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Report Demonstrates Urgency for Addressing Teen Mental Health Crisis
The most recent Centers for Disease Control and Prevention (CDC) report on adolescent mental health is cause for alarm. In 2021, more than 40% of high school students felt so sad or hopeless that they could not engage in their regular activities for at least 2 weeks during the previous year. Almost 60% of female students experienced persistent feelings of sadness or hopelessness during the past year, and almost 25% made a suicide plan. And minority subgroups, including LGBTQ, presented an even bleaker picture. Compared to earlier years, statistics for 2021 were appreciably worse.
We must look to the social determinants of health to understand these changes in adolescent mental health. On one hand, we know negative social determinants have been very deleterious for teens recently. Social isolation and virtual schooling due to the COVID-19 pandemic have disrupted adolescent relationships with peers and schools, and have increased conflicts within families. Long hours on social media have contributed to teens’ social isolation, and frequent social media ads directed at teens have diminished personal sense of self-esteem and self-worth.
Yet, by contrast, the CDC also has noted the salutary effects of several positive social determinants. School connectedness, i.e., feeling close to people at school, has a long-lasting, protective impact for adolescents well into adulthood on almost all the behaviors and experiences examined. Parental monitoring, i.e., knowing where students are going and who they are with, is another key protective factor for adolescent health and well-being.
Our response to this crisis must be multifold and incorporate direct work on the social determinants, as well as more traditional clinical interventions. And it must involve structural and interpersonal programs.
President Joe Biden already has expressed concerned about the adolescent mental health crisis, and he has proposed changes in 2022 and 2023 to address this crisis. First, he has proposed legislation and regulations to eliminate social media data collection from teens, as well as all subsequent targeted advertising. Similarly, in both years, he has recommended dramatic expansions in school-based mental health services. Congress has not yet acted on social media reform but has provided some resources in both years for service expansion in schools.
Schools have a very intense focus on academics and sports, and other goal-oriented group activities. However, very little attention is devoted to personal or group wellbeing. Schools must devise ways to remedy this deficit. Every day, at least one or more activities for every student should focus on improving personal wellbeing, extending social support, building friendship networks, and promoting confidence and self-esteem.
The mental health field must become engaged in devising and implementing structural and interpersonal strategies to reduce teens’ social isolation and loneliness. These interventions are needed to improve teens’ relationships with parents or other family members, with peers from the community and school, and with teachers and coaches at school. Such strategies could be implemented via the use of mentors, peer-to-peer supports, and engaging social events.
Mental health providers in schools have a very important training role. They can help teachers, coaches, and administrators to recognize and take action on emerging mental health and substance use issues. Further, they also can provide training on how to promote student resiliency and wellbeing. This latter area represents an important new area of opportunity.
The clinical role of mental health providers in schools is essential; however, upstream interventions like those identified above are equally, if not more important. Clearly, if we are to undertake these latter activities in an effective manner, training programs for school mental health providers will need to be rethought and broadened. This is an urgent call for our colleges and universities to undertake this essential transformation.
The current teen mental health crisis demands our immediate attention. Reducing the number of teens who contemplate suicide or who express sentiments of hopelessness is both a clinical mission and a moral one. Lack of action now can lead to decades of required care in the future as today’s teens become tomorrow’s adults. Our strategy today must be multifold and involve a broad range of leadership, preclinical, training, and clinical activities.
Ron Manderscheid, PhD, is the former president and CEO of NACBHDD and NARMH, as well as an adjunct professor at the Johns Hopkins Bloomberg School of Public Health and the USC School of Social Work.
The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.
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