Stressors associated with the COVID-19 pandemic

The COVID-19 pandemic and shelter-in-place policies caused significant disruption to youths' academic progress and milestones, mental health, physical health, and social relationships [3, 4, 5]. Family dynamics were affected by financial stress, loss of loved ones, and caregiver job loss [7]. Ethnic-racial minority families experienced more health and financial hardships compared to White families [6]. These hardships were associated with higher levels of parental psychological distress, parenting stress, and adolescent loneliness [7]. In fact, youths reported declines of open family communication, parental support, and family satisfaction that coincided with caregivers' perceptions of pandemic-related stress [8]. Consequently, strained family functioning negatively affected youths’ mental health [9].

COVID-19 stressors related to school, financial stress, and home-confinement influenced youths’ mental health [10,11]. For example, in a longitudinal study assessing the impact of family behaviors on psychopathology in a sample of children and adolescents living in the U.S., Rosen et al. [11] found that youths reported a substantial increase in internalizing and externalizing problems over the course of the COVID-19 pandemic. Relative to youths who were exposed to fewer pandemic-related stressors, youths who were exposed to more pandemic-related stressors reported higher rates of internalizing and externalizing symptoms during the period of the stay-at-home orders and six months later [11]. Many youths reported experiencing persistent feelings of sadness or hopelessness [12]. Empirical evidence suggests that some youths considered attempting suicide and a minority of youths attempted suicide during the pandemic [12]. Female and gender non-binary youths were especially vulnerable to experiencing negative mental health outcomes [13, 14, 15, 16].

All youths reported similar mental health concerns and challenges during the pandemic, but ethnic-racial minority youths experienced elevated COVID-19–related worry and stress that impacted their well-being [17,18]. Black youths reported that school was a major stressor and source of emotional toll, with many experiencing decreased concentration, reduced motivation, and a lack of focus relative to their academic tasks [19]. Disparities in access to virtual learning resources (e.g., limited internet access, lack of technological resources, lack of quiet spaces to do homework, less adult supervision due to caregivers being essential workers, and attending poorly resourced schools) among Black youths made it difficult for them to adjust academically [19,20]. A qualitative study assessing Black adolescents' experiences with COVID-19 challenges found that these youths also experienced behavioral challenges, such as difficulties with sleep and a lack of interest engaging in daily activities [19]. Youths reported worries with health hygiene (e.g., interacting with large crowds, being around sick people, worries about schools being unsanitary), which were more pronounced among youths who experienced personal losses in their family units [19]. In addition, youths were deeply affected by the lack of interaction with their teachers, friends at school, family members who lived outside of their homes, and their religious/spiritual community [19]. These challenges were further exacerbated by barriers to mental healthcare utilization, which decreased Black youths’ likelihood of receiving treatment for stressors and trauma related to the COVID-19 pandemic [21].

Racial injustice, discrimination, and media during COVID-19

Although ethnic-racial minority youths face higher levels of COVID-19 related stress, racism against Asian communities and the national spike in Black Lives Matter protests in the summer of 2020 against police brutality prompted youths’ awareness toward racism and discrimination, which compounded together to influence their mental health [22]. Adolescents who perceived higher levels of racism and discrimination during the COVID-19 pandemic, especially Asian, Black, and multiracial youths, reported poorer mental health outcomes and more difficulty concentrating, remembering, or making decisions [22]. Anti-Asian sentiments surrounding the origins of the virus and the highly publicized recordings of police brutality against Black individuals heightened youths’ anxiety, promoted feelings of othering, and fostered a reduced sense of belonging in these communities [19,23, 24, 25, 26]. Ethnic-racial minority youths reported anger, frustration, and hopelessness because they lacked resources to enact change against the cyclical nature of racial violence [27].

