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 Occupational Health, McGill University, Montreal, Quebec, Canada.
10 Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
11 Department of Psychology, Concordia University, Montreal, Quebec, Canada.
12 Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada.
13 Department of Medicine, McGill University, Montreal, Quebec, Canada.
14 Department of Psychology, McGill University, Montreal, Quebec, Canada.
15 Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.

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.