lunch is associated with high educational attainment [57, 58].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [57] Schwartz AE, Rothbart MW (2020) Let them eat lunch: The impact of universal free meals on student performance. J Policy Anal Manage 39(2):376–410 source

      Not checked in the free run.

    • cites [58] Bitler MP, Seifoddini A (2019) Health impacts of food assistance: evidence from the United States. Annu Rev Res Econ 11:261–287 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Food insecurity is associated with low educational performance.

    “Studies show that food insecurity is associated with low educational performance, while school lunch is associated with high educational attainment [57, 58].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [57] Schwartz AE, Rothbart MW (2020) Let them eat lunch: The impact of universal free meals on student performance. J Policy Anal Manage 39(2):376–410 source

      Not checked in the free run.

    • cites [58] Bitler MP, Seifoddini A (2019) Health impacts of food assistance: evidence from the United States. Annu Rev Res Econ 11:261–287 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    The public health community and policymakers may be directing more COVID-19 resources and informational messaging toward large cities.

    “Because urban areas are more densely populated, which raises concerns during an infectious disease outbreak, the public health community and policymakers may be investing more of its COVID-19 resources and informational messaging towards large cities.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Urban areas are more densely populated, which raises concerns during an infectious disease outbreak.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The COVID-19 pandemic resulted in widespread forced adoption of telehealth services to deliver psychiatric and mental health support.

    “Additionally, although the COVID-19 pandemic has resulted in a widespread forced adoption of telehealth services to deliver psychiatric and mental health support [59–61], healthcare providers should identify ways to cater more healthcare workers, those infected by COVID-19, and the families of these groups through employer benefits and insurance companies.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [59] Zhou X, Snoswell CL, Harding LE, Bambling M, Edirippulige S, Bai X et al (2020) The role of telehealth in reducing the mental health burden from COVID-19. Telemed e-Health 26(4):377–379 source

      Not checked in the free run.

    • cites [60] Ohannessian R, Duong TA, Odone A (2020) Global telemedicine implementation and integration within health systems to fight the COVID-19 pandemic: a call to action. JMIR Public Health Surveil 6(2):e18810 source

      Not checked in the free run.

    • cites [61] Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J et al (2020) Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare 26(5):309–313 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Children and young adults in close contact with healthcare workers may be more worried about contracting the virus because of their direct contact.

    “Because healthcare workers are on the frontlines in combatting COVID-19 as they treat patients on a frequent basis, children and young adults who are in close contact with these healthcare professionals may be even more worried about contracting the virus, given their level of direct contact.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    Even if the non-peer-reviewed studies were excluded, the overall findings would remain the same.

    “However, even if we did exclude these non-peer reviewed studies from our systematic review, our overall findings would remain the same.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Rural areas usually have elder populations with worse health outcomes.

    “This is not surprising as rural areas, as opposed to urban areas, often have limited mental health services, lacking access to adequate healthcare, being economically and educationally under-resourced, and usually consisting of elder populations with worse health outcomes—making those living in these communities even more vulnerable to COVID-19 [49–51].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [49] Ranscombe P (2020) Rural areas at risk during COVID-19 pandemic. Lancet Infect Dis 20(5):545. https://doi.org/10.1016/s1473-3099(20)30301-7 source

      Not checked in the free run.

    • cites [50] Human J, Wasem C (1991) Rural mental health in America. Am Psychol 46(3):232–9. https://doi.org/10.1037//0003-066x.46.3.232 source

      Not checked in the free run.

    • cites [51] CDC. Rural Communities CDC2021 [cited 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/rural-communities.html.

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    College students who worked several jobs to pay for tuition or housing were also laid off, adding economic pressure during an already overwhelming time.

    “As a result, college students who worked several jobs to pay for tuition and/or housing were also laid off—adding economic pressure during an already overwhelming time.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the U.S., rural areas are becoming more racially and ethnically diverse as more Black/African American, Latinx, and Native American populations migrate to rural communities.

    “In the U.S., specifically, rural areas are becoming more racially and ethnically diverse, with more Black/African American, Latinx, and Native American populations—groups who are at increased risk of contracting COVID-19 and having severe illness due to inequities in social determinants of health—migrating to rural communities [51, 52].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [51] CDC. Rural Communities CDC2021 [cited 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/rural-communities.html.

      Not checked in the free run.

    • cites [52] CDC. Health Equity Considerations and Racial and Ethnic Minority Groups CDC2020 [cited 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fracial-ethnic-minorities.html.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review identified more college student studies than children-related studies.

