Depression and suicidal activity have decreased slightly for teens since 2021, but simultaneously there have been alarming increases in violence, bullying and school avoidance, according to the Centers for Disease Control and Prevention.
In 2023, two in ten teens were bullied at school and one in ten did not attend due to safety concerns, 4% increases since 2021. Two percent more were injured or threatened at school. About one in ten experienced sexual violence, roughly the same amount as two years ago, according to 20,000 high schoolers surveyed nationwide for the latest iteration of the CDC’s Youth Risk and Behavior survey.
For the first time, the CDC’s 2023 survey prompted teens to reflect on racism, unfair discipline and social media use. Nearly one third of students reported being “treated badly or unfairly at school because of their race or ethnicity” by educators or peers.
Some key indicators show “progress” in combatting the youth mental health crisis: About 10% of Black students reported attempting suicide in 2023, down from 14% in 2021. At the same time, fewer female and Hispanic students seriously considered suicide or experienced persistent sadness or hopelessness in 2023 than in 2021. But roughly half of both groups still experience depressive symptoms, and at rates higher than national averages.
“The data released today show improvements to a number of metrics that measure young people’s mental well-being – progress we can build on. However, this work is far from