Global crises hit mental health and well-being in low and middle-income countries - Young Lives report

The well-being and mental health of young people in low- and middle-income countries have been dramatically affected by the series of crises hitting the world.

As the international community continues to struggle with the impact of COVID-19, conflict and climate change, the latest report from the Young Lives project shows a long-running upward trend in young people’s well-being has been sharply reversed alongside widespread anxiety and depression. Young people are less confident about their futures for the first time in the 20-year study.

Before the pandemic, there had been a steady but notable upward trend in young people’s sense of well-being across all four countries in the Young Lives study: Peru, Vietnam, India and Ethiopia. But new data from the most recent survey, collected during the pandemic, shows young people reported a significant decline in well-being – and high levels of anxiety and depression.

The latest report shows global crises are triggering mental health issues among disadvantaged youth at a critical period in their lives – because long-term mental health issues often begin in adolescence and early adulthood. Many countries are ill-equipped to manage this wave of anxiety and depression, as mental health support services for young people are hugely underfunded around the world – especially in poorer countries, where there is often an acute shortage of mental health specialists.

‘We are very concerned about the long-term impact of declining well-being and widespread anxiety and depression across our study countries. Urgent action is needed to protect, promote and care for young people’s mental health, particularly those from disadvantaged backgrounds,’ says Kath Ford, Senior Policy Officer at Young Lives and lead author of the new report.

One factor which seems to have protected some young people from mental health issues over the last two years has been close family relationships and friendships. In Peru, young people, who did not have a strong relationship with their parents before the pandemic experienced significantly higher symptoms of depression (36%) than those who had a strong parental relationship (28%).

Young Lives has followed 12,000 young people across two age cohorts over 20 years. During the pandemic, researchers interviewed them five times by phone and found:

Vietnam was very successful in limiting infections throughout 2020 – and in that year just 5% of young people reported symptoms of anxiety and 6% reported symptoms of depression.

The stress and loneliness of prolonged school and university closures, and uncertainty surrounding the virus, affected young people’s well-being and mental health. Young women’s mental health was disproportionately affected by interrupted education and also by increased domestic work associated with the pandemic.

Young people’s mental health worsened as the pandemic became more severe. In 2020, Peru had one of the highest death rates from COVID-19 in the world. After the first months of the pandemic, 40% of young people reported symptoms of anxiety and 30% reported symptoms of depression (compared to 18% experiencing depression in 2019).

 ‘I feel very stressed when I am at home… I mean for virtual classes and all that. I have anxiety when I am at home.’  (Daniela, female university student from rural Peru, 2021)

Job losses also caused widespread anxiety for young people with those who lost their jobs most likely to experience symptoms of anxiety in all four study countries. In India, those who lost their jobs were twice as likely to report anxiety.

Young people are often coping with multiple, intersecting crises. In all countries, persistent food insecurity was found to be taking a toll on young people’s mental health, exacerbated by the pandemic but also by conflict and climate-related shocks such as severe drought in Ethiopia.

The evidence shows young people were increasingly worried about running out of food during 2021, with those from poorer and marginalised groups most affected. In Ethiopia, the ongoing conflict in Tigray was an additional threat to young people’s mental health.

Two out of five young people in Tigray experienced mental health issues in the initial months after the start of the conflict with rates of depression increasing from 16 to 25%. Young men experienced greater anxiety, whilst young women were more at risk of increased depression.

 ‘A significant increase in global investment in young people’s mental health is critical to support developing countries in meeting the Sustainable Development Goal target on promoting mental health and well-being for all ages. Priority should be given to measures which mainstream and integrate mental health care into existing services at the community level, as well as to break the silence around mental health issues,’ says Kath Ford.

Young Lives will return to the field in 2023 to gather new data and insights on the medium-term impact of the pandemic on young people’s mental health and well-being, alongside the compounding effects of increasing food insecurity and the ongoing conflict in Ethiopia.

The full report is available here: Kath Ford & Richard Freund (2022) ‘Young Lives Under Pressure: Protecting and Promoting Young People’s Mental Health at a Time of Global Crises’