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BackgroundAdolescence is a critical period for social and emotional development. We sought to examine the impacts of Covid-19 and related social restrictions and school closures on adolescent mental health, particularly among disadvantaged, marginalised, and vulnerable groups.MethodsWe analysed four waves of data – 3 pre-Covid-19 (2016–2019) and 1 mid-Covid-19 (May–Aug 2020; n, 1074; 12–18 years old, >80% minority ethnic groups, 25% free school meals) from REACH (Resilience, Ethnicity, and AdolesCent Mental Health), an adolescent cohort based in inner-London, United Kingdom. Mental health was assessed using validated measures at each time point. We estimated temporal trends in mental distress and examined variations in changes in distress, pre- to mid-Covid-19, by social group, and by pre- and mid-pandemic risks.ResultsWe found no evidence of an overall increase in mental distress midpandemic (15.9%, 95% CI: 13.0, 19.4) compared with prepandemic (around 18%). However, there were variations in changes in mental distress by subgroups. There were modest variations by social group and by pre-Covid risks (e.g., a small increase in distress among girls (b [unstandardised beta coefficient] 0.42 [−0.19, 1.03]); a small decrease among boys (b − 0.59 [−1.37, 0.19]); p for interaction .007). The most notable variations were by midpandemic risks: that is, broadly, increases in distress among those reporting negative circumstances and impacts (e.g., in finances, housing, social support and relationships, and daily routines) and decreases in distress among those reporting positive impacts.ConclusionsWe found strong evidence that mental distress increased among young people who were most negatively impacted by Covid-19 and by related social restrictions during the first lockdown in the United Kingdom.

Background Recent estimates suggest around 14% of 11-16-year-olds in England have a mental health problem. However, we know very little about the extent and nature of mental health problems among diverse groups in densely populated inner cities, where contexts and experiences may differ from the national average. Aims To estimate the extent and nature of mental health problems in inner-city London, overall and by social group, using data from our school-based accelerated cohort study of adolescent mental health, REACH (Resilience, Ethnicity and AdolesCent Mental Health). Methods Self-report data on mental health (general mental health, depression, anxiety, self-harm) were analysed (n, 4353; 11-14yrs, 85% BAME). Mixed models were used to estimate weighted prevalences and adjusted risks of each type of problem, overall and by gender, cohort, ethnic group, and free school meals (FSM) status. Results The weighted prevalence of mental health problems was 18.6% (95% CI 16.4-20.8). Each type of mental health problem was more common among girls compared with boys (adjusted risk ratios [adjRR]: mental health problems, 1.33 [95% CI: 1.18-1.48]; depression, 1.52 [1.30-1.73]; anxiety, 2.09 [1.58-2.59], self-harm, 1.40 [1.06-1.75]). Gender differences were more pronounced in older cohorts compared with the youngest. Mental health problems (1.28 [1.05-1.51]) and self-harm (1.29 [1.02-1.56]) – but not depression or anxiety – were more common among those receiving (vs. not receiving) FSM. There were many similarities, with some variations, by ethnic group. Conclusions Adolescent mental health problems and self-harm are common in inner-city London. Gender differences in mental health problems may emerge during early adolescence.