The Centers for Disease Control and Prevention is warning of an accelerating mental health crisis among adolescents, with more than 4 in 10 teens reporting that they feel “persistently sad or hopeless,” and 1 in 5 saying they have contemplated suicide, according to the results of a survey published Thursday.
The findings draw on a survey of a nationally representative sample of 7,700 teens conducted in the first six months of 2021, when they were in the midst of their first full pandemic school year. They were questioned on a range of topics, including their mental health, alcohol and drug use, and whether they had encountered violence at home or at school. They were also asked about whether they had encountered racism.
Although young people were spared the brunt of the virus — falling ill and dying at much lower rates than older people — they might still pay a steep price for the pandemic, having come of age while weathering isolation, uncertainty, economic turmoil and, for many, grief.
In a news conference, Kathleen A. Ethier, head of the CDC’s division of adolescent and school health, said the survey results underscored the vulnerability of certain students, including LGBTQ youth and students who reported being treated unfairly because of their race. And female students are far worse off than their male peers.
“All students were impacted by the pandemic, but not all students were impacted equally,” Ethier said.
It’s not the first time officials have warned of a mental health crisis among teens. In October, the American Academy of Pediatrics declared a national emergency in child and adolescent mental health, saying that its members were “caring for young people with soaring rates of depression, anxiety, trauma, loneliness, and suicidality that will have lasting impacts on them, their families, and their communities.”
In December, Surgeon General Vivek H. Murthy issued an advisory on protecting youth mental health.
“The pandemic era’s unfathomable number of deaths, pervasive sense of fear, economic instability, and forced physical distancing from loved ones, friends, and communities have exacerbated the unprecedented stresses young people already faced,” Murthy wrote. “It would be a tragedy if we beat back one public health crisis only to allow another to grow in its place.”
The CDC survey paints a portrait of a generation reeling from the pandemic, grappling with food insecurity, academic struggles, poor health and abuse at home. Nearly 30 percent of the teens surveyed said a parent or other adult in their home lost work during the pandemic, and a quarter struggled with hunger. Two-thirds said they had difficulty with schoolwork.
But the survey also offers hope, finding that teens who feel connected at school report much lower rates of poor health. The finding calls attention to the critical role schools can play in a student’s mental health.
Ethier said the findings add to a body of research that show that feeling connected at school can be “a protective factor" for students. Schools can deliberately foster connectedness in a number of ways, including instructing teachers on how to better manage classrooms, to facilitating clubs for students and ensuring that LGBTQ students feel welcome. Such steps can help all students — and not just the most vulnerable — do better, she said.
“When you make schools less toxic for the most vulnerable students, all students benefit — and the converse is also true,” Ethier said.
Katelyn Chi, a 17-year-old junior at Rowland High School in Rowland Heights, Calif., said her school’s Peer Counseling Club was key to helping her get through last school year, which was entirely virtual. At the beginning of each online club meeting, she and other members filled out a Google form that simply asked them how they were doing. The forms were viewed by the club’s president, who checked in with her whenever she indicated she felt down.
“It really helped,” Chi said. “I received support and validation.”
Concerns about adolescent mental health were rising before the pandemic: Teens had been reporting poor mental health at higher rates. Between 2009 and 2019, the percentage of teens who reported having “persistent feelings of sadness or hopelessness” rose from 26 percent to 37 percent. In 2021, the figure rose to 44 percent.
The survey results also underscore the particular vulnerability of LGBTQ students, who reported higher rates of suicide attempts and poor mental health. Nearly half of gay, lesbian and bisexual teens said they had contemplated suicide during the pandemic, compared with 14 percent of their heterosexual peers.
Girls, too, reported faring worse than boys. They were twice as likely to report poor mental health. More than 1 in 4 girls reported that they had seriously contemplated attempting suicide during the pandemic, twice the rate of boys. They also reported higher rates of drinking and tobacco use than boys.
And, for the first time, the CDC asked teens whether they believed that they had ever been treated unfairly or badly at school because of their race or ethnicity. Asian American students reported the highest levels of racist encounters, with 64 percent answering affirmatively, followed by Black students and multiracial students, about 55 percent of whom reported racism. Students who said they had encountered racism at school reported higher rates of poor mental health and were more likely to report having a physical, mental or emotional problem that made it difficult for them to concentrate.
The study also shed light on household stresses. One in 10 teens reported being physically abused at home, and more than half reported emotional abuse, including being insulted, put down or sworn at.
The survey also revealed that students who felt connected at school fared far better than those who did not. Teens who said they felt “close to people at school” were far less likely to report having attempted or thought about attempting suicide, and they were far less likely to report poor mental health than those who did not feel connected at school. The same held true for teens who felt connected virtually to friends, family members and clubs.
“Comprehensive strategies that improve connections with others at home, in the community, and at school might foster improved mental health among youths during and after the pandemic,” the report concluded.
Chi said she wishes policymakers could take adolescent mental health more seriously. She sometimes feels like people her age are dismissed because of their age.
“I’d like to ask them to provide us with a lot of more resources and a lot more empathy on what we’re going through,” Chi said, adding that her school delayed the opening of a much-needed student wellness center this year. “With things so hard right now, it’s hard to see the future as something better.”
John Gies, the principal of Shelby High School in Shelby, Ohio, said he noticed a rise in the number of his students who were “struggling.” Sometimes, they would not make eye contact. Other times, students without previous disciplinary issues acted out and ended up in his office.
So he used some of the money the school received from the American Rescue Plan to connect more students with counseling, and created an arrangement to bring counselors from a local counseling center to school several times a week. The school has created a support group for grieving students and for a cohort of freshmen who educators worry could fall through the cracks.
“The mental health struggle had been there” before the pandemic, Gies said. “The pandemic really brought it to the surface and made it actually a little bit worse.”