While adolescents used digital communication to maintain connection among family, friends, and school-related responsibilities, higher screen time increased exposure to racism- and discrimination-related messaging on social media platforms, both personally and vicariously [28]. The murder of George Floyd by police officers was a critical point during the COVID-19 pandemic that led to racial unrest and prompted action to hold police and other perpetrators accountable. Recordings of racial mistreatment, killings, and racial violence inflicted on Black people were shared rapidly across social media platforms. As a result, many adolescents engaged in social media activism to spread solidarity and share resources [27,28]. Although civic engagement has been linked to positive well-being, online racial justice activism also exposes youths to vicarious racial trauma and to an onslaught of racial discrimination via social media. In a study conducted by Tao and Fisher [29], the researchers highlighted how social media operated as both a harmful space for racism to occur and a safe space where youths could seek stress relief against racism and mental health distress. Tao and Fisher also found that adolescents who posted information about racial issues were more likely to report depressive symptoms and alcohol use disorder due to instances of racial discrimination experienced on social media platforms.

COVID-19 discrimination towards Black youths

The COVID-19 pandemic was viewed as a time of racial reckoning, especially surrounding anti-Blackness, police brutality, and COVID-19 disparities [30]. Although research on Black youths' experiences is limited, existing literature suggests that Black youths showed a strong awareness of this racial division and experienced high levels of racism-based stress [19]. A qualitative study by Crooks et al. [24] found that Black youths reported increased media coverage surrounding these injustices, which caused racial tension, anxiety, and distress. Experiencing online racial discrimination affected Black youths’ mental health [31]. Black youths who reported higher exposure to online racial discrimination and online traumatic events reported higher trauma symptoms of discrimination, such as, difficulty relaxing, feeling numb, worrying, discomfort, physiological symptoms, and worries about safety and the future [28]. The link between online racial discrimination and mental health was not fully explained by time spent online or by general cyber victimization experiences [31], suggesting other mechanistic pathways from exposure to online racial discrimination to mental health outcomes.

Some Black youths watched and participated in protests to address systemic and interpersonal injustices, citing their experience of both fear and empowerment [24]. Additionally, Black youths reported having conversations about the racial divide with their family members, which were often emotionally draining, especially for youths from mixed race families [24]. Given that Black youths experienced separations from their social networks, they lost opportunities to utilize their communities to increase understanding about racial tensions [24]. Some youths received opposing messages about Black culture, which increased internalized stigma, negative public regard and private regard and led them to reject parts of their ethnic-racial identities [24]. For other youths, this moment created learning opportunities about culture and history, which increased their confidence and promoted empowerment [24]. This is consistent with a study by Rogers et al. [32], which found that the sociopolitical influence of Black Lives Matter changed youths’ ecological contexts and affected their ethnic-racial identity narratives.

COVID-19 discrimination towards Asian American youths

The COVID-19 pandemic was laced with misinformation and xenophobic sentiments that targeted Asian community members and led to discrimination, which negatively affected Asian American (AA) youths’ mental health. Survey data from a national representative sample of middle and high school students in the U.S. suggest that 82% of AA adolescents experienced COVID-19 related discrimination [33]. Another study found that 25% of AA youths reported higher frequency in the direct experiences of anti-Asian harassment since the beginning of the pandemic [26]. In a study examining cyberbullying before and during the COVID-19 pandemic, AA youths were most likely to report increased victimization during the pandemic. Specifically, 23.5% of AA youths reported being cyberbullied for their race in 2021 compared to 7.4% in 2019 [34]. Furthermore, AA adolescents and young adults who indicated feeling less safe after the pandemic started (76%) were more likely to report increased depression severity and experiences of discrimination since the start of the pandemic [26].

Among Eastern and Southeast Asian American (ESEAA) adolescents, experiences of online and in-person COVID-19 related discrimination predicted higher levels of anxiety, depression, and PTSD symptoms above and beyond lifetime discrimination and previous traumatic events [25,33]. A few studies with Chinese American youths revealed that about half of these youth were directly targeted by COVID-19 racial discrimination online (45.7%) and/or in-person (50.2%); [23,35]. Additionally, youths reported at least 1 incident of COVID-19 vicarious racial discrimination online (76.5%) and/or in-person (91.9%). Experiences of online direct discrimination, online vicarious discrimination, in-person direct discrimination, and sinophobia were negatively associated with youths' psychological well-being and positively associated with anxiety symptoms. Finally, adolescent's experiences of COVID-19 related racial discrimination were associated with more internalizing problems [23].

We want to give special thanks to one of our excellent undergraduate research assistants, Min Yeung, who wrote the annotated references for the articles we highlighted as of special and outstanding interest.