In 2021, a survey by the Centers for Disease Control and Prevention on teen mental health focused on a stark crisis: Nearly three in five teenage girls reported feeling persistent sadness, the highest rate in a decade.
But the newest iteration of the survey, distributed in 2023 to more than 20,000 high school students across the country, suggests that some of the despair seen at the height of the pandemic may be lessening.
Fifty-three percent of girls reported extreme depressive symptoms in 2023, down from 57 percent in 2021. For comparison, just 28 percent of teenage boys felt persistent sadness, about the same as in 2021.
Suicide risk among girls stayed roughly the same as the last survey. But Black students, who reported troubling increases in suicide attempts in 2021, reported significantly fewer attempts in 2023.
Still, the number of teens reporting persistent sadness in 2023 remained higher than at any point in the last decade aside from 2021. And around 65 percent of lesbian, gay, bisexual and transgender high school students reported persistent hopelessness, compared with 31 percent of their cisgender or heterosexual peers. One in five L.G.B.T.Q. students reported attempting suicide in the past year.
“For young people, there is still a crisis in mental health,” said Kathleen Ethier, head of the C.D.C.’s adolescent and school health program. “But we’re also seeing some really important glimmers of hope.”
The C.D.C. has conducted the survey, called the Youth Risk Behavior Survey, every two years since 1991. The latest batch of data is the first to give a sense of how the pandemic shaped teenagers’ lives.
Corinne Catarozoli, a clinical psychologist at Weill Cornell Medicine in New York who specializes in treating young people, said that the improvements over the past few years may be partly attributed to an increased focus on getting teenagers earlier access to mental health services, particularly providing such care at pediatricians’ offices.
She noted that pediatric emergency visits at Weill Cornell for psychiatry care from January to May 2024 had plateaued, a promising change from the steady increases seen in recent years.
“This data we’re seeing today is promising and shows that we’re on the right track,” Dr. Catarozoli said. Still, she added, “there is still a long way to go in terms of access and in terms of insurance coverage.”
Though the stress and isolation of the pandemic led to alarming increases in teenage distress, Dr. Ethier said that a mental health crisis had been mounting well before Covid.
“Mental health was moving in the wrong direction prior to the pandemic — we just were less as a country focused in that way,” Dr. Ethier said.
She noted that teenagers’ experiences of violence have steadily increased over the last decade. Nearly 2 in 10 female students reported experiencing sexual violence, and more than 1 in 10 reported being forced to have sex. Nearly 1 in 5 L.G.B.T.Q. students and 16 percent of girls reported not attending school in the previous 30 days because of fears of violence. And more than 1 in 5 female or L.G.B.T.Q. students reported being bullied online in the last year.
But other metrics have continued to trend in a positive direction over the past decade. Fewer students reported risky sexual behaviors. Just 6 percent of teenagers reported having four or more lifetime sexual partners, compared with 15 percent in 2013.
Alcohol and drug use has also continued to decline. Just 22 percent of teens reported drinking in 2023, versus 35 percent in 2013. Seventeen percent said they smoked marijuana, compared with 23 percent in the decade prior. Female and L.G.B.T.Q. students were more likely than other groups to report alcohol and drug use.
The survey asked new questions about social media use, housing, parental monitoring and experiences of racism and discipline in schools.
In 2023, 32 percent of high schoolers reported experiencing racism in school. Asian students reported the highest rate, at 57 percent. Among Black students, 46 percent reported racism at school and 23 percent reported being unfairly disciplined.
More than three-quarters of students reported using social media several times a day, with roughly 82 percent of girls reporting frequent social media use compared with 73 percent of boys.
In June, the U.S. Surgeon General, Dr. Vivek Murthy, pushed for warning labels on social media platforms about potential harm to young people’s mental health. But Dr. Ethier cautioned against putting too much blame on social media.
“We know that there are some difficult and in some cases dangerous exposures that young people have on social media,” Dr. Ethier said. The C.D.C. plans to carry out a more thorough analysis of the survey data on social media and mental health, she added. “But this data that we’re presenting today doesn’t point to it being the whole story.”
If you or someone you know is having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.
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