Socioeconomic inequalities in children's and adolescents' mental health remained evident throughout the COVID-19 pandemic period, with inequalities temporarily narrowing during the pandemic but re-increasing post-pandemic as recovery effects were only visible for young people in higher socioeconomic status.
Key Findings
Results
Children and adolescents with low socioeconomic status had higher prevalence of mental health problems than those with high socioeconomic status across the entire survey period.
Pre-pandemic prevalence of mental health problems: 14.6% in low SES vs. 6.2% in high SES groups
Post-pandemic prevalence of mental health problems: 18.3% in low SES vs. 11.0% in high SES groups
Data were drawn from population-based BELLA study (pre-pandemic, N=1,580) and longitudinal COPSY study (post-/pandemic, N=1,586–1,701) with participants aged 7 to 22 years
Surveys conducted before (BELLA T0, 2017), during (COPSY T1-T5, 2020–2022), and after the COVID-19 pandemic (COPSY T6-T7, 2023–2024) in Germany
Results
Mental health problems increased significantly in all socioeconomic status groups during the COVID-19 pandemic.
The increase in mental health problems was observed across low, middle, and high SES groups during the pandemic period (COPSY T1-T5, 2020–2022)
Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ)
Both parental education and net equivalent household income were used as indicators of socioeconomic status
Results
Socioeconomic health inequalities in youth mental health narrowed during the pandemic and nearly equalized by autumn 2022.
Mean values in youth mental health problems were nearly the same for high and low educated parents in autumn 2022 (COPSY T5)
Health inequality remained stable and even narrowed towards the end of the pandemic
This pattern was visible but less pronounced when using household income as the SES indicator compared to parental education
Results
After the pandemic, socioeconomic mental health inequalities began to re-increase, with post-pandemic recovery effects only visible for young people in higher socioeconomic status.
Mental health inequalities started to re-increase after the pandemic (COPSY T6-T7, 2023–2024)
Post-pandemic recovery was observed only among youth from higher SES backgrounds
Post-pandemic prevalence remained higher than pre-pandemic levels for low SES youth (18.3% vs. 14.6%)
Results
Personal resources, family cohesion, and social support served as protective factors for youth mental health.
Panel regression analyses were used to examine the role of additional factors including parental psychopathology, social support, and family cohesion
These protective factors were identified as relevant across the study period
The authors highlight the importance of strengthening these personal and social resources especially for socially disadvantaged children and families
Methods
Parental psychopathology was examined as a risk factor alongside socioeconomic status in relation to youth mental health outcomes.
Parental psychopathology was included as an additional factor in panel regression analyses
Both risk factors (parental psychopathology, low SES) and resource factors (social support, family cohesion) were examined
The study used a longitudinal design spanning seven time points from 2017 to 2024
Reiss F, Erhart M, Kaman A, Devine J, Zoellner F, Ravens-Sieberer U. (2026). Tracing socioeconomic inequalities in children's and adolescent's mental health: longitudinal study findings from 2017 to 2024.. BMC public health. https://doi.org/10.1186/s12889-026-26577-0