Young people in the U.S. are experiencing a mental health crisis. Reports from the surgeon general, the American Academy of Pediatrics and the American Psychological Association highlight the catastrophe, with families and children trying to get a moment with overwhelmed counselors, psychologists or social workers.

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Is this crisis caused by the pandemic? No. Those of us monitoring the health and well-being of youth know this storm began years ago. In 2022 we continue to fund a children's mental health system based on the needs of adult war veterans.

Scientific advances have identified effective school-based mental health practices, such as emotional-regulation training that teaches children how to cope with strong feelings, or screenings to detect mental health crises before they occur. These insights and practices have largely been ignored. Now is the time to act on them. Long-disproved theories of physical and mental health as being two independent systems have motivated the annual investment of billions in medical research and physician training, but staggeringly few resources are available to advance psychological science or a mental health workforce.

The need is clear. Data from the Centers for Disease Control and Prevention, where one of us (Ethier) is director of adolescent and school health, reveal that in 2009–2019, a remarkably high number of young people reported feeling severe emotional distress. Specifically, in 2019, 37 percent of high school students surveyed felt so sad and hopeless they couldn't participate in regular activities, about one in five seriously considered suicide, and about one in 11 attempted suicide.* Adolescent girls and youth who identified as lesbian, gay, bisexual or transgender or who were questioning their identity were overrepresented among those who considered or attempted suicide.

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The CDC's Adolescent Behaviors and Experiences Survey, the first nationally representative survey of U.S. high school students during the pandemic, revealed that young people's lives were extremely disrupted. Almost a quarter of U.S. youth told us they experienced hunger; more than half had been emotionally abused by an adult in their homes. More than 60 percent of Asian students and more than half of Black students encountered racism. Emotional distress and suicidal thoughts and behaviors continued to worsen and were more significant among female and LGBTQ students.

The way forward can be found in science-based psychosocial approaches that one of us (Prinstein) and our psychologist colleagues have developed over recent decades. We have identified effective methods to prevent emotional or behavioral distress by teaching children skills to cope with stressors, develop healthy social relationships and spot depression warning signs. For instance, during the pandemic, students who felt connected to others in school were less likely to experience indicators of poor mental health, as well as suicide plans and attempts.

Before the pandemic, by 2018, 79 percent of high schools identified safe spaces for LGBTQ youth, 96 percent had antiharassment policies and 77 percent had inclusivity professional development for staff. Many schools also had inclusive, student-led clubs. Recent CDC research found that having such policies and practices improved mental health not only for LGBTQ students but for all young people. Similar results from antiracism programs make schools less toxic for historically marginalized youth and improve the health and well-being of all students.

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These approaches are not controversial. Methods to increase connectedness include classroom-management techniques that reinforce attentive, cooperative and collaborative behaviors, reduce peer victimization, and help youth understand how others feel and behave. Psychological prevention strategies can teach youth how to less frequently blame themselves for harsh experiences, help peers feel valued and included, and consider adaptive and healthy responses, even when confronted with aggression.

These programs require a commitment to the science of behavior and the deployment of innovative initiatives. And they need resources—to deploy these prevention approaches at scale and among populations most at need. Failure to address this mental health crisis will result in not only the distress of millions of U.S. youth today but a change in the productivity, success and wellness of U.S. citizens at large as this generation matures.

*Editor’s Note (11/7/22): This sentence was edited after posting to correct the description of high school students in a 2019 survey.