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.

Open MRI for assessing joint biomechanics – applications for osteoarthritis

Hip osteoarthritis is prevalent, disabling and costly to individuals and the healthcare system. Symptomatic hip osteoarthritis affects 4.2 percent of people over 50, and radiographic degenerative changes are seen in almost 20 percent of the same population. In many patients, total hip arthroplasty is used to relieve pain and improve function. Though effective in improving a patient’s quality of life, joint replacements will eventually fail and require revision surgeries that have a higher complication rate and less predictable results. Better strategies to delay or stop the progression of osteoarthritis are needed, which can only be created with a clearer understanding of the disease’s etiology.

While there is strong evidence that structural changes around the hip are major etiological factors in the development of osteoarthritis, it is not clear how to protect hips from the disease. Anatomical abnormalities such as cam-type femoroacetabular impingement (a deformity of the hip bones) may account for 90 percent of hip osteoarthritis cases. However, it is not clear why only some people with these deformities get hip osteoarthritis. It is widely assumed that the relationships between activity and deformity size and their effect on joint mechanics are critical. Investigating these relationships has not been possible to date because there have been few well-validated methods for assessing impingement directly in vivo. This project will answer two research questions:

  1. Which activities lead to direct cam impingement at the hip in patients with FAI deformities?
  2. How is this impingement influenced by deformity size?

To answer these questions, we will use gait analysis to measure hip movements and mechanics in symptomatic and healthy subjects for a range of activities associated with hip pain. These measurements will be used to develop subject-specific numerical models predicting direct impingement for each participant. Model predictions of direct impingement will be validated by scanning participants using an established protocol in UBC’s upright open MRI scanner.

We have developed a knowledge translation strategy for this project with the Arthritis Patient Advisory Board; they will post the project summary on their website as well as profile the research findings on social media. Results will be published in both clinically- and research-oriented journals and at conferences for both clinicians and scientists.