{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T10:45:59Z","timestamp":1758192359547,"version":"3.44.0"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100005258","name":"National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention","doi-asserted-by":"publisher","award":["U38PS004650"],"award-info":[{"award-number":["U38PS004650"]}],"id":[{"id":"10.13039\/100005258","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R24 HD042828"],"award-info":[{"award-number":["R24 HD042828"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["P30 AI027757"],"award-info":[{"award-number":["P30 AI027757"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["P30 MH123248"],"award-info":[{"award-number":["P30 MH123248"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosmentalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Ment Health"],"abstract":"<jats:p>The COVID-19 pandemic and associated prevention measures reshaped students\u2019 lives. We estimated the effects of virtual learning during the pandemic on adolescents\u2019 mental health, suicidal thoughts and behaviors, substance use, and violence-related experiences and behaviors. Using Youth Risk Behavior Survey data from 25 local jurisdictions, we compared overall and relative changes from 2019 (n\u2009=\u200949,740) to 2021 (n\u2009=\u200942,995) between jurisdictions where high school students predominantly attended school virtually vs. in-person during the 2020\u20132021 school year with Rao-Scott chi-square tests and difference-in-differences logistic regression. P-values&lt;0.050 were considered significant. From 2019 to 2021, reported persistent feelings of sadness\/hopelessness (2019\u2009=\u200936.3%, 2021\u2009=\u200941.3%), seriously considering suicide (17.0-18.7%), making suicide plan(s) (14.2-16.9%), and experiencing sexual dating violence in past 12 months (6.7-7.8%) increased significantly, while alcohol use (22.5-17.1%), binge drinking (8.5-6.2%), and marijuana use (20.2-14.3%) in past 30 days, ever prescription opioid misuse (16.0-13.2%), and gun-carrying (5.5-4.5%), physical fighting (22.3-17.3%), and any sexual violence (11.3-10.4%) in past 12 months decreased significantly. Students in virtual learning jurisdictions reported relative decreases in injury during suicide attempt(s) (OR=0.68, 95%CI\u2009=\u20090.52-0.88), experiencing sexual violence (OR=0.78, 95%CI\u2009=\u20090.67-0.91), using electronic vapor products (OR=0.81, 95%CI\u2009=\u20090.70-0.95), using alcohol (OR=0.84, 95%CI\u2009=\u20090.74-0.95), and misusing prescription opioids (OR=0.82, 95%CI\u2009=\u20090.72-0.94). Learning model was not associated with relative changes in persistent feelings of sadness\/hopelessness, seriously considering suicide, making suicide plan(s), attempting suicide, binge drinking, marijuana use, gun-carrying, physical fighting, experiencing sexual dating violence, or being electronically bullied. Additional efforts to support schools in providing safe, supportive environments are needed, particularly where schools returned in-person in fall 2020.<\/jats:p>","DOI":"10.1371\/journal.pmen.0000409","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T17:30:41Z","timestamp":1758130241000},"page":"e0000409","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmen.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of COVID-19 school learning model on mental health, suicidal thoughts and behaviors, substance use, and violence related behaviors and experiences among U.S. high school students"],"prefix":"10.1371","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7786-0194","authenticated-orcid":true,"given":"David A.","family":"Katz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjana","family":"Pampati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"DeGue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Y.","family":"Ko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0128-2949","authenticated-orcid":true,"given":"Dawn","family":"Pepin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Casey E.","family":"Copen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ari","family":"Fodeman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-958X","authenticated-orcid":true,"given":"Deven T.","family":"Hamilton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"issue":"9","key":"pmen.0000409.ref001","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0248925","article-title":"COVID-19-associated school closures and related efforts to sustain education and subsidized meal programs, United States, February 18-June 30, 2020","volume":"16","author":"N Zviedrite","year":"2021","journal-title":"PLoS One"},{"key":"pmen.0000409.ref002","volume-title":"Science brief: transmission of SARS-CoV-2 in K-12 schools and early care and education programs - updated","year":"2020"},{"key":"pmen.0000409.ref003","unstructured":"Centers for Disease Control and Prevention. Preparing K-12 school administrators for a safe return to school in fall 2020. 2020. 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Promoting mental health and well-being in schools: an action guide for school and district leaders. 2023. Accessed 2024 August 30. https:\/\/www.cdc.gov\/healthyyouth\/mental-health-action-guide\/index.html"},{"key":"pmen.0000409.ref037","volume-title":"Key substance use and mental health indicators in the United States: results from the 2019 National Survey on drug use and health","author":"Substance Abuse and Mental Health Services Administration","year":"2020"},{"key":"pmen.0000409.ref038","unstructured":"Centers for Disease Control and Prevention. Prevention resources for action. 2023. 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