Beyond Average Changes: How the Distribution of Youth Mental Health Shifted Before, During, and After the COVID-19 Pandemic

Stress can affect not only average levels of mental health, but also how positive and negative aspects of mental health relate to one another. The COVID-19 pandemic provides a unique context to examine those population-level differences. We investigated youth mental health before, during, and after the pandemic by examining mean levels, association between wellbeing and depressive symptoms, and latent mental health profiles.Using large population-based samples from the Netherlands of youth aged 12–25 years, we compared mental health before (N = 14,146, 58% female), during (N = 14,308, 55% female), and after the pandemic (N = 37,797, 62% female) in a repeated cross-sectional design.Wellbeing and depressive symptoms were stronger correlated during (r = −.70) and after the pandemic (r = −.69) compared to pre-pandemic (r = −.49, ps < .001). Latent profile analyses further showed differences in the population distribution of mental health. Pre-pandemic, two profiles were identified, whereas during and after the pandemic three-profile solutions provided the best fit, including a large group with intermediate levels of wellbeing and depressive symptoms (38-40%). Across periods, most youth were classified in a high mental health profile (51-86%), whereas a smaller proportion were classified in a low mental health profile (8-14%). Loneliness, self-rated health, optimism, and stress exposure consistently differed between profiles. Youth mental health differed across periods in average levels, the strength of the association, and distribution of wellbeing and depressive symptoms. These findings show the value of moving beyond average effects when studying population responses to large-scale stress.