    “There were also more college student studies identified than children-related studies.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The review answers a more expansive question than other similar reviews.

    “Some strengths of our review are it answers a more expansive question (as opposed to other similar reviews [62–65]), it is focused on COVID-19, and covers a large date range, which makes our review one of the first systematic reviews to have these qualities.”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [62] Loades ME, Chatburn E, Higson-Sweeney N, Reynolds S, Shafran R, Brigden A et al (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. J Am Acad Child Adolesc Psychiatry. https://doi.org/10.1016/j.jaac.2020.05.009 source

      Not checked in the free run.

    • cites [63] Racine N, Cooke JL, Eirich R, Korczak DJ, McArthur B, Madigan S (2020) Child and adolescent mental illness during COVID-19: A rapid review. Psychiatr Res. https://doi.org/10.1016/j.psychres.2020.113307 source

      Not checked in the free run.

    • cites [64] Guessoum SB, Lachal J, Radjack R, Carretier E, Minassian S, Benoit L et al (2020) Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatr Res. https://doi.org/10.1016/j.psychres.2020.113264 source

      Not checked in the free run.

    • cites [65] da Silva Junior FJG, de Souza Monteiro CF, Costa APC, Campos LRB, Miranda PIG, de Souza Monteiro TA et al (2020) Impact of COVID-19 pandemic on mental health of young people and adults: a systematic review protocol of observational studies. BMJ Open 10(7):e039426 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Children are not only experiencing worse mental health outcomes but are also having their physical health negatively impacted.

    “This highlights an important global health concern as children are not only experiencing worse mental health outcomes, but their physical health is also being negatively impacted.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Prolonged school closures can have significant health consequences for children living in poverty.
    • Rests on an assumption: Many low-income students rely on school meals.
36 of 36

  • The paper relies on this without support.

    Little is known about the impact of disease outbreaks on the mental health of children and college students, especially on a global scale.

    “very little is known about the impact of disease outbreaks on the mental health of children and college students, especially on a global scale.”

  • The paper relies on this without support.

    Children and college students may lack adequate academic resources, social contact and support, or a learning-home environment, which may lead to loneliness, distress, anger, and boredom and cause an increase in negative psychological outcomes.

    “Due to this unexpected and forced transition, children and college students may not have adequate academic resources, social contact and support, or a learning-home environment, which may lead to a heightened sense of loneliness, distress, anger, and boredom—causing an increase in negative psychological outcomes.”

  • The paper relies on this without support.

    Inequities and disparities in social determinants of health may contribute further to psychological distress among children and college students during the COVID-19 pandemic.

    “Additionally, inequities and disparities in the social determinants of health (e.g., income status, immigrant background, language barrier, parents’ educational background, and access to adequate healthcare) may contribute further to the development of psychological distress among children and college students living through the COVID-19 pandemic.”

  • The paper relies on this without support.

    Urban areas are more densely populated, which raises concerns during an infectious disease outbreak.

    “Because urban areas are more densely populated, which raises concerns during an infectious disease outbreak, the public health community and policymakers may be investing more of its COVID-19 resources and informational messaging towards large cities.”

  • The paper relies on this without support.

    Prolonged school closures can have significant health consequences for children living in poverty.

    “Schools that are closed for a long period of time can have significant health consequences for children living in poverty.”

  • The paper relies on this without support.

    Many low-income students rely on school meals.

    “This will exacerbate food insecurity as many low-income students rely on school meals.”

  • The paper relies on this without support.

    There are far more children needing mental health support than can be served individually.

    “In a pandemic where there are far more children in need of mental health support than we have capacity to serve individually, it is important to invest in mental health programs that can have positive effects across a larger population.”
7 of 7

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • These findings must be contextualized in the period of transition from the strictest phase of the pandemic to a consistent restoration of social and in-person academic activities.

    “These findings must be contextualized in the period of transition from the strictest phase of the pandemic to a consistent restoration of social and in-person academic activities, thus resulting in contrast with data collected during the first phases of the pandemic when social isolation was imposed to limit the spread of the virus (Elharake et al., 2023; Li et al., 2021; Lisitsa et al., 2020; Sen”

    From Social connections combat loneliness and promote wellbeing among college students coming out of the COVID-19 pandemic (2025) · cites this paper as Elharake et al., 2023

    The Discussion (page unavailable) describes early lockdowns and school closures that increased social isolation, and says students were beginning to transition to in-person learning. It does not establish a consistent restoration of social and in-person academic activities. The contrast with the citing authors’ findings is their own contextualization, not a finding of this review. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • College students experienced particular challenges in terms of disruption to their social and academic lives, with negative consequences for their mental health.

