Leaders Call a National State of Emergency in Children's Mental Health

The Amer­i­can Acad­e­my of Pedi­atrics, Amer­i­can Acad­e­my of Child and Ado­les­cent Psy­chi­a­try and Children’s Hos­pi­tal Asso­ci­a­tion recent­ly declared a Nation­al State of Emer­gency in Children’s Men­tal Health. Even before the COVID-19 pan­dem­ic, health experts have been call­ing atten­tion to a grow­ing men­tal health cri­sis among chil­dren, youth and young adults over the last decade. Trends on youth sui­cide, depres­sion and anx­i­ety have been going in the wrong direc­tion for many years and, trag­i­cal­ly, the pan­dem­ic has accel­er­at­ed this cri­sis and exac­er­bat­ed inequities for chil­dren of col­or and LGBTQ youth.

Youth Men­tal Health Trends Before the Pandemic

Accord­ing to the Amer­i­can Acad­e­my of Pedi­atrics, the Kaiser Fam­i­ly Foun­da­tion and Men­tal Health Amer­i­ca, the men­tal health of young peo­ple was a con­cern pri­or to the pan­demic’s start:

• The share of youth ages 12 to 17 report­ing a major depres­sive episode in the pre­vi­ous year dou­bled between 2009 and 2019.
• The rate of hos­pi­tal emer­gency room vis­its for children’s delib­er­ate self-harm rose by 329% from 2007 to 2016.
• Youth sui­cide rates con­sis­tent­ly increased over the past decade and by 2018, sui­cide became (and still is) the sec­ond lead­ing cause of death for ages 10 to 24. Chil­dren of col­or have been more like­ly to attempt sui­cide than white youth, and con­cern­ing increas­es in sui­cide attempts and deaths had been doc­u­ment­ed for African Amer­i­can youth.
• LGBTQ youth were three times more like­ly to report seri­ous­ly con­sid­er­ing sui­cide than their het­ero­sex­u­al peers.
• Most chil­dren who need men­tal health care do not receive it, but chil­dren of col­or con­sis­tent­ly have been less like­ly than white youth to receive treat­ment for men­tal health issues.

Fur­ther, accord­ing the KIDS COUNT Data Cen­ter, the share of U.S. high school stu­dents report­ing per­sis­tent sad­ness or hope­less­ness increased over the past decade, from 26% in 2009 to 37% in 2019. In Cal­i­for­nia, this fig­ure reached near­ly half of high school stu­dents in 2019. In a sim­i­lar­ly trou­bling trend, the share of young adults ages 18 to 24 report­ing zero poor men­tal health days had been declin­ing pri­or to the pan­dem­ic, with only 46% report­ing no poor men­tal health days in the past month by 2017–2019.

The Youth Men­tal Health Cri­sis Now

New data from numer­ous sources are point­ing to the same fact: The COVID-19 pan­dem­ic has wors­ened an already grim men­tal cri­sis among America’s youth. A few recent findings:

• Accord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, in 2020, emer­gency room vis­its for men­tal health rea­sons increased by 24% for ages 5 to 11 and by 31% for ages 12 to 17.
• Men­tal Health Amer­i­ca (MHA) reports a 628% increase from 2019 to 2020 in youth ages 11–17 tak­ing their online men­tal health screen­ing assess­ment. MHA also reports con­tin­ued inequities, with the high­est rates of depres­sion among youth iden­ti­fy­ing as Native Amer­i­can or Amer­i­can Indi­an and those iden­ti­fy­ing as mul­tira­cial. In addi­tion, MHA reports that thoughts of sui­cide or self-harm were espe­cial­ly high among LGBTQ youth in 2020.
• Accord­ing to a 2021 Kaiser Fam­i­ly Foun­da­tion report, more than one in four high school stu­dents report­ed that their emo­tion­al health wors­ened dur­ing the pan­dem­ic, and more than one in five par­ents with kids ages 5 to 12 report­ed that their children’s men­tal or emo­tion­al health wors­ened dur­ing the pandemic.
• The Kaiser Fam­i­ly Foun­da­tion also shared that, dur­ing the pan­dem­ic, near­ly three in four LGBTQ teens ages 13 to 17 report­ed symp­toms of anx­i­ety, two in three report­ed symp­toms of depres­sion and about half have had thoughts of suicide.
• A nation­al Har­vard Youth Poll found that in Fall 2021, among all young adults age 18 to 24, one in four (26%) had thoughts of self-harm at least sev­er­al days in the last two weeks.

