Mental Health and Well-Being of U.S. Youth Aged 3–24 During the Covid-19 Pandemic: A 38-Month Scoping Review

Introduction: The COVID-19 pandemic and infection control measures have profoundly disrupted daily life, particularly for U.S. children, adolescents, and young adults. These changes created uncertainty, fear, and physical and social isolation, significantly impacting their well-being and mental health. This scoping review examines the pandemic's short- and long-term effects on mental health outcomes over 38 months. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we conducted a comprehensive search (June 2020–March 2024) across PubMed, medRxiv, Web of Science, and Google Scholar, using keywords related to COVID-19, children, adolescents, mental health, and the U.S. Peer-reviewed, English-language studies were included if they contained data on U.S. youth (<24 years) during the pandemic. Study quality was assessed via the National Heart, Lung, and Blood Institute (NHLBI) tools. Results: Out of the 6,147 nonduplicate records, 220 full-text articles were reviewed, and 146 studies were selected. Of these, 46% were longitudinal, 38% were cross-sectional, and 16% used national electronic databases. An analysis of more than 20 million participants revealed widespread declines in psychological well-being and increases in mental health issues, including reduced physical activity, heightened stress, loneliness, depression, anxiety, posttraumatic stress, self-harm, and suicidality. The quality ratings revealed approximately 60% “good,” 30% “fair,” and 10% “poor.” Discussion: This scoping review highlights the extensive and lasting mental health effects of the COVID-19 pandemic on U.S. youth with key moderating factors include age, gender, socioeconomic status, pre-existing conditions, parental mental health, and social support. self-regulation, parental mental health, parenting quality, family functioning, social support, isolation. Disrupted routines, reduced peer interaction, and inconsistent or unavailable mental health services contribute to worsened mental health. Conclusion: The COVID-19 pandemic and containment measures significantly affected U.S. children’s and adolescents’ mental health. High school students, in particular, experienced elevated stress, anxiety, depression, and suicidal ideation. Health-related quality of life declined during the pandemic and remained low post-lockdown. Sustained research and targeted public health interventions are critical to mitigate long-term consequences.