Immediate and longer-term changes in mental health of children with parent-child separation experiences during the COVID-19 pandemic

Background The psychological impact of the COVID-19 pandemic has been understudied among vulnerable populations. This study aimed to examine the immediate and longer-term changes in the mental health of children with parent-child separation experiences during the COVID-19 pandemic, and identify potential buffering opportunities for mental health. Methods This longitudinal cohort study used data from 723 rural Chinese children who provided data before (Oct. 2019) the COVID-19 pandemic and during the following 2 years. Changes in the probability of depressive symptoms, anxiety symptoms, non-suicide self-injurious (NSSI), suicidal ideation, suicide plan, and suicide attempt were tested across four waves using generalized estimating models (GEE). Results Compared with children who never experienced parent-child separation, children persistently separated from parents since birth experienced greater deterioration in all mental health in the 2-year follow-up (average change: depressive symptoms: beta = 0.59, 95% CI [0.26, 0.93]; anxiety symptoms: beta = 0.45, 95% CI [0.10, 0.81]; NSSI: beta = 0.66, 95% CI [0.31, 1.01]; suicide ideation: beta = 0.67, 95% CI [0.38, 0.96]; suicide plan: beta = 0.77, 95% CI [0.38, 1.15]; suicide attempt: beta = 1.12, 95% CI [0.63, 1.62]). However, children with childhood separation from their parents but reunited with them during the transition to adolescence showed similar even lower changes to counterparts who never experienced parent-child separation (all ps > 0.05). Conclusion These results indicating improvements in supportiveness of the caregiving environment during the transition to adolescence may provide the opportunity to buffer the adverse impact of COVID-19 on mental health. Translating such knowledge to inform intervention and prevention strategies for youths exposed to adversity is a critical goal for the field.