Social media can sometimes damage the self-esteem of teen girls. stock-eye/iStock via Getty Images Plus
It’s a well-established fact that children’s and teens’ mental health took a hit during the pandemic. But new research suggests that teen girls in particular are suffering in unprecedented ways.
A survey by the Centers for Disease Control and Prevention that was published in early February 2023 found that, in 2021, 57% of high school girls reported experiencing “persistent feelings of sadness or hopelessness in the past year,” up from 36% in 2011. That’s nearly twice as high as the 29% of males who reported having those feelings in 2021.
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What’s worse, 30% of the girls surveyed reported seriously considering suicide and 13% attempted suicide one or more times in 2021. That is beyond shocking. It’s appalling.
We are a research team that studies children and their social and emotional development, and during the pandemic we’ve been specifically focused on mental health in children and adolescents. Since 2020, we’ve seen more changes in girls, overall, including increases in depression and thoughts of suicide.
In our view, a number of key factors have converged to create this mental health crisis in teen girls.
The stress experienced by teens is unique and significant.
A perfect storm of factors
Previous CDC research has shown that the COVID-19 pandemic disproportionately affected girls. And in a 2021 study that our team conducted with 240 teens, 70% of girls said that they “very much” missed seeing people during the pandemic, compared with only 28% of boys reporting that sentiment.
A second factor is social media, which can be a wonderful source of support but also, at times, a crushing blow to the self-esteem and psychological well-being of girls.
Finally, we think that all young people are struggling with issues like climate change and social upheaval. These aren’t just abstractions for many boys and girls: They are their future. Children and teens are usually neither indifferent to nor unaware of political realities.
So how can parents, teachers and friends help girls through this crisis?
Here are six strategies that research shows can work.
1. More emphasis on social support
Social and emotional connectivity between humans is likely one of the most potent weapons we have against significant stress and sadness. Studies have found strong links between a lack of parental and peer support and depression during adolescence. Support from friends can also help mitigate the link between extreme adolescent anxiety and suicidal thoughts. In one study of teens, social support was linked to greater resilience – such as being better able to withstand certain types of social cruelty like bullying.
2. Supporting one another instead of competing
During the 1970s and 1980s, competition between women was seen as something that held women back. Unfortunately, this message seems to have been lost in the tsunami of media coverage about bodies, looks and social achievement. Research has found that social media encourages competition between girls, particularly around their physical appearance.
Teaching girls at young ages to be cheerleaders for one another – and modeling that behavior as grownups – can help ease the sense of competition that today’s teens are facing.
3. Showcasing achievements
Thinking about your own appearance is natural and understandable. But an overemphasis on what you look like is clearly not healthy, and it is strongly associated with depression and anxiety, especially in women.
Adults can play a key role in encouraging girls to value other qualities, such as their artistic abilities or intelligence. Childhood can be a canvas for children to discover where their talents lie, which can be a source of great satisfaction in life.
One way that adults can help is simply by acknowledging and celebrating those qualities. For instance, at the Massachusetts Aggression Reduction Center, an organization we direct and manage that is focused on prevention of bullying and cyberbullying, staff members post female achievements – be they intellectual, artistic, scientific, athletic or literary – on social media channels every Friday, using the hashtag #FridaysForFemales.
This young woman once felt sad, anxious and trapped.
4. Empowering women
Girls look to grown women for examples of how they can behave and what they can do. You may not be the chief executive officer of a huge corporation, but maybe you are a wonderful teacher, or maybe you run a small business that provides an important product or service. Modeling pro-women attitudes means valuing all of the roles that people play in a society.
In addition, teaching the history behind women’s movements and other important steps toward equality, such as the women’s right to vote, is key to empowering girls to value themselves and their roles. Women played central roles in war efforts during World War II. Women have led social movements and fought for people’s rights. And women have been renowned scientists, writers, artists and experts in virtually every other profession you can name.
Marie Curie, seated, was a Polish-born physicist and pioneer in radioactivity. Together with her husband she won a Nobel Prize for Physics in 1903. Her daughter, Irene, standing in photo, won a joint Nobel Prize for Chemistry in 1935. Culture Club/Hulton Archive via Getty Images
5. An honest look at social media
Social media represents a unique form of human interaction that has taken on an outsize role in the lives of teens. This is magnified for teenage girls, for whom every social media interaction may feel consequential and potentially cataclysmic.
