Adolescent Suicide During the COVID-19 Pandemic: Bullying Dynamics, Risk Factors, and Prevention Strategies: An Updated Narrative Review

Objectives: To analyze the evolution of suicide rates among adolescents during the COVID-19 pandemic, examine the evidence regarding the relationship between bullying, cyberbullying, and suicidal behavior in adolescents during this period, and identify evidence-based prevention strategies. Methods: This study is a narrative literature review synthesizing current knowledge on adolescent suicide during the COVID-19 pandemic, was conducted following a structured search strategy across five databases (PubMed, CINAHL, PsycINFO, Embase, and Dialnet) for publications between 2020 and 2025, with quality appraisal using STROBE and SRQR guidelines. MeSH and DeCS keywords were used with Boolean operators. Inclusion criteria comprised peerreviewed articles investigating adolescent suicide during COVID19, including quantitative, qualitative, mixedmethods studies, and relevant systematic reviews. Results: Twentysix articles were selected for analysis, representing studies from 10 countries across four continents. The evidence demonstrates that the COVID19 pandemic significantly impacted adolescent mental health, with increased rates of depression (5–7% increase), anxiety, and suicidal ideation, particularly among females and vulnerable populations. Key risk factors identified included social isolation, excessive social media use, preexisting mental health conditions, LGBTQ+ identity, and low socioeconomic status. While traditional bullying decreased during school closures (78.2% reduction), cyberbullying increased dramatically (264.4% increase). Protective factors included family support, access to mental health services, and structured school environments. Conclusions: The evidence from this review indicates that the COVID19 pandemic created a significant mental health crisis among adolescents, with increased suicide risk across most countries studied. The shift from traditional bullying to cyberbullying represents a critical emerging threat. Evidencebased prevention strategies identified include universal screening in schools and primary care, telehealth mental health services, social emotional learning programs, family based interventions, and community support systems. A multitiered prevention approach (universal, selective, and indicated) is essential. The persistent shortage of mental health professionals and lack of comprehensive national prevention plans remain critical barriers. Future research should focus on longterm pandemic effects and evaluation of prevention program effectiveness in postpandemic contexts.