Mental Health and Adolescence

youth health mental

Many youth are facing new and complex stressors. They’ve experienced the COVID-19 pandemic, family losses, and financial challenges. They’ve been exposed to racial and identity-based discrimination, gun violence, and environmental triggers such as natural disasters, global unrest, and climate change.

These factors have contributed to a growing demand for mental health care that exceeds the capacity of traditional services to respond.

Adolescence is a time of growth and change.

Adolescence includes remarkable changes in the body, brain, and emotions. These transitions prepare young people for adulthood and give them opportunities to choose the path they want for their future. But some risk factors, like bullying, a lack of supportive relationships and structures, harsh parenting, or poverty can lead youth down a different path.

This year, we’ve seen an alarming rise in mental health symptoms among our city’s teens. The number of adolescent girls reporting anxiety or depression has been particularly high. It’s possible that increased stress from a number of sources is contributing to these symptoms—such as social isolation during the COVID-19 pandemic, economic hardship, and family loss or disruption.

Fortunately, we’ve also seen youth build resilience and find hope. Some teens have begun volunteering at a crisis hotline or a shelter; they’ve started to talk openly about their mental illness. And many are getting better care and support—including treatment, peer-to-peer support groups, and more.

It’s a time of uncertainty.

As they enter adolescence, young people are adjusting to new environments and responsibilities. These changes can be challenging for any individual, but can also lead to increased stress and anxiety. This is a perfect time to promote mental health, and to provide avenues — in digital or in person — where youth can seek help and find comfort.

This is especially important because research shows that the same prevention strategies that promote mental health, like helping teens feel connected to school and family, can prevent a range of negative experiences, from drug use to violence. And because adolescence is when many health behaviors are established that will carry through adulthood, the stakes are high.

Despite the positive trends, young people face unique challenges because of stigma. This stigma is pervasive in the home, in schools and in places of worship. It is also exacerbated when youth experience multiple forms of disadvantage, including trauma, poverty, mental illness and intersectional identities.

It’s a time of transition.

Adolescence is a time when behaviors, habits and beliefs that impact adult health are established. Those include mental health, substance use, sexual health and risk behaviors that can lead to HIV and unintended pregnancy. Many of these behaviors are preventable when young people feel connected to school and family.

Several youth described experiencing overlapping symptoms of MH problems, including anxiety and depression, delinquent behavior and physical or verbal aggression. Youths with fewer resources and those who live in more rural areas have limited access to information, therapists or support services.

Many of those with a mental illness have difficulty finding treatment that is accessible and affordable. In addition, for some young people, stigma is a barrier that prevents them from seeking help. Fortunately, there are signs of progress. For example, some states have expanded Medicaid-eligible children’s behavioral health services without requiring a mental health diagnosis. They have also implemented strategies like school-based programs, telehealth and integrated care for youth.

It’s a time of vulnerability.

During this stage, young people are prone to mental health challenges that may go undiagnosed and undetected. In fact, during the first stretch of the COVID-19 pandemic in 2020, New York youth showed alarming spikes of anxiety and depression.

A strong support system and access to care are critical to maintaining good mental health. This includes family, friends and community members; a supportive school environment; access to resources such as telehealth, counseling and social services; and culturally sensitive mental health information and interventions.

But stigma and a lack of information prevent many teens from getting help. In their 2022 essays, some described being hesitant to discuss mental illness with parents and teachers; feeling that they had to suffer in silence or be labeled as “crazy.” They also reported that schools often offer limited or outdated mental health information. This is why NIH created Youth Mental Health First Aid, a training program that teaches parents, caregivers, teachers, school staff, peers and neighbors how to help a youth in crisis or non-crisis situations.