Child and adolescent mental health in South Tyrol, Italy: A narrative synthesis of the Corona and Psyche – South Tyrol (COP-S) survey series, 2021–2025

Background: Five years after the onset of the COVID-19 pandemic, mental health indicators in children and adolescents have not returned to pre-pandemic levels. This narrative synthesis of the Corona and Psyche – South Tyrol (COP-S) study series, conducted in a bilingual Alpine region of Northern Italy, summarizes the course of youth mental health, its correlates, and prevention implications. Methods: Findings from four cross-sectional COP-S survey waves between 2021 and 2025 were synthesized and contextualized by one external comparison with the neighboring Austrian Tyrol. Waves covered children aged 7–10 years (6–10 years in 2025; parental proxy) and adolescents aged 11–19 (proxy and self-report). Validated instruments assessed mental health outcomes—emotional and behavioral difficulties, anxiety, depressive symptoms, psychosomatic symptoms, quality of life, and eating-disorder risk—and correlates including social support, resilience, health literacy, problematic Internet use, sleep, physical activity, school stress, family affluence and subjective financial strain. Results: The gender gap was pronounced for anxiety, where higher scores in girls were largely independent of covariates. The leading correlates shifted from pandemic-related fears to school stress, problematic Internet use, poor sleep and subjective financial strain. School-language differences were not driven by home–school language mismatch. Parental health literacy was associated with proxy reporting in younger children. Perceived social support and resilience related to outcomes through parallel rather than sequential pathways. Eating-disorder risk was marked by widespread body dissatisfaction and a treatment gap, without difference in SCOFF screening between questionnaire languages. Outcomes were broadly similar in South Tyrol and neighboring Austrian Tyrol. Discussion: The mental health burden in South Tyrolean youth in 2025 reflects persistent everyday stressors rather than the acute pandemic-related factors. Prevention can combine school-based reduction of academic stress, age-appropriate digital-media policies, sleep measures, and joint social-support and resilience interventions. Anxiety-specific approaches for female adolescents, parental health-literacy education and family-level economic support may complement universal measures.