Interacting in a fun and positive way with peers on social media platforms can be a positive and affirming experience. On the other hand, seeing the things that others post, and comparing it with your own stuff, can make people of any age feel anxious about how they’re appearing, and whether they’re being socially included or excluded. This anxiety applies to both boys and girls, but the potential for emotional distress seems to be higher for girls.
Awareness of how social media has the capacity to influence your feelings and mental health seems to help people keep some distance from their interactions on social media. Adults can help girls by discussing with them how social media influences their feelings, their self-perception and even their body image.
6. Teaching kids to recognize their feelings
Learning to recognize and label feelings doesn’t come automatically for many people. The good news, though, is that kids can learn ways to help themselves when they’re experiencing anxiety or depression. Kids can learn to appreciate how hugging their dog, playing a board game, or talking with their parent(s) can help reduce anxiety, once they understand the feelings.
We think it’s worth noting that everything discussed here can also be helpful for boys, who are by no means immune to mental health problems. Encouraging achievement recognition, understanding how moods can be influenced by social media, and increasing support for both boys and girls is a positive step as we move toward a post-pandemic world.
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This article has been updated to correct Marie Curie’s place of birth.
The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
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6 stats that show which teens receive mental health services—and why
6 stats that show which teens receive mental health services—and why
As with most health care systems in the U.S., accessing quality mental health treatment is far from an equal-opportunity process. Factors such as access to wealth, insurance status, geographic location, race, and gender all affect who can receive mental health services and who can't. Unsurprisingly, many of these same barriers to healthcare access are stressors that have well-documented negative effects on people's psychological and physical health.
Young people struggle with mental health issues at exceptionally high rates, according to the Substance Abuse and Mental Health Services Administration. A SAMHSA report released in October 2021 found that an estimated 7.9 million U.S. teens ages 12-17 received some form of mental health service in 2020, though this number may likely fall far below the number who sought or needed care. The barriers to teens accessing mental health services are similar to those of adults, but the stakes of not receiving that care are even more dire: Teens and young adults have the highest suicide rates of all age groups.
Mental health care can include specialized services such as inpatient or outpatient visits with a private therapist or psychologist in a mental health clinic, hospital program, or residential treatment center. Nonspecialized services include school counselors or psychiatrists, school programs for kids with behavioral problems, pediatricians, juvenile detention centers or jails, and child welfare or foster care services. In 2020, 17% of teens received specialized mental health services, and 18% received assistance from a nonspecialized source, according to SAMHSA.
Charlie Health analyzed survey data from the 2020 National Survey on Drug Use and Health and SAMHSA to identify which teens received mental health services across the U.S. Survey data were collected via a mix of phone and in-person interviews, as well as online surveys.
The coordinated sample design is state-based with an independent, multistage area probability sample within each state and the District of Columbia. SAMHSA collects data about gender and sex based on the binary classifications "male" and "female," which excludes essential information about the mental health experiences of those who do not identify with those categories.
In this analysis, supplemental data for the mental health of LGBTQ+ teens are from a 2022 survey by The Trevor Project comparable to national probabilistic surveys like those used by the Centers for Disease Control and Prevention in its Youth Risk Behavior Surveillance System.
Read on to learn more about which teens are—and aren't—able to access mental health treatment and what barriers stand in their way.
2.4 million teens received specialty mental health services for feelings of depression
Mental health problems amongst teens have been on the rise for over a decade, according to CDC data. Between 2009 and 2019, persistent feelings of hopelessness and sadness amongst high schoolers increased by 40%, and suicide death rates for people ages 10-24 increased by around 47% on average from 2000 to 2018, according to a September 2020 CDC report.
Teens have cited academic and social pressures and cultural expectations around appearance as some of their top concerns, likely contributing to soaring rates of depression and anxiety. The COVID-19 pandemic also presented adolescents with unprecedented challenges, including a lack of socialization, less structured days, and a disturbing increase in emotional abuse from parents or guardians. Being unable to attend school was particularly impactful for those who were already in vulnerable circumstances, like unsafe home conditions or poverty.
One change in access to mental health services brought on by the pandemic was the rise of online therapy and other telehealth treatments. Though teletherapy existed prior to the pandemic, it exploded in popularity as lockdowns began and social distancing became vital.
In June 2020, roughly three-quarters of mental health providers practiced exclusively online. Now ubiquitous, online therapy has the potential to make mental health services more accessible for those who live in isolated geographic areas, have limited access to transportation, or have less flexibility in their schedules.
