Adolescent Mental Health and Well-Being

Adolescents’ mental health challenges grew steadily worse in the decade before the COVID-19 pandemic. These challenges included family losses, economic stress, and the effects of racial- and identity-based discrimination and gun violence.

In response, Governors launched the 2022-2023 NGA Chair’s Initiative on Strengthening Youth Mental Health. Learn more here.

Adolescence

Adolescence is a time of rapid physical and cognitive development. It is a natural phase when adolescents test boundaries, explore their identity and develop ideas for their adult selves. However, if they experience severe adversity, are under pressure to conform and spend too much time on social media, it can impact their mental health.

Emotional disorders such as anxiety and depression are more common in this age group. They can also be at higher risk for suicidal thoughts and actions. They may also be more likely to abuse alcohol or drugs. This can lead to poor school performance and social withdrawal. A renewed sense of egocentrism can also occur.

Addictions

Addiction is a complex disease that impacts all areas of life. It changes both brain structure and function, just like heart disease or diabetes. It causes many youth to have trouble in school or with relationships and often leads to dangerous behaviors such as drug and alcohol use, poor health and even suicide.

The most impactful solutions to strengthen youth mental health draw on the expertise of many state agencies, including education, insurance regulators, workforce boards and social safety net programs. These are the agencies that typically serve youth and families, but coordination across these systems can be key. For example, universal availability of mental health screenings can help identify underlying conditions and connect youth to care.

Adversity

Adversity is a significant factor in mental health challenges, contributing to feelings of hopelessness and despair among young people. It can also lead to unhealthy or damaging behaviors that exacerbate their mental health issues, such as substance use, self-harm, and suicidal thoughts.

A recent study found that childhood adversity is highly prevalent in youth who are registered for mental health care, and that multiple adverse experiences show a graded relationship with internalizing problems (such as depression or anxiety) and post-traumatic stress symptoms.

Participants discussed how to build resilience in youth by promoting positive social environments, strengthening education and ensuring access to mental health services. They also focused on reducing social, self and structural stigma, and expanding training and support for those who interact with youth daily, including caregivers and educators.

Discrimination

Many youth experience discrimination, leading to poor mental health outcomes such as depression, anxiety and suicidal thoughts. Studies show that experiences of discrimination are negatively associated with health behaviors and indicators of physical health, including adherence to medication regimens and utilization of care.

In New York, Governor Hochul hosted a series of youth listening sessions and a spring summit to explore issues impacting youth mental health. At the event, young leaders joined New Jersey, North Carolina and North Dakota First Spouses, along with policy and subject experts, to discuss how States can expand access and quality of youth mental health services.

Family Issues

The state of mental health among young people is a complex interplay of many factors, with family issues playing a key role. In families where open communication, emotional support and understanding exist, youth develop resilience and have the resources they need to overcome mental health challenges.

Unfortunately, much of the typical dialogue around this crisis overlooks vital contributing and preventive factors that could significantly improve the situation. These include addressing family dynamics that can contribute to anxiety and depression, improving education on how to recognize mental health challenges in children and teens, and expanding training for those who interact with youth daily. Civic institutions like schools, churches and communities can also have a powerful influence on youth mental health.

Friendships

Friendships play a significant role in adolescents’ lives and are a primary source of support during mental health crises. However, studies on friendship-based interventions have been sparse. Most interventions focus on teaching individuals about the signs of mental illness and improving their help-seeking attitudes. Additionally, some studies use peer mentoring programmes to improve adolescent mental health and well-being.

Interventions using avatar-based training and virtual peers report positive outcomes, including improved help-seeking attitudes, knowledge of symptoms, and confidence in supporting a friend in distress. Other interventions, such as BRAVE, use text messages and role-model videos to promote mental health among Native youth. These interventions have been shown to be effective in reducing depressive symptoms and improving school connectedness.