The impact of COVID-19 and bushfires on the mental health of Australian adolescents: a cross-sectional study

BACKGROUND

When COVID-19 spread to Australia in January 2020, many communities were already in a state of emergency from the Black Summer bushfires. Studies of adolescent mental health have typically focused on the effects of COVID-19 in isolation. Few studies have examined the impact of COVID-19 and other co-occurring disasters, such as the Black Summer bushfires in Australia, on adolescent mental health.

METHODS

We conducted a cross-sectional survey to examine the impact of COVID-19 and the Black Summer bushfires on the mental health of Australian adolescents. Participants (N = 5866; mean age 13.61 years) answered self-report questionnaires about COVID-19 diagnosis/quarantine (being diagnosed with and/or quarantined because of COVID-19) and personal exposure to bushfire harm (being physically injured, evacuated from home and/or having possessions destroyed). Validated standardised scales were used to assess depression, psychological distress, anxiety, insomnia, and suicidal ideation. Trauma related to COVID-19 and the bushfires was also assessed. The survey was completed in two large school-based cohorts between October 2020 and November 2021.

RESULTS

Exposure to COVID-19 diagnosis/quarantine was associated with increased probability of elevated trauma. Exposure to personal harm by the bushfires was associated with increased probability of elevated insomnia, suicidal ideation, and trauma. There were no interactive effects between disasters on adolescent mental health. Effects between personal risk factors and disasters were generally additive or sub-additive.

CONCLUSIONS

Adolescent mental health responses to community-level disasters are multi-faceted. Complex psychosocial factors associated with mental ill health may be relevant irrespective of disaster. Future research is needed to investigate synergistic effects of disasters on young mental health.

Associations between Adverse Childhood Experiences and Pandemic-Related Stress and the Impact on Adolescent Mental Health during the COVID-19 Pandemic

Vulnerabilities of adolescents during times of crisis have been previously identified, but little research has investigated the compounding effects of lifetime adversities and pandemic-related stress on adolescent mental health. This study uses adolescent self-report data to model relationships between stress exposures and indicators of poor mental health from the longitudinal COVID Experiences (CovEx) Surveys. These surveys were administered online in English to U.S. adolescents ages 13-19 using the NORC AmeriSpeak® panel, a probability-based panel designed to be representative of the U.S. household population. Two waves of data were collected (Wave 1: October-November 2020, n = 727; Wave 2: March-May 2021, n = 569). Measures included demographics, adverse childhood experiences (ACEs, 8 items), pandemic-related stress (Pandemic-Related Stress Index [PRSI], 7 items), and depression symptoms (Patient Health Questionnaire for Adolescents [PHQ-A], 9 items). Path analyses were conducted to examine pathways between Wave 1 ACEs, Wave 1 PRSI, and Wave 2 PHQ with covariates of sex and race/ethnicity. Females had higher ACEs, PRSI, and PHQ scores than males. The PRSI score at Wave 1 was positively associated with the PHQ at Wave 2 (b = 0.29, SE = 0.14, p < 0.001). ACEs at Wave 1 were positively associated with PRSI at Wave 1 (b = 0.31, SE = 0.03, p < 0.001) and with PHQ at Wave 2 (b = 0.32, SE = 0.12, p < 0.001). The direct effect of ACEs on PHQ (b = 0.23, SE = 0.12, p < 0.001) remained significant even after accounting for the indirect effect of pandemic-related stress (b = 0.09, SE = 0.05, p < 0.001). Pandemic-related stress had a direct, adverse impact on adolescent depressive symptoms and demonstrates a compounding effect of childhood adversity and pandemic-related stress on depression. Findings can aid the design of interventions that promote mental health and support adolescent coping and recovery.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-022-00502-0.