Teens from low-income households were least likely to receive mental health support
The link between poverty and poor mental health is cyclical, particularly in regard to accessing mental health services. Both young people and adults living in low-income households are at greater risk for mental health issues for reasons including deprivation conditions, increased risk of poor health, and social stigma and discrimination.
At the same time, accessing adequate mental health services as a low-income teen is more difficult than it is for other groups—in fact, teens living in poverty are the least likely to get mental health treatment. A variety of barriers block low-income young people from receiving care: high treatment costs, poor insurance coverage, limited provider availability, and not knowing what, if any, resources are available.
Teens in metro and nonmetro areas received mental health support at similar rates
Around 17% of young people in large metro areas received mental health care in 2020, compared with 18% in small cities and 16% in nonmetro areas. However, there was a disparity between teens in entirely rural areas and those in urban areas. In 2019, only 13.6% of rural young people received specialized mental health services, compared to 16.8% in large metros. (For entirely rural areas, 2020 data was not offered due to low precision that was likely a result of the COVID-19 pandemic and its related social distancing restrictions.)
The access gap in mental health treatment between rural and urban areas has been well documented—so much so that some researchers have put out calls to action to remedy the disparity. A couple of causes of the gap range are fewer providers in rural areas and fewer resources among those seeking care. Teens in rural areas are particularly vulnerable to this limited access since many mental health providers who specialize in working with young people are more concentrated in urban areas.
Girls were almost twice as likely to receive mental health care as boys
The gender gap in teen mental illness has been observed globally, with adolescent girls reporting greater rates of mental health issues than boys in most countries. While the size of the gender gap varies significantly between nations, studies have shown that wealthier Western countries have poorer mental health outcomes and a larger gender gap than low- and middle-income nations. In the U.S., 65% of teens who received mental health care were female, while only 35% were male.
While explanations for the gender gap are generally inconclusive, researchers have hypothesized that it could be partially explained by adolescent girls experiencing disproportionately higher rates of sexual violence compared to boys. Sexual violence and trauma are factors that significantly impact psychological health and wellness.
Some studies caution against taking higher reported rates of mental health issues amongst teenage girls at face value, however. A 2022 study published in Child and Adolescent Psychiatry and Mental Health found teen boys often underreport symptoms of mental illness or act out behaviorally rather than internalizing their feelings. The report points to masculine-gendered socialization being frequently at odds with internal emotional reflection. This finding also suggests that more adolescent girls receive mental health treatment and diagnoses than boys.
Only 6% of Asian American teens received specialized mental health services
Many barriers prevent nonwhite teens from accessing mental health treatment. Interwoven systemic issues like racism and poverty negatively influence the mental health of young people (and adults), increasing their likelihood of experiencing violence, discrimination, and trauma. At the same time, these systemic problems make it more difficult for young people to access treatment services for reasons including affordability and availability of care.
These are not the only obstacles Black, Latino, Asian, and Indigenous youth face when trying to access mental health care, however. A Journal of Clinical Child & Adolescent Psychology study found that minority teens are less likely to receive evidence-based, culturally competent care.
Both general and specialized mental health services and resources have not historically been distributed equitably, creating disparities that disproportionately impact communities of color. Meanwhile, white youth have significantly higher access rates to these resources. Mistrust of medical institutions, cultural stigma (which tends to affect Asians more deeply compared to other communities), and other negative attitudes toward mental health treatment can also impact young people's access to services.
Of the 82% of LGBTQ+ youth who wanted mental health care in the past year, more than half were unable to get it
LGBTQ+ teens experience high rates of mental health issues for reasons including societal marginalization, discrimination, and legal barriers to receiving affirming health care. According to The Trevor Project's 2022 National Survey on LGBTQ Youth Mental Health, nearly half of LGBTQ+ young people seriously considered suicide in the past year. Mental health outcomes were significantly better when queer youth felt supported and accepted at home or school.
For transgender and nonbinary teens, in particular, receiving gender-affirming health care decreases adverse mental health outcomes like suicide, self-harm, and psychological distress. Recent legislative measures in multiple states targeting affirming health care for trans youth, in addition to economic and social barriers, have impacted the accessibility of this type of treatment, particularly for low-income LGBTQ+ teens and queer youth of color.
LGBTQ+ young people also face barriers when seeking out mental health services. Along with financial and social obstacles, many LGBTQ+ teens struggle to find a mental health care provider who practices culturally competent, evidence-based, specialized care.
This story originally appeared on Charlie Health and was produced and distributed in partnership with Stacker Studio.
