Young people in the United States are experiencing a mental health crisis. Warnings from the surgeon general, the American Academy of Pediatrics, the American Psychological Association and other prominent organizations, as well as regular news reports, highlight the catastrophe, with parents struggling to help their children, and students lined up in school halls to get even a few minutes with counselors, psychologists or social workers who are overwhelmed with young patients seeking services.
Has the current crisis been caused by the pandemic? No. Those of us who have been monitoring the health and well-being of youth know this storm began years ago. In 2022, we continue to fund a system to address children’s mental health that is similar to an infrastructure initiated in the 1940s, when returning veterans were the priority for mental health treatment. The system that emerged was—and is—geared to adults.
Scientific advances have identified effective mental health practices, such as school-based emotional regulation training that teaches children how to cope with strong feelings, or school-based screenings that could allow us to detect mental health crises before they occur. Scientific advances have identified effective mental health practices, which have been largely ignored, and now is the time to act on them. Based on centuries-old and long disproven theories of physical and mental health as two independent systems, billions are invested annually on medical research and physician training, but staggeringly few resources are available to advance psychological science or the development of a mental health workforce.
The results are clear. Data from the Centers for Disease Control and Prevention, where one of us (Ethier) is the director of adolescent and school health, reveal that in the 10 years prior to the pandemic, a remarkably high number of young people reported feeling severe emotional distress. Specifically, in 2019, 37 percent of high school students questioned in a survey said they felt so sad and hopeless that they couldn’t participate in their regular activities, and about one in five U.S. teens seriously considered or attempted suicide. Adolescent girls, and youth who identified as lesbian, gay, bisexual, transgender, or who were questioning their identity, were overrepresented among those teens who considered or attempted suicide.
Since the pandemic began, the situation has worsened. Children who were vulnerable before the pandemic now were in crisis, and those less vulnerable before the pandemic were at risk for the onset of psychological symptoms.
During COVID, adolescent visits to emergency departments for suicide attempts and eating disorders increased. The CDC’s Adolescent Behaviors and Experiences Survey, the first nationally representative survey of U.S. high school students during the pandemic, revealed that young peoples’ lives were extremely disrupted, in ways unexpected or less easily managed.
More than a quarter of youth in the U.S. told us they experienced hunger, and more than half told us they experienced emotional abuse by an adult in their homes. We also heard that more than 60 percent of Asian students and more than half of Black students experienced racism in their schools. As we saw prepandemic, emotional distress and suicidal thoughts and behaviors continued to worsen, and these problems were more significant among female and LGBQ students.
And so now a crisis that existed prior to the pandemic has been exacerbated, leaving many to wonder what can be done. The answer can be found in scientific discoveries that one of us (Prinstein) and psychological science colleagues have developed over the past several decades, yet which have been largely ignored when developing policies or best practices in schools, homes and communities.
For instance, scientists now have identified evidence-based treatments to ameliorate severe psychological symptoms, but few caregivers know how to seek treatments that have been proven to work.
Science also has identified effective strategies to prevent emotional or behavioral distress by teaching children skills for how to interpret or cope with stressors, how to develop healthy social relationships, strategies to lower anxiety, and how to spot the warning signs for depression. Yet resources are not available to allow these prevention approaches to be deployed at scale or used among populations most at need. Thus, youth continue to suffer needlessly. Schools dedicate time to teach children how to brush their teeth, but not these science-based mental health strategies that could save decades of emotional distress and stop youth from self-harm.
CDC data confirm these approaches work. For instance, data show that during the pandemic, students who felt connected to others in school were less likely to experience emotional distress and other indicators of poor mental health, as well as suicide plans and attempts. Prior to the pandemic, we were making progress in addressing the needs of LGBTQ youth, for example. By 2018, 79 percent of high schools reported identifying safe spaces for LGBTQ youth, 96 percent had anti-harassment policies, 77 percent had inclusivity professional development for school staff, and 64 percent had student-led clubs for LGBTQ youth.
Recent CDC research found that having these four policies and practices in place at school not only improved mental health for LGBTQ students, but for non-LGBTQ youth as well. Similar results are evident from antiracism programs that make schools less toxic for historically minoritized youth and improve the health and well-being of all students.
These approaches are not controversial. Methods to increase connectedness include classroom management techniques that reinforce attentive, cooperative and collaborative behaviors, reduce peer victimization and help youth understand how others feel and behave. Psychological prevention strategies can teach youth how to less frequently blame themselves for harsh experiences, how to help all peers feel valued and included, and how to consider adaptive and healthy responses, even when confronted with aggression.
But these approaches, based on decades of rigorous science, will require an acknowledgement that children’s mental health is in crisis. A commitment to the science of behavior is imperative, as is the deployment of innovative programs, created by scholars, that have languished in academic journals rather than being turned into practice.
Failure to address this mental health crisis will result in not only the distress of millions of youth in the U.S. today, but a change in the productivity, success, and well-being of U.S. citizens-at-large as this generation matures.
This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.
