Associations between COVID-19 pandemic experiences and suicidal ideation among adolescents: the mediating role of life satisfaction, subjective wellbeing, and anxiety

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Introduction: The aim of this study was to examine associations between adolescents' experiences during the COVID-19 pandemic and life satisfaction, subjective wellbeing, anxiety, and suicidal ideation. Methods: Data were drawn from the 2022 cross-national Health Behavior in School-aged Children study conducted in Slovenia, using a representative sample of 8,638 adolescents aged 11, 13, 15, and 17 years (51.7% girls). Adolescents reported on their experiences during the COVID-19 pandemic (hospitalization of a family member and perceived changes in relationships, school performance, future expectations, and family finances), life satisfaction, subjective wellbeing, anxiety, and suicidal ideation. A structural equation model (SEM) was tested, with pandemic-related experiences as predictors, mental health indicators as intervening variables, and suicidal ideation as the outcome. Results: Suicidal ideation was reported by 16.7% of adolescents. The model explained 45.4% of the variance in suicidal ideation. Perceived impacts of the pandemic on family relationships and future expectations, as well as the hospitalization of a family member, were associated with suicidal ideation both directly and indirectly through all three mental health indicators. The perceived impact on friendships was associated with suicidal ideation directly and indirectly via life satisfaction, whereas perceived changes in academic performance were associated with suicidal ideation both directly and indirectly via subjective wellbeing and anxiety. Pandemic-related changes in family relationships showed the strongest overall association with suicidal ideation. Conclusion: Pandemic-related family stressors and disruptions to future expectations were associated with suicidal ideation both directly and indirectly through poorer mental health indicators. These findings suggest the importance of integrated family- and school-based approaches to supporting adolescent mental health during periods of major societal disruption. Strengthening family support systems, early identification of anxiety symptoms, and school-based prevention programs may help mitigate adverse mental health outcomes among adolescents. The findings may also inform preparedness planning for future public health emergencies.

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