CDC says teen girls facing record levels of sadness, violence: Warning signs to know

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Teen girls are experiencing record-high levels of sadness, violence and suicidal behavior, and LGBTQ+ youth are facing increased distress and hopelessness, according to a new report from the U.S. Centers for Disease Control and Prevention.

While all teens reported increased mental health challenges in 2021, the data show that adolescent girls across the U.S. are bearing the brunt of a national youth mental health crisis, experts say. The findings were published in the CDC’s Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021.

“America’s teen girls are engulfed in a growing wave of sadness, violence and trauma," Dr. Debra Houry, CDC’s chief medical officer and Deputy Director for Program and Science, told reporters in a CDC media briefing on Feb. 13. Over the past decade, teen girls have experienced dramatic increases in violence, poor mental health and suicide risk, Houry added.

In 2021, 57% (or about three in five) teen girls in the U.S. felt persistently sad or hopeless — double that of boys — which represents a nearly 60% increase since 2011 and the highest level reported over the past decade, according to the CDC. Additionally, 30% of (almost one in three) teen girls seriously considered attempting suicide in the last year, the report found.

"These data are hard to hear and should result in action. ... As a parent to a teenage girl, I am heartbroken (and) as a public health leader, I'm driven to act," Houry said.

Overall, 32% of all high school students surveyed experienced persistent sadness and hopelessness, and 10% attempted suicide in the last year, Dr. Kathleen Ethier, director of the CDC’s Division of Adolescent and School Health, told reporters at Monday's briefing.

The CDC has conducted the Youth Risk Behavior Survey every other year since 1991 among a nationally representative sample of high school students across the country, per the CDC.

“The YRBS provides data on key behaviors and experiences among adolescents related to sexual behavior, substance use, experience of violence, mental health and suicidality,” Houry explained.

The findings from 2021 are the first YRBS data presented since the start of the COVID-19 pandemic.

Teen girls are facing unprecedented levels of sadness and violence

"Although we have seen worsening trends and mental health for young people over the last 10 years, the levels of poor mental health and suicidal thoughts and behaviors reported by teenage girls are now higher than we have ever seen," Ethier said.

The data also showed record-high levels of violence among teen girls in 2021, per the CDC. About 18% or one in five teen girls experienced sexual violence in the past year, which is a 20% increase since 2017, when CDC started monitoring this measure, according to Ethier.

More than 14% of teen girls reported that they had been forced to have sex at least once, the report found. "That number jumped from 11% to 14% from 2019 to 20121, in just two years. ... This is truly alarming," Ethier said. "For every 10 teenage girls you know, at least one of them and probably more has been raped."

The findings are very concerning but also not surprising, Dr. Anish Dube, chair of the American Psychiatric Association's Council on Children, Adolescents and Their Families, tells

“These trends we have been observing clinically, and this CDC report confirms what we’ve been experiencing,” says Dube, adding that experts have been warning of a pediatric mental health crisis since last year.

Many of these mental health trends and concerns among teens existed before the pandemic, says Dube, but COVID-19 "blew the lid off" — and school and social interactions shifting from in-person to virtual and back has been a major challenge. "That socialization that was missing, and now how do you re-socialize in a world that's rapidly changing?" Dube adds.

However, the findings highlight that two groups — teen girls and sexual and gender minorities — are the most vulnerable, says Dube.

LGBTQ+ students remain at high risk

The report findings confirm ongoing trauma and poor mental health outcomes among LGBTQ+ teens, the experts say. "Unfortunately, as we’ve been seeing for many years, LGBTQ+ students continue to be at high risk for experiencing violence and suicide," Ethier said.

Nearly 70% of LGBQ+ students experienced persistent feelings of sadness or hopelessness during the past year, the report found, and one-third were bullied online. "Tragically, nearly 25% or one in four attempted suicide," Ethier added.

“These alarming data further emphasize what we already knew to be true: queer students face disproportionate rates of victimization, and this directly contributes to their higher rates of poor mental health and suicide risk," Dr. Ronita Nath, Vice President of Research at The Trevor Project, tells in a statement.

Queer students are not inherently prone to these challenges because of their identities, Nath says, and schools must be safe places where all students can learn instead of a source of bullying and discrimination.

Schools are a lifeline for struggling youth

The CDC report highlights the urgent need for action at all levels, the experts say. "We must meet youth where they are and provide the tools and resources that are needed for lasting change," said Houry, adding that many of these challenges are preventable.

Schools, which are on the front lines of the mental health crisis, must be equipped with tools to help students, the experts say.

"We suggest that our schools start by educating their staff and their families on what mental health is, what supports are available and how they can access their services," Anna King, President of the National PTA, told reporters at the Feb. 13 CDC media briefing.

This includes teaching about social and emotional learning, connecting students with counseling and providing families with tools to have mental health conversations at home, King added.

The experts also call for increased training for teachers to manage mental health problems they encounter in the classroom, said Ethier. "Schools should also provide high-quality health education that teaches skills like understanding sexual consent, managing emotions, and communication — these are critical lifelines for students," Ethier explained.

Federal investments are crucial to make this happen and ensure all children succeed, said King.

“Schools need to take action, but I also think that we need to put resources into schools,” says Dube.

“Our governments and school officials must respond to this public health crisis with comprehensive suicide prevention strategies tailored to meet the unique needs of students who are LGBTQ and/or are people of color,” Nath adds.

Warning signs parents should look out for

The experts urge families and guardians to engage in routine, open conversations with their children about mental health and look out for warning signs.

"It's critical to talk with our children about what they're feeling and their concerns. ... These conversations will help parents figure out what's going on emotionally and show (children) their feelings matter," said King.

Parents should try to keep an "open door" and remain curious without being too intrusive, offers Dube, especially with teenagers. "The tricky thing is that while they need the support and they’re still dependent on their parents, teenagers are also learning to be independent so they might seek some distance," Dube explains.

When it comes to warning signs, Dube says to watch out for any abrupt changes.

"An introverted shy child is not necessarily a red flag, but if you have an outgoing child, then all of a sudden they're closed off ... that's something to watch out for," Dube adds. Parents should also be mindful of any changes in their child's eating or sleeping habits, social life and performance in school.

If you're concerned your teen won't talk to you about their feelings, don't hesitate to ask for help from another adult whom they trust. "You want to know that there’s at least one adult figure in that young person’s life that they can turn to if they’re not feeling well," whether that's a counselor, coach, teacher or doctor, Dube says.

If you have any doubts about your child's well being, contact their health care provider.

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