May 7, 2024 – Teen mental health problems have reached a brand new high within the United States, and the gap between the variety of teens reporting conditions reminiscent of anxiety, depression and hopelessness and the number receiving treatment is widening.
According to a new report from the United Hospital Fundan independent nonprofit group dedicated to improving healthcare for New Yorkers. The report summarizes the newest statistics on youth mental health each in New York and across the country. Although these numbers are from 2022, the peak of the pandemic, the report clearly shows that the sharp decline in youth mental health began 10 years earlier, long before COVID-19 reached our shores.
In 2022, 6.7 million U.S. youth suffered from a number of mental illnesses, and the full variety of those affected has skyrocketed from 2011 to 2021. During this decade, for instance, the variety of youth per 100,000 experiencing a significant depressive episode (MDE) increased from 8,063 in 2011 to 19,863 in 2021—a rise of nearly 150%. While the rise in clinically diagnosed depression was smaller, it increased by a median of seven% per 12 months from 2016 to 2022.
Equally concerning is the rise in persistent sadness and hopelessness amongst highschool students. From 2011 to 2021, the speed of this condition per 100,000 teens increased from 28,459 to 42,347. That's a rise of 49%, or a median of 4% per 12 months.
Data shows that the decline in teenage mental health began even before the pandemic, with the variety of adolescents with clinically diagnosed anxiety disorders increasing from 10,427 in 2016 to 13,808 in 2019 – a rise of 32% in only three years.
“The pandemic has exacerbated these trends, but this problem has grown year over year over the past decade,” said Oxiris Barbot, MD, president and CEO of United Hospital Fund. “And there have been no earth-shattering events, either locally or nationally, to give us any indication that things are changing for the better.”
Risky behavior
Teens who're sad and hopeless are more likely to interact in dangerous behavior than those with a more positive attitude, the report says. They are 3 times more prone to use illegal drugs, 2.3 times more prone to binge drink, 1.5 times more prone to drive while inebriated, and 1.3 times more prone to have sex with none type of contraception.
As the mental health crisis has deepened amongst them, the variety of teens who've considered or attempted suicide has risen, and stark racial disparities are emerging. The variety of white highschool students who considered suicide rose 4% annually from 2011 to 2021; in contrast, the number rose 5% annually for black students and three% for Hispanic students, while declining barely for Asian students. High school girls were rather more likely to think about suicide or experience a significant depressive episode than boys in 2021.
Another group that fared worse mentally than their peers were LGBTQ youth. In 2021, 6% of heterosexual highschool students attempted suicide, in comparison with 24% of lesbian, gay, and bisexual students and 18% of kids within the “other/doubtful” category.
Social media and other sources of stress
You've probably heard it before: Social media is taking a toll on the mental health of today's teens. Since the early 2010s, teens and adolescents have develop into obsessive about social media on their smartphones – at the least one factor that has exacerbated the issue, as U.S. Surgeon General Vivek Murthy and sociologist Jonathan Haidt cite of their recent bestseller, “Social Media.” The fearful generation. Social media use has reportedly caused depression and/or anxiety amongst many adolescents, partially displacing personal relationships. In addition, it has led to an explosion in cyberbullying and social competition online.
“While social media offers some advantages, there may be considerable evidence that social media may also pose a risk to the mental health and wellbeing of kids and young people. Social media use by young people is sort of universal, with as much as 95% of young people aged 13 [to] 17 reported using a social media platform, and greater than a 3rd said they use social media ‘almost constantly,'” the Surgeon General said in a statement published in May 2023.
Experts interviewed by WebMD agreed that social media plays a large role in the problems facing American teenagers. But that's not the whole story.
“The world is perceived as more dangerous than ever before,” says Dr. John Piacentini, a child psychologist and professor of psychiatry and biobehavioral sciences at UCLA. “The American Psychological Association does a Stress in America survey every few years. And in the 2018 report, they found that Gen Z kids are significantly more worried about mass shootings and school shootings than the general population because that's what's happening to them. Climate change and global warming are also an issue for them.”
