Young people are facing an unprecedented increase in mental health disorders
The journey to adulthood is often a turbulent one, but recent research shows that today’s adolescents are struggling with dramatic increases in mental distress. In 2019, more than 1 in 3 U.S. high school students said they had experienced persistent feelings of sadness or hopelessness, a 40% increase since 2009, according to the Centers for Disease Control and Prevention. Reports also show significant increases in youth mental health disorders, including depression, anxiety, and suicide ideation.
The COVID-19 pandemic intensified this crisis, prompting the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association to declare a national emergency in child and adolescent mental health in autumn 2021.
U.S. Surgeon General Vivek Murthy also issued the Protecting Youth Mental Health advisory in 2021, which called for “an all-of society effort, including policy, institutional, and individual changes in how we view and prioritize mental health.”
“[T]he challenges today’s generation of young people face are unprecedented and uniquely hard to navigate,” Murthy wrote. “And the effect these challenges have had on their mental health is devastating.”
Worsening Mental Health of Girls
Mental health is affected by biological factors, including genes and brain chemistry, and environmental factors, including life experiences and larger social forces. Globally, it’s estimated that one in seven 10- to 19-year-olds experiences a mental disorder, according to the World Health Organization, and adolescent mental health conditions are increasing in many countries worldwide. Research has also shown that these increases are greatest in female adolescents.
“Across clinical and community settings and measured with various instruments, girls and women are more likely than boys and men to experience a range of internalizing conditions and symptoms, including depression, psychological distress, anxiety, and suicidal ideation,” says Jonathan Platt, assistant professor of epidemiology in the University of Iowa College of Public Health.
Platt, along with Katherine Keyes from the Columbia University Mailman School of Public Health, co-authored a paper that reviews and summarizes studies published since 2010 from around the world to understand trends, causes, and consequences of gender differences in internalizing conditions—mental health symptoms that individuals express inwardly, such as anxiety, sadness, worthlessness, and withdrawal.
The paper, which appeared in the Journal of Child Psychology and Psychiatry, closely examines several potential causes of increasing mental health symptoms in youth. The authors then present a framework to evaluate whether these risk factors could plausibly explain the increased concentration of symptom rates among female adolescents.
The authors found that potential factors in the worsening mental health of girls are trends in cyber-bullying, education-related pressures, and earlier onset of puberty. Other potential risk factors that require more research include climate anxiety, social media use, and global economic and political instability. The short- and long-term consequences of the COVID-19 pandemic will also be “a critical part of mental health surveillance for years to come,” the authors write.
Platt and Keyes stress that “there are no simple stories for the increase” in youth mental health conditions. They call for additional research and training to continue to unpack the underlying reasons so that evidence-based solutions can be developed. They also note the urgent need for studies that include more expansive measures of gender expression beyond the male/female classification.
“The science is woefully behind on moving beyond binary measures of gender,” Keyes says. “Not only is binary gender inaccurate, but without assessing internalizing symptoms across a broader spectrum of gender, we miss important disparities.”
The Latest Youth Risk Behavior Survey
The CDC’s Youth Risk Behavior Survey, which examines health behaviors and experiences among U.S. high school students, further illuminates the struggles of girls and marginalized groups. Data collected in fall 2021 and released in early 2023 revealed that teen girls are experiencing the highest levels of sexual violence, sadness, and hopelessness they have ever reported. Three in five girls felt persistently sad and hopeless in 2021—double that of boys and the highest level reported over the past decade.
The same report also confirms ongoing and extreme distress among teens who identify as lesbian, gay, bisexual, or questioning (LGBQ+). More than half (52%) of LGBQ+ students had recently experienced poor mental health and more than 1 in 5 (22%) had attempted suicide in the past year.
Findings by race and ethnicity also show high and worsening levels of persistent sadness or hopelessness across all racial and ethnic groups, and that reported suicide attempts increased among Black youth and white youth.
Working with Schools
Helping young people navigate these challenges requires a full range of support from families, policies, and institutions. School personnel and educators are key partners in the effort, given that children spend so much time in school.
“With the right programs and services in place, schools have the unique ability to help our youth flourish,” Kathleen Ethier, director of the CDC Division of Adolescent and School Health, said in a press release.
One project that aims to increase the number of school-based mental health services professionals (MHSPs) is called MPath—Multidisciplinary Pathways to Recruit, Train, and Retain School Mental Health Providers in Iowa.
The MPath project focuses on developing a multidisciplinary training model to increase the number of highly qualified school-based MHSPs serving high need areas of Iowa. With a grant from the U.S. Department of Education, MPath will fund 72 graduate students in school psychology, school counseling, school social work, and public health over the next five years. Special emphasis will be focused on increasing the number of MHSPs from underrepresented, nontraditional, and minoritized backgrounds.
The graduate students will receive practicum supervision from credentialed professionals in their respective degree programs. They’ll acquire the expertise and practical experience necessary to address the broad range of mental health concerns encountered by high-need local education agencies. Two Master of Public Health students, Jaron Jones and Ngonyo Mungara, are currently enrolled in the program.
Ann Santos, clinical associate professor in school psychology, serves as the project director. Ebonee Johnson, assistant professor of community and behavioral health in the College of Public Health, is a co-project director, along with Enedina Vazquez, clinical professor of school psychology, Gerta Bardhoshi, professor of school counseling and Scanlan Center for School Mental Health Director of Research and Training, and Sarah Witry, clinical assistant professor of social work.
“MPATH will make a significant and positive impact on school mental health workforce expansion in the state of Iowa,” says Johnson. “By partnering closely with Keystone and Mississippi Bend Area Education Agencies, students will receive their clinical training in high-need schools and districts. Students will also receive Iowa-based job placement support as they matriculate to ensure we’re retaining a workforce that is committed to addressing the mental health needs of Iowa’s youth.
“Working as a part of this multidisciplinary team has been so rewarding, and I’m excited to see the long-term impact of this work,” Johnson says.
There are no quick fixes for solving the mental health challenges facing youth. However, improving awareness, support, and policies can lead to better prevention and treatment of mental health conditions.
“Everyone has a role in addressing the mental health of our youth: families, teachers and staff, clinicians, and researchers,” advises Platt. “Only through cooperation and sustained commitment can we work together to identify who is struggling and why, in order to get kids the help that they need and reverse the crisis we face today.”