Population-level changes in anxiety and depression and the unmet need for support at school among adolescents with and without disabilities, 2017–2021: The effects of the COVID-19 pandemic

Adolescents' mental health problems increased during the COVID-19 pandemic, but little information is available on how adolescents with disabilities were affected. We investigated the population-level changes in depression and anxiety and the unmet need for support at school from social workers/psychologists, doctors/nurses, and teachers among adolescents with specific disabilities and those without disabilities before (2017–2019) and during (2021) the pandemic. We analyzed population-based cross-sectional data from the Finnish School Health Promotion study of lower secondary school students obtained in 2017 (n = 73,678), 2019 (n = 87,215), and 2021 (n = 91,560). Students with disabilities were classified into four groups based on self-reporting: disabilities only in mobility, cognition, sensory, or two or more domains. Regression models were applied to investigate population-level changes. From 2017–2019 to 2021, anxiety and depression increased at the population level among all adolescents. The interaction analysis revealed that the increase was higher among adolescents with cognitive and mobility disabilities and lower among those with sensory disabilities compared to adolescents without disabilities. The increase in the prevalence of the unmet need for support was similar for those with and without disabilities, except for support from social workers/psychologists, where the unmet need was higher among those with mobility disabilities. The COVID-19 pandemic had more detrimental effects on the mental health of adolescents with mobility and cognitive disabilities than those without disabilities. There is an urgent need for resources and targeted support to prevent anxiety and depression among adolescents with mobility and cognitive disabilities during crises.