Familial Mechanisms Linking COVID-19 Lockdown with Mental Health Problems in Singaporean Children and Adolescents

The COVID-19 pandemic and related confinement measures have profound impacts on the mental health of children and adolescents. This study investigated familial mechanisms underlying such impacts by studying the unique case of Singapore, which has undergone a period of local transmission without many restrictions (February–March 2020), followed by a nationwide lockdown (April–May 2020). In June 2020, we collected retrospective reports on everyday activities, social relationships, and mental health of 164 children and adolescents (Mage = 14.3, Range = 7-18, 49% female) across three timepoints: Pre-pandemic, Pre-lockdown, and Lockdown. Parental mental health, parenting values and practices were also collected. Multilevel modelling showed increased mental health problems in children from Pre-pandemic to Pre-lockdown, and from Pre-lockdown to Lockdown. Mediation analyses indicated that the increase in children’s mental health problems from Pre-pandemic to Pre-lockdown was partially explained by a decrease in time spent outdoors, an increase in their conflict with fathers, and an increase in their mothers’ mental health problems, with the last factor being the only significant mediator when all three factors were considered simultaneously. The increase in children’s mental health problems from Pre-lockdown to Lockdown was partially explained by a further increase in their mother’s mental health problems. These findings suggest that lockdown measures issued by authority may lead to further deterioration of children’s mental health beyond the pandemic itself. Multiple personal and familial factors may underlie these deteriorations, among which maternal mental health could be especially influential and should be targeted in family support service and intervention.