The COVID-19 pandemic caused immense disruptions to the daily life of children and adolescents—and took a devastating toll on their mental health. More than one in three high school students in the US reported experiencing poor mental health during the pandemic, and in October 2021, the American Academy of Pediatrics declared a national emergency in child and adolescent mental health. California data also show a troubling rise in mental health incidents, especially among adolescent girls. Recent state investments to support schools’ efforts in early detection and intervention promise to play a critical role in countering the mental health crisis among youth.
About one-third of California adolescents age 12–17 experienced serious psychological distress between 2019 and 2021, according to the California Health Interview Survey. While the share reporting psychological distress remained steady during this time period, there was a notable increase in the number of adolescent suicides during the first year of the pandemic; suicides had previously been declining since 2016. While the most recent data for California suicides is from 2020, this trend may have continued in subsequent years. For example, a recent study from Illinois that included data through June 2021 found a sharp increase in children’s emergency department visits related to suicidal thoughts since 2016, and anecdotal evidence from a large pediatric hospital in San Diego indicates that the number of behavioral health crises is much higher today than several years ago.
Gender differences in behavioral health incidents during the pandemic have been striking. While the number of suicides is lower among girls than boys, recent increases have been higher among girls. From 2019 to 2020, suicides increased by 39% among girls and 11% among boys. In addition, adolescent girls are much more likely than boys to visit the emergency department due to self-harm: in 2020, adolescent girls made about 7,700 visits due to self-harm (a 9% increase from 2019), while boys made roughly 2,100 visits (an 8% decrease) These findings suggest that the pandemic had a greater impact on adolescent girls’ mental health. National student surveys during the 2020–21 school year also found that female students and those who identify as neither male nor female reported consistently higher rates of mental health concerns.
Schools play an important role in assessing students’ mental health and delivering behavioral health care. Prior to the pandemic, 58% of adolescents nationwide who used mental health services received these services in an educational setting. Even when campuses were closed during the pandemic, schools remained a hub for a full continuum of behavioral health supports for students and their families. And to assist the transition back to in-person learning, federal education grants contributed to school-based mental health services, including increasing the number of mental health professionals.
Behavioral health treatments delivered in schools have demonstrated success at reducing anxiety and depression, posttraumatic stress, behavioral disorders, and substance use problems. A recent study of teen mental health finds that, during the pandemic, students who felt close to people at school had significantly better mental health—for example, they were less likely to experience persistent feelings of sadness, and were less likely to seriously consider or attempt suicide—than those who did not feel close to people at school.
California’s recent multibillion-dollar investment in kids’ mental health services aims to increase the number of school counselors and provides grants to schools for suicide prevention and crisis response. These resources will build on other state efforts to establish a collaborative framework for making schools into “centers of wellness” and to fund partnerships between health and education agencies to deliver school-based mental health services to young people and their families. Since the mental health effects of the pandemic will likely be long-lasting, these investments in school services will be critical in addressing the profound effects of social isolation, widespread illness and loss of life, and potential economic hardship on adolescents.