# Self‐reported changes in adolescent mental health, deliberate self‐harm, substance use, and help‐seeking behavior before and after the COVID‐19 pandemic – A Finnish time‐trend study

## TL;DR

This study shows that adolescent mental health and self-harm behaviors increased significantly in Finland after the COVID-19 pandemic, especially among girls.

## Contribution

The study compares mental health trends pre- and post-pandemic using identical survey designs across three time points.

## Key findings

- Females showed significant increases in mental health issues, self-harm, and substance use after the pandemic.
- Males experienced smaller increases in mental health problems and decreased alcohol consumption.
- Minimal changes were observed between 2014 and 2018, suggesting pandemic-specific effects.

## Abstract

Despite the impact that the COVID‐19 pandemic had on adolescents' mental health, there is a lack of studies comparing it pre‐ and postpandemic using consistent designs and measurements. Therefore, this study aimed to analyze changes in adolescent psychopathology, deliberate self‐harm behavior, substance use, and help‐seeking behavior pre‐ and post‐COVID‐19, with an identical study design.

The study included three repeated cross‐sectional studies conducted in 2014, 2018, and 2023, including self‐reported data from Finnish secondary school students in grades 7 to 9, aged 13 to 16 (n = 9,024). The survey measured demographic information, mental health using the Strengths and Difficulties Questionnaire (SDQ), deliberate self‐harm behavior, substance use, and help‐seeking behavior.

Comparing data in 2023 with 2018, there were significant increases among females in total SDQ score (OR 2.1, 98.33% CI 1.7–2.7), conduct problems (OR 1.7, 98.33% CI 1.1–2.7), emotional symptoms (OR 1.8, 98.33% CI 1.5–2.3), and hyperactivity symptoms (OR 2.8, 98.33% CI 2.2–3.6). Perceived severe overall difficulties (OR 2.8, 98.33% CI 2.0–3.7), weekly smoking (OR 2.7, 98.33% CI 1.5–4.9), and seeking help (OR 1.5, 98.33% CI 1.2–2.0) increased. For males, increases were noted only in hyperactivity symptoms (OR 2.5, 98.33% CI 1.2–1.9) and perceived severe overall difficulties (OR 1.5, 98.33% CI 1.0–2.1), along with a decrease in alcohol consumption (OR 0.7, 98.33% CI 0.5–0.9). By contrast, the period from 2014 to 2018 showed minimal changes.

The concerning rise in psychopathology after the COVID‐19 pandemic, particularly among females, highlights the importance of early detection and effective interventions.