Impact of social determinants of mental health on child and parent risk, resilience and support access in the COVID-19 era: A nested mixed-methods study of short and long-term outcomes

This award is co-funded by Health Research BC, through CIHR’s Operating Grant: Understanding and mitigating the impacts of the COVID-19 pandemic on children, youth and families in Canada. 


Project co-leads include Evelyn Stewart MD and Hasina Samji PhD, who brought together their extensive collaborative networks. Dr. Stewart is a UBC professor, child and adolescent psychiatrist and Director of Research for Child and Adolescent Psychiatry, BCCH. Dr. Samji is an epidemiologist, SFU assistant professor and senior scientist at BCCDC.


Between November 2020 and July 2021, the group collected baseline data for the Personal Impacts of COVID-19 Survey (PICS), a Canadian study identifying vulnerability factors to poor mental health related to preexisting medical and living conditions, sex/gender minorities and poverty. Based on our PICS baseline findings, which includes 3,351 Canadians, rates of several COVID-era mental illnesses were several-fold higher than expected; and one quarter of parents reported needing but not receiving mental health support.


Our mixed-methods study will build upon PICS findings by re-contacting participants to better understand their pandemic-era mental health service access, future preferences and the role of social risk and resilience factors. It will also identify those with persisting, resolving and newly emerging mental illness during the COVID-19 recovery phase. In this way, our study will provide a current, comprehensive perspective on families’ experience of the COVID-19 pandemic and how services providers, community organizations and policymakers can best serve child and parent populations at highest risk for ongoing mental health impacts.

Progress Update – May 2023


Most exciting outputs so far

Data collection and qualitative analysis have been completed with a total of 18 youths and 17 parents who provided one-hour interviews on their experiences during the pandemic. As a result, two manuscripts are currently being written to share the most salient results.

The first manuscript is a mixed-methods study of unmet youth mental health support needs during COVID-19. This study combined longitudinal survey data from the first iteration of the Personal Impacts of COVID-19 Study (PICS 1) with the qualitative interview (PICS 2).

The COVID-19 pandemic occurred during critical social, emotional, and developmental phases for children and youth, which has led to significant disruptions in all facets of youth’s lives. While research has sprung into action to quantify outcomes for youth and families during this time, there are many personal narratives and small stories that exist amongst the data.

With this in mind, the second manuscript will explore the impact that the pandemic has had on youth’s domains of life through individual perspectives.

Impact so far

As part of the COVID and Kids Project and in partnership between BC Children’s Hospital, SFU, UBC, and CHART (Capturing Health and Resilience Trajectories), a deliberative dialogue was hosted to provide key stakeholders an opportunity to connect and discuss priority recommendations for promoting mental health and well-being among youth during and after the COVID-19 pandemic.

PICS 2 outcomes, quotes, and recommendations from youth and their families were presented to help inform stakeholders on family priorities. A report is being compiled with the recommendations from this event, and will hopefully help to inform future efforts to improve mental health coming out of the pandemic.

We have also presented outcomes from this study at various leadership meetings at the BC Children’s and Women’s Hospital and at research rounds. Additionally, we have been able to provide families and youths an opportunity to share their experiences and feel heard.

Potential Influence

We hope that the results from this project will be helpful in informing new initiatives to fill the gaps in youth and family mental health supports. COVID has increased the mental health burden and strained already strained mental health services and we hope to help pinpoint particular areas that are most needed by families and the barriers that are in the way of access.

Gaining a better understanding of COVID-19’s impact may also be important for building resilience for future events like COVID-19. By collecting qualitative data through interviews, we hope this study can begin to bridge a gap between families and mental health professionals, stakeholders, and researchers. We also hope to improve our understanding of the long-term consequences of the pandemic on youths from their own perspectives on what mattered most to them.

Next steps

We hope to produce additional publications to continue disseminating the parent and youth narratives we have collected. In tandem with the quantitative outcomes from PICS 1 survey data, we hope to be able to paint a more detailed picture of pandemic mental health outcomes. We also have plans to present our findings at several conferences. An additional population with increased risk during the pandemic was young adults, who we found to have the worst mental health outcomes from PICS 1 survey data. Once we have completed our reports on youth and families, we hope to conduct similar interviews with young adults to better understand why this population was disproportionately impacted.