An Examination of Mental Health Rates in Children During the First Year of the COVID-19 Pandemic: Findings from the National Health Interview Survey 2019–2020

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Abstract
The study objective was to examine the mental health of children during a time period that included the COVID-19 Lockdown. The sample included a cross-section of children aged 2 to 17 years (2019; n = 4, 194; 2020; n = 5,172), from the National Health Interview Survey. In multivariate models, survey years 2020 and 2019 were compared for significant changes in anxiety, depression, and social behaviors in children after adjustment for sociodemographic variables. Bivariate analysis also examined sociodemographic characteristics, health care utilization by anxiety, depression, and social behaviors, and examined differences in anxiety and depression from 2019 to 2020. In multivariate models, there was an increased risk of anxiety ((AOR = 1.3(1.0, 1.6)), depression ((AOR = 1.2 (1.0, 1.4)) and difficult social behaviors (AOR = 1.2 (1.0, 1.4) in children from 2019 to 2020. Girls were at increased risk compared to boys for anxiety and depression ((anxiety; AOR = 1.4 (1.2, 1.8), depression; AOR = 1.2 (1.0, 1.3)), however, girls were at decreased risk compared to boys for uncontrolled social behaviors (AOR = 0.51 (0.43, 0.61)). White children were at increased risk for anxiety and depression compared to all other race and ethnic groups. High rates of anxiety, depression and difficult social behaviors that preexisted the Covid-19 Lock Down, continued or increased during the Lockdown. Effective public health interventions could prevent further declines in mental health, and a potential trajectory into adulthood of poor physical and mental health.

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