1 Department of Psychiatry, McGill University, Montreal, Quebec, Canada. marie-claude.geoffroy@mcgill.ca.
2 McGill Group for Suicide Studies, Douglas Mental Health University Institute/Douglas Research Centre, McGill University, Montreal, Quebec, Canada. marie-claude.geoffroy@mcgill.ca.
3 Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada.
4 Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.
5 Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
6 Douglas Research Centre, Montreal, Quebec, Canada.
7 Department of Psychology, University of Montreal, Montreal, Quebec, Canada.
8 Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada.
9 Department of Epidemiology, Biostatistics and Occupationa

Objectives: This systematic review and meta-analysis aims to describe Canadian youth mental health during the COVID-19 pandemic, focusing on changes in anxiety and depressive symptoms and suicidality.

Methods: We searched four databases up to February 2023 for longitudinal or repeated cross-sectional studies reporting on changes in depressive and anxiety symptoms, suicidality, or related services utilization among young people under 25 years old residing in Canada during the COVID-19 pandemic. Random-effects meta-analyses were performed for studies comparing depressive and anxiety symptoms from before to during the first, second, and third COVID-19 waves (up to June 2021), and between COVID-19 waves. Other studies were described narratively. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist.

Synthesis: Of the 7916 records screened, 35 articles met inclusion criteria for this review. Included studies were highly heterogeneous in design, population, and type of change investigated, and many had a high risk of bias. The meta-analyses found that depressive symptoms worsened minimally from pre-pandemic to wave 1 but returned to pre-pandemic levels by wave 2. Anxiety symptoms were broadly comparable from pre-pandemic to waves 1 and 2 but worsened from waves 1 to 3 and from pre-pandemic to wave 1 for girls. The narrative review included several studies that provided inconclusive evidence of increases in services utilization.

Conclusion: The current evidence is limited and highly heterogeneous, making it insufficient to draw definitive conclusions regarding the short- to medium-term impact of the pandemic on youth mental health in Canada. Obtaining better mental health surveillance among Canadian youth is imperative.