Mental Health and Well-Being of U.S. Youth Aged 3–24 During the Covid-19 Pandemic: A 38-Month Scoping Review

Background:: The COVID-19 pandemic caused prolonged social disruption in the United States, affecting children, adolescents, and young adults during their developmentally sensitive periods. We synthesized data from the first 38 months of the pandemic to assess the prevalence, correlates, and moderators of youth mental health outcomes. Methods:: Following PRISMA-ScR guidelines, we searched PubMed, Web of Science, medRxiv, and Google Scholar (June 2020–December 2024) for peerreviewed English-language studies of U.S. youth aged 3–24 years. Studies included longitudinal, cross-sectional, and observational designs reporting preand pandemic outcomes. Results:: Of 276 screened studies, 163 were included (N~20.5M). Physical inactivity and sedentary behavior correlated with elevated depression, anxiety, and suicidality. Mental health ED visits rose by 24-31% among ages 5-17, despite overall declines in pediatric visits. Adolescents showed the steepest increases in depression and suicidality; college students reported the highest clinical symptom rates. Girls, gender-diverse youth, racial/ethnic minorities, and economically disadvantaged groups faced disproportionate risk. Discussion:: Psychiatric impacts varied by developmental stage. Loneliness, disrupted routines, and family stress served as transdiagnostic risk factors. Digital engagement maintained social connection but worsened distress when excessive. Childhood outcomes centered on caregiver functioning, while adolescent and young adult distress reflected disrupted autonomy and peer networks. Conclusion:: Mental health and well-being deteriorated substantially among U.S. youth during COVID-19. Infection control measures and school closures affected youth mental health, with impacts varying by developmental stage. These findings highlight the importance of developmentally informed, traumaresponsive interventions to promote resilience among youth during future crises.