Mental Health of Adolescents Orphaned by COVID-19 and Service System Responses: A Longitudinal Study

Abstract

Objective

Researchers have predicted increasing and persistent psychological problems among adolescents orphaned by COVID-19. However, empirical evidence in this regard remains scarce. This study aimed to examine the long-term mental health outcomes of adolescents orphaned by COVID-19 and the corresponding mental health service responses.

Method

This was a longitudinal study. Forty-four adolescents orphaned by COVID-19 and forty-four matched adolescents (based on demographic characteristics) were selected through purposive sampling. Both groups were assessed across five time points over one and a half years using the same set of questionnaires.

Results

Baseline t-test results indicated that the orphaned group exhibited more clinical symptoms—including internalizing and externalizing disorders, social problems, suicidal thoughts, and PTSD symptoms—and lower levels of perceived social support and psychological well-being than the matched group. Repeated measures analyses showed that these differences persisted across the four follow-up stages, except for perceived social support, which increased in the orphaned group. According to Cochran's Q results, the prevalence of internalizing disorders and suicide attempts in the orphaned group increased over time. Mixed model results demonstrated that perceived social support was significantly associated with all clinical symptoms and psychological well-being. Notably, none of the participants had access to mental health services.

Conclusion

The findings indicate a deterioration in the mental health of some adolescents orphaned by COVID-19 over time, with no free or accessible mental health services available to them during or after the pandemic.