WINNIPEG -- While the full impact of the COVID-19 pandemic on mental health is still evolving, a new report says youth mental health was already in decline between 2014 and 2018.

The report from the international Health Behaviour in School-aged Children (HBSC) study which was released Tuesday by the World Health Organization (WHO) shows that adolescent mental well-being declined in many countries over that four-year period. 

The report assessed health and social behaviours of nearly 230,000 schoolchildren aged 11, 13 and 15 from 45 countries. It provides a baseline against which future studies can measure the impact of COVID-19 on young people’s lives.

The “Spotlight on adolescent health and well-being” shows that mental well-being declines as children grow older, with girls particularly at risk of having poor mental well-being outcomes compared to boys. 

One in four adolescents report feeling nervous, feeling irritable or having difficulties getting to sleep at least once a week.

“That increasing numbers of boys and girls across the European Region are reporting poor mental health – feeling low, nervous or irritable – is a concern for us all,” says Dr. Hans Henri P. Kluge, WHO regional director for Europe, in a news release. 

“How we respond to this growing problem will echo for generations. Investing in young people by, for example, ensuring they have easy access to mental health services appropriate to their needs, will buy a triple dividend: bringing health, social and economic gains to today’s adolescents, tomorrow’s adults and future generations.” 


The report presents the findings from the HBSC survey in countries from the European region and Canada, which is undertaken every four years. Other key findings from this latest study include:

  • Risky sexual behaviour remains a concern: one in four adolescents who have sex are having unprotected sex. At age 15, one in four boys (24 per cent) and one in seven girls (14 per cent) report having had sexual intercourse;
  • Drinking and smoking have continued to decline among adolescents, but the number of current alcohol and tobacco users remains high among 15-year-olds, with alcohol the most commonly used substance. One in five 15-year-olds (20 per cent) have been drunk two times or more in their lifetime, and almost one in seven (15 per cent) had been drunk in the last 30 days;
  • Fewer than one in five adolescents meet the WHO recommendations for physical activity – levels have declined in around one third of countries since 2014, especially among boys. Participation remains particularly low for girls and older adolescents;
  • Most adolescents are failing to meet current nutritional recommendations, undermining their capacity for healthy development. Around two out of three adolescents do not eat enough nutrient-rich foods, with one in four eating sweets and one in six consuming sugary drinks every day; and
  • Levels of overweight and obesity have risen since 2014, and now affect one in five young people, with higher levels among boys and younger adolescents; one in four adolescents perceive themselves as too fat, especially girls.

As the latest HBSC study, featuring findings from 2017/2018, is released, the world is grappling with the COVID-19 pandemic. The next study, which will feature findings from 2021/2022, will therefore reflect the impact of the pandemic on the lives of young people.

“The broad range of issues covered by the HBSC study give important insights into adolescent’s lives today and should also provide us with a useful baseline to measure the impact of COVID-19 on adolescence when the findings from the next study emerge in 2022,” said Martin Weber, program manager for child and adolescent health for the WHO regional office for Europe. 

“The data comparison will enable us to measure to what extent and how prolonged school closures and community lockdowns have affected young people’s social interactions, and physical and mental well-being.”