Understanding the teen mental health crisis

The COVID-19 pandemic may be receding as a matter of intense public concern, but one bit of fallout is receiving a lot of attention: A crisis of mental health among American teens. "The pandemic era's unfathomable number of deaths, pervasive sense of fear, economic instability, and forced physical distancing from loved ones, friends, and communities have exacerbated the unprecedented stresses young people already faced," U.S. Surgeon General Vivek Murthy warned in December.

The numbers back up this sense of alarm. The Centers for Disease Control said in March that four in 10 teens feel "persistently sad or hopeless," Moriah Balingit writes in The Washington Post, and one in five have contemplated suicide. While young people largely escaped the COVID-19 deaths that afflicted older generations, "they might still pay a steep price for the pandemic, having come of age while weathering isolation, uncertainty, economic turmoil, and, for many, grief." What is behind this epidemic of teen sadness, and what can be done about it?

It's not just a pandemic thing…

Over the last three decades "anxiety, depression, suicide, and self-harm have soared" among teens, says Matt Richtel in the New York Times. "In 2019, the American Academy of Pediatrics issued a report noting that 'mental health disorders have surpassed physical conditions' as the most common issues causing 'impairment and limitation' among adolescents." That predates the pandemic, and it means there needs to be a close examination of other possible factors — including, yes, social media. (Whistleblower Frances Haugen disclosed last year that Facebook's internal research showed that teens blame Instagram for their depression.) "Lifestyle changes have led to declines in sleep, physical activity, and other healthful activities among adolescents." One other possible problem: Having meaningful relationships. "This generation professes to feeling particularly lonely," Richtel adds, "a major factor in depression and suicide."

…but the pandemic (and school closures) probably made it worse

With schools mostly closed for much of 2020, the pandemic "limited kids to their home — which wasn't always a safe place," Taylor Leamy writes at CNET. Young people had to deal with their loved ones' stress over illness and losing jobs to lockdowns, or had no way to escape abusive situations. LGBT youth in particular reported higher rates of emotional abuse from their parents. The recent CDC data suggests "that school can act as a protective layer for students and their troubles." That protection was rarely available during the depths of the COVID-19 crisis. "Virtual school was tough on kids, as anyone who went through it knows," Leamy goes on. "It compromised their ability to connect with their teachers and other students."

Maybe the federal government should step in

Congress recently held hearings on the Platform Transparency and Accountability Act (PATA), writes Alexander Danvers in Psychology Today. The act's provisions include measures to "increase transparency in social media platforms and to give researchers access to critical data collected by these platforms." That would help experts understand just how much platforms like Facebook, Instagram and the rest affect teen mental health. While it's true that "teens using more social media are more likely to be depressed," it's another thing entirely "to really establish that social media causes depression." The best way to get at the answer? Start "running experiments where we randomly take away some teens' social media access for a period of time."

The good news is that some of the federal government's pandemic assistance is already going towards addressing the problem, Christine Vestal reports for the Pew Charitable Trusts. "States are responding" to an influx of $190 billion in education and health grants from Washington D.C. "Last year, 38 states enacted nearly 100 laws providing additional resources to support mental wellbeing in K-12 schools" and mostly they "aim to upgrade school mental health resources and create comprehensive plans to prevent teen suicides and promote child mental wellbeing."

Mental health is just as important as physical health

When a child has a cough or a broken leg, says Dr. Claire McCarthy at Harvard Health Publishing, parents often contact a doctor or nurse for guidance. But if a teen seems sad or disengaged, those same adults "tend to think of it as a phase, or teen angst, or something else that can be ignored." Bad idea. "Not only does mental health affect physical health, but untreated mental health problems interfere with learning, socialization, self-esteem, and other important aspects of child development that can have lifelong repercussions." If you see something, do something. "Call your doctor. Don't put it off."

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