    “Recent systematic reviews and metanalyses (Buizza et al., 2022; Carvalho et al., 2022; Elharake et al., 2023; Luo et al., 2021) point out that college students experienced particular challenges in terms of disruption to their social and academic lives, with negative consequences for their mental health”

    From Social connections combat loneliness and promote wellbeing among college students coming out of the COVID-19 pandemic (2025) · cites this paper as Elharake et al., 2023

  • The findings contrast with data collected during the first phases of the pandemic.

    “These findings must be contextualized in the period of transition from the strictest phase of the pandemic to a consistent restoration of social and in-person academic activities, thus resulting in contrast with data collected during the first phases of the pandemic when social isolation was imposed to limit the spread of the virus (Elharake et al., 2023; Li et al., 2021; Lisitsa et al., 2020; Sen”

    From Social connections combat loneliness and promote wellbeing among college students coming out of the COVID-19 pandemic (2025) · cites this paper as Elharake et al., 2023

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentt(208) = 2.47reported p = .014 · recomputed p = .014

    “t (208) = 2.47, p = .014”

  • Consistentt(208) = 8.89reported p < .001 · recomputed p < .001

    “t (208) = 8.89, p < .001”

  • Consistentt(208) = 6.64reported p < .001 · recomputed p < .001

    “t (208) = 6.64, p < .001”

3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Ma study's stress percentage is about tenfold too high

    Major

    The reported 26,600 participants are 3.56% of the study's 746,217 participants, not 34.9%.

    Reported 34.9 · recomputed 3.564647

  • Elmer study's second-cohort male percentage is incorrect

    Minor

    Cohort 2 lists 57 men among 86 participants, which is 66.28%, not 62%.

    Reported 62 · recomputed 66.27907

  • Stated maximum sample excludes a larger included study

    Minor

    The stated upper sample size is 89,588, but the included Ma et al. study lists 746,217 participants.

  • College-study count changes from sixteen to seven

    Minor

    The results identify 16 included college-student studies, then describe the participant range as coming from seven studies.

  • Sun study's female percentage uses the wrong denominator

    Minor

    The table lists 1,334 women among 1,912 participants. That is 69.77%, rather than the reported 59%.

    Reported 59 · recomputed 69.769874

  • Depressive-thought categories exceed the study sample

    Minor

    The four depressive-thought categories in the US Wang et al. study total 2,088 participants, while its stated sample contains 2,031.

    Reported 2031 · recomputed 2088

  • Chen study's depression percentage does not match its count

    Minor

    The table reports 112 children with depression among 1,036 participants, which is 10.81%, not 11.78%. The stated lower end of the depression range repeats the incorrect percentage.

    Reported 11.78 · recomputed 10.810811

  • Duan adolescent anxiety-score deviation differs between table and prose

    Minor

    The table gives an adolescent anxiety-score standard deviation of 19.79; the narrative gives 19.70 for the same mean.

8 of 8

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Duran F, Hepburn K, Irvine M, Kaufmann R, Anthony B, Horenn N et al (2009) What works? A study of effective early childhood mental health consultation programs. Georgetown University. Center for Child and Human Development, Washington, DC

Cited by

Sorted by citations

Related

Authors
Elharake, J. A., Akbar, F., Malik, A. A., Gilliam, W., & Omer, S. B.
Affiliations
Yale University (US)
Corresponding author
Elharake, Jad A.
ORCID
Venue
Child Psychiatry & Human Development
Publisher
Springer Science and Business Media LLC
Published
2022-01-11
Volume
54
Issue
3
Pages
913-925
ISSN
  • 0009-398X (ISSN-L)
  • 1573-3327
DOI
10.1007/s10578-021-01297-1
PMC
PMC8747859
OpenAlex
W4205830803
Cited by
279
References
53
Citations by year
2026: 25 · 2025: 48 · 2024: 83 · 2023: 91 · 2022: 31 · 2021: 1
FWCI
10.57
Type
journal article
Language
en
Open access
Licence
Locations
  • Child Psychiatry & Human Development (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Yale Institute for Global Health
Topics
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
Keywords
COVID-19 pandemic, mental health, children, university students, anxiety, depression, fatigue, distress, school closures, lockdown, social isolation, rural residence, socioeconomic status, online learning
MeSH terms
COVID-19, Child, Communicable Disease Control, Humans, Mental Health, Students, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-05.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-05.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review