Addi­tion­al­ly, the KIDS COUNT Data Cen­ter recent­ly added new data from the Cen­sus Bureau’s House­hold Pulse Sur­vey on young adult men­tal health. These data revealed that, from Sept. 15 to Oct. 11, 2021, young peo­ple ages 18 to 24 report­ed the fol­low­ing feel­ings for near­ly every day or more than half the days in the past two weeks:

• One in three (34%) felt down, depressed or hope­less. Of the 26 states with avail­able data that month, this fig­ure ranged from one in five (20%) in Con­necti­cut and Min­neso­ta to about half of young adults (52%) in Missouri.
• Two in five (41%) felt ner­vous, anx­ious or on edge. Of the 24 states with data, Con­necti­cut once again had the low­est share, with 18%, and Mis­souri had the high­est, with two-thirds (67%) of young adults report­ing per­sis­tent anx­i­ety or nervousness.

The men­tal health of par­ents and adults liv­ing with chil­dren also can have a pro­found impact on young peo­ple. Chil­dren and youth need sta­ble, nur­tur­ing fam­i­ly rela­tion­ships and envi­ron­ments in order to thrive. The same House­hold Pulse Sur­vey found that from July 21 to Oct. 11, 2021, about one in five adults in house­holds with chil­dren under 18 report­ed that they felt down, depressed or hope­less—and near­ly one in three (30%) felt ner­vous, anx­ious or on edge—for near­ly every day or more than half the days in the past two weeks. It is essen­tial that efforts to improve children’s emo­tion­al health also sup­port the men­tal health of par­ents and caregivers.

Time for Action on Youth Men­tal Health

Mil­lions of chil­dren and youth have been suf­fer­ing for too long, and inequities in men­tal health con­di­tions and access to care must be addressed. It is time to ele­vate the pri­or­i­ty and urgency of youth men­tal health at the nation­al, state and local lev­els. Thank­ful­ly, this crit­i­cal issue has gained new nation­al atten­tion, with the recent dec­la­ra­tion of a state of emer­gency by lead­ing health orga­ni­za­tions, as well as recent reports from the White House, U.S. Depart­ment of Edu­ca­tion and U.S. Depart­ment of Health and Human Ser­vices.

The fol­low­ing resources out­line a range of action steps that can be tak­en now by pol­i­cy­mak­ers, edu­ca­tion lead­ers and edu­ca­tors, ser­vice providers, admin­is­tra­tors, fun­ders, advo­cates, fam­i­lies, youth and oth­ers. At min­i­mum, it will require mul­ti­ple sec­tors giv­ing this issue high­er pri­or­i­ty, back­ing it up with ade­quate fund­ing, pol­i­cy and infra­struc­ture, improv­ing col­lab­o­ra­tion across orga­ni­za­tions and sec­tors, increas­ing men­tal health ser­vices and sup­ports, espe­cial­ly at schools, and focus­ing on equi­ty and youth empow­er­ment at every step.

• Address­ing the Youth Men­tal Health Cri­sis: The Urgent Need for More Edu­ca­tion, Ser­vices, and Supports
• AAP-AACAP-CHA Dec­la­ra­tion of a Nation­al Emer­gency in Child and Ado­les­cent Men­tal Health
• School-Based Strate­gies for Address­ing the Men­tal Health and Well-Being of Youth in the Wake of COVID-19
• Sup­port­ing Child and Stu­dent Social, Emo­tion­al, Behav­ioral and Men­tal Health
• Fact Sheet: Improv­ing Access and Care for Youth Men­tal Health and Sub­stance Use Conditions
• Fos­ter­ing Healthy Men­tal, Emo­tion­al, and Behav­ioral Devel­op­ment in Chil­dren and Youth: A Nation­al Agenda

Learn More & Stay Connected

See all men­tal health data on the KIDS COUNT Data Cen­ter and read about the Annie E. Casey Foundation’s focus on sup­port­ing youth and youth adults, includ­ing their men­tal health, in the Thrive by 25 announce­ment. Stay up to date on the lat­est data and infor­ma­tion by sign­ing up for our newslet­ter.