New federal data on youth mental health offers a few silver linings, but experts caution these signs of progress don’t mean U.S. students are out of the storm.
The CDC released the results of its biennial Youth Risk Behavior Survey earlier this month, highlighting changes in students’ responses from 2021 compared to 2023.
Over those two years, the percentage of students overall who reported feeling persistent sadness fell slightly (by 2 percent). Separated by gender, the percentage of girls reporting feeling hopeless and who said they considered suicide in the previous year both decreased.
In 2023, Hispanic students reported lower rates of persistent sadness, overall poor mental health, thoughts of suicide and planning suicide. The rate of Black students attempting and being injured during suicide attempts both declined.
While those recent improvements are heartening, the report also shows that mental health and well-being trends over the past 10 years are mostly heading in the wrong direction. The 2023 data reveals that students are reporting skipping school more frequently due to safety concerns and experiencing more bullying, both of which increased by 4 percent since 2021.
Erica Fener Sitkoff, senior vice president of mental health strategy at FullBloom, says the findings of the Youth Risk Behavior Survey mirrors what her organization sees in the schools it helps develop mental health support for students.
“[It] tells us that positive change is possible, and the improvements are encouraging,” Fener Sitkoff says. “That tells us that the increased awareness and unprecedented funding that’s come since the pandemic are working. It also tells us one year of reversing the trend doesn’t mean we can let up, because the numbers still aren’t great. We should dig deeper and invest more in what’s working.”
Changing Mental Health Needs
Principal Chris Young had increased the number of mental health staff at North Country Union High School in Vermont, in a rural district less than 10 miles from the Canadian border, about a year before anyone had even heard of COVID-19. Then after the health crisis hit, with two school-based clinicians, two college and career counselors, a wellness counselor and a behavior specialist, he felt the school was well-equipped to support students during the return to in-person classes after the previous school year was cut short.
“The thing that surprised us the most when students returned in fall of 2020 was just how angry they were,” Young says. “I’d not seen a group of students collectively with this much anger. We thought students would be happy to be back and see friends, but we missed the mark on giving them time and space to mourn what they lost. They missed a whole semester, weren’t able to communicate anywhere except online, which is super unhealthy. We should have been more intentional to support them working through what they experienced.”
Since then, Young says the school has adopted a campus-wide approach to well-being. Part of that is the creation of what they call advisory teams, where teachers lead groups of 12 to 14 students in activities that can range from icebreakers to talking about serious topics like suicide prevention and substance use.
“That’s the biggest change, taking it from a centralized approach where some people are doing all the work, to decentralized where all teachers are doing some work and wellness [staff] are working with the most high-need kids,” Young says. “What we’re trying to do is create community. If you feel seen and heard, you’re more likely to do better in school and feel better about yourself.”
Young’s approach aligns with what Fener Sitkoff says is the best way for schools to get students mental health support before they reach a crisis, while also preserving the bandwidth of counseling staff. She says schools can strengthen their mental health scaffolding through the addition of what she calls universal skills curriculum — which teaches students concepts like building positive relationships and advocating for themselves — along with screenings to identify students who are at risk of, but not yet experiencing, a mental health crisis.
“Schools are going to increasingly see themselves as part of the solution, and families will, too,” Fener Sitkoff says. “Clinicians in the community often have months-long waiting lists, and families are going to schools saying, ‘Help.’ Because it shows up and attendance or grades, they can see it a little earlier.”
A Student Perspective
To assume that students today are comfortable reaching out for help with mental health issues would be a mistake, says high school senior Anjali Verma. The 17-year-old is president of the National Association of Secondary School Principals’ National Student Council and became a mental health advocate as a freshman.
“I’ve had many students say they are very much struggling, especially with suicidal ideation, and they do not feel comfortable talking to an adult in their school,” Verma says. “People feel like it shows a reflection of them being lesser of a person, when that’s the furthest from the truth. I do think we are making strides toward increased wellness, but it would be wrong to assume mental health is destigmatized — because it’s absolutely not.”
Verma says she’s had her own experiences with online bullying and, as a student athlete, saw how she and her teammates struggled with toxic competitiveness, seeing “our identity in athletics and not seeing each other as people first.”
“They feel like their mental health isn’t taken [as seriously] as physical health,” she says. “It’s so much easier to talk to someone for a taped ankle than for when they were feeling hopeless.”
Verma is a strong advocate for peer-to-peer support, training students to recognize the signs of distress in themselves and their friends — and how to connect with mental health resources.
One challenge adults need to keep in mind, she says, is that teens are good at hiding their pain. Referring to the Youth Risk Behavior Survey’s data showing that girls report feeling persistently sad or hopeless at higher rates than boys, Verma says that number doesn’t tell the whole story considering that other national data shows men die by suicide at rates four times higher than women.
“That’s a way that the stigma comes into play: Boys and male-identifying people feel they’re weak if they ask for help, or they are not manly enough if they’re seen struggling,” she says.
If a student is going to signal they need help, she adds, it’s likely going to start with their peers.
“It’s teaching them things like self-care, emotional first aid kits, what they can have in their back pocket for when they’re having an anxiety-inducing situation or don’t feel like themselves,” Verma explains. “Making sure there is a body of students trained to know what to do when peers are in crisis [is important] because a lot of times students take it upon themselves to take on a friend’s struggles when, a lot of times, a mental health professional needs to step in.”
