Heterogeneity in maternal and child mental health responses to the COVID-19 pandemic

Why did we do this study?

• The COVID-19 pandemic and resulting public health measures disrupted the lives of families worldwide. Young children who attended early childhood education and care settings were abruptly required to stay at home.
• Early research suggested that low-income families were particularly negatively impacted by the pandemic. Because of this, we wanted to understand the effects the pandemic had on the mental health of low-income mothers and children in Toronto
• Social support and childcare stability have been found to be protective factors during large-scale disruption. We examined how these factors related to these families’ mental health responses to the pandemic.

What did we do?

• We used data on CCM families before and during the pandemic.
• We used the Strengths and Difficulties Questionnaire for children’s mental health, and the Generalized Anxiety Disorder-2 for maternal anxiety, Perceived Stress Scale-4 for maternal stress and PHQ-2 for maternal depression. We had data on these measures for both mothers and children before the pandemic (on average 21 months earlier). 
• We used the Social Support Questionnaire-Short form to measure mothers’ levels of social support during the pandemic.
• Early analyses revealed that looking at our sample as a whole masked important group differences in patterns of mental health responses. To capture these group differences we used latent profile analysis.

What did we find?

We found 5 groups for mothers:

Sailing Along: Mothers with low levels of stress, anxiety, and depression before and during the pandemic

Typical Moms Feeling a Little Blue: Mothers with average levels of stress pre-pandemic, but who had higher levels of depression during the pandemic

Typical Moms Heading for a Crash: The largest group with more than a third of mothers. They had average levels of stress pre-pandemic, and ended up with higher levels of stress, anxiety, and depression during the pandemic

Somewhat Stressed Moms Losing Ground: Mothers who had slightly elevated levels of pre-pandemic stress who ended up with higher levels of anxiety and depression

Stressed Moms Lose the Blues: Mothers who were quite stressed and depressed pre-pandemic, whose depression ended up going down during the pandemic.

• There were minimal associations between maternal mental health groups and demographic characteristics
• Satisfaction with social support was higher for Typical Moms Feeling a Little Blue when compared to Stressed Moms Lose the Blues

We found 4 groups for children:

Superkids Slip a Little: Children with low and average pre-pandemic mental health issues, whose emotional, peer and hyperactivity problems increased during COVID-19, but stayed within the average range.

Typical Kids Doing Better: The largest group with 38% of children with typical levels of pre-pandemic mental health who had lower levels of conduct problems and showed less prosocial problems during the pandemic.

Challenging Kids Feeling the Strain: Children with higher levels of conduct problems and hyperactivity pre-pandemic, who experienced higher emotional problems during the pandemic.

Concerning and Unaffected: Children with elevated pre-pandemic levels of mental health that remained elevated during the pandemic.

• Challenging Kids Feeling the Strain had more males than other groups.
• Children in Concerning and Unaffected had more ECEC transitions than children in Typical Kids Doing Better.

What does this mean?

• Looking at the population as a whole can mask important and unique patterns of mental health responses in times of crises.
• Mental health levels declined for mothers and children with high and low levels of pre-pandemic mental health. Interventions should target a wide range of individuals instead of focusing only on those with prior mental health concerns.
• In this low-income sample, demographic characteristics don’t seem to matter as much as the prior social and ECEC experiences of these families. Research and policy solutions should incorporate measures of lived experiences.
• Finally, a surprising number of mothers and children seemed to be doing better during the pandemic! Something about their typical lives may not be meeting their needs. It is crucial to understand how to improve the everyday experiences of mothers and children who fared better during a global crisis that required social isolation.