Adolescent Mental Health and School Belonging in KwaZulu-Natal, South Africa: Impact of the COVID-19 Pandemic and Subsequent Government Lockdowns.

PURPOSE

We hypothesized that extended exposure to the COVID-19 pandemic and government lockdown was associated with increased depression and anxiety symptoms among South African adolescents and a sense of school belonging mediated these relationships. We also hypothesized that poor mental health or school belonging impacted alcohol consumption.

METHODS

Embedded in the Asenze Cohort Study, data were collected from adolescents between 2019 and 2021. The Patient Health Questionnaire, General Anxiety Disorder questionnaire and Psychological Sense of School Membership scale were used to measure depression, anxiety, and school belonging, respectively. Alcohol consumption was a cumulative score of the total number of days alcohol was consumed in the previous 30 days. Lockdown exposure was the number of months participants were exposed to lockdown conditions. Structural equation modeling was used to assess the relationship between the outcome variables.

RESULTS

Among 866 adolescents included in the analysis, approximately 20% met the symptom criteria for moderate or severe depression or anxiety. The mean school belonging score was high (23; SD = 5.79) and alcohol consumption low. Lockdown exposure was not directly or indirectly associated with depression or anxiety symptoms. A greater sense of school belonging reduced both depression and anxiety symptoms.

DISCUSSION

This study contradicts previous studies and suggests that lockdown was not associated with poor mental health in this cohort of adolescents. School belonging was high despite school closures and associated with lower depression and anxiety. Research around school belonging and how it can be promoted to better support isolated students is recommended.