Robin Gurwitch, PhD, a psychologist and professor at Duke University School of Medicine, agreed.
“Climate change is a major concern and worry for young people today, as are school shootings,” she noted. “We also know that social media increases anxiety and depression among young people, and both are getting worse.”
In his book, Haidt points to another factor that predates social media. This is the trend that began in the 1990s when many parents restricted their children's freedom out of concern for their safety. Haidt argues that these parents hindered their children's normal social development by not allowing their children to go out and play with their friends and even engage in unsupervised, risky games, which can lead to depression and anxiety.
“The lack of free time and play opportunities for children and the decreasing independence of children are very important,” Piacentini said. “The things our generation did as children are wrongly perceived as unsafe. A child whose feet never touch the ground never learns to walk. So I agree with Haidt, and he is saying what many other people are thinking and researching.”
Why are girls affected so much more often than boys? Gurwitch noted that there has always been a gender difference in mental health issues. Not only do girls tend to internalize feelings of depression and anxiety more than boys, she said, but boys are also less likely to express their feelings.
“For decades, boys have been less allowed to admit that they are not feeling well and are under stress. For girls, it is more acceptable to admit to behavioral problems.” Nevertheless, Gurwitch believes that girls are particularly at risk from social media.
“Before the pandemic, we saw an increase in online bullying. And as kids became more addicted to their phones, anxiety increased, especially among girls. They don't sleep well because they're so afraid they might miss a text or a message or what someone is saying,” she said. “They're not as well rested and they don't do as well in school.”
Why teenagers don’t get help
One of the most astonishing findings of the United Hospital Fund report is the gap between the number of teens with behavioral health issues and the number who receive professional help. For example, of 20 teens who reported symptoms of depression in 2022, only 10 were clinically diagnosed with depression; of 20 teens who reported symptoms of anxiety, only nine were clinically diagnosed with the condition.
Treatments are rarer than diagnoses and are becoming increasingly rare. For example, in 2010, 5,182 out of 100,000 adolescents had a major depressive episode but did not receive treatment; however, 2,880 other adolescents with MDEs received treatment. In 2021, 12,042 out of 100,000 adolescents had MDEs without treatment and 7,822 with MDEs received treatment. This means that in 2021, only 39% of those who needed treatment for an MDEs were able to access it.
The main reason for this discrepancy, experts say, is the inadequate number of medical professionals who can help troubled teens. The shortage of licensed therapists and psychiatrists in the U.S. is a problem for adults and even worse for teens, who may not be able to seek help on their own.
Schools should be a natural place for young people to seek treatment. A recent report on child and adolescent mental health found that students are more likely to receive mental health treatment in school than in other settings. However, the report found that 80% of school-age children with a mental health diagnosis did not receive treatment. One reason for this was the lack of mental health support and professionals in schools. Another report pointed out that only about half of the schools conduct mental health screenings for students and even fewer offer treatment options.
In addition, the resources we currently have are “fragmented and disjointed,” said Barbot, CEO of the United Hospital Fund. While children are affected by multiple systems that affect their health – including the education system, the child protection system and child welfare services – they don't necessarily communicate with each other.
Integrated pediatric practices
The American Academy of Pediatrics, the declared a national emergency in Children's Mental Health in 2021 called for more mental health care in schools and more pediatric practices utilizing behavioral health providers. But to date, not many practices have moved in that direction.
“On the human resources issue, we should be clear that we cannot provide enough doctors in a brief time frame to treat the issues that youth are facing today,” Barbot said. “So we want to concentrate on how we will expand that care in order that not every child who shows these symptoms must see a baby psychiatrist or social employee. We must focus more on how we reach out to peers and train more peers to be a resource for his or her fellow youth.”
She cited the Ballmer Institute for Children's Behavioral Health on the University of Oregon. This program offers a bachelor's degree in child behavioral health. Students are trained in early identification, behavioral health promotion, and supervised practice in schools and community settings, allowing them to counsel youth in schools and other settings without having to undergo the long training cycle for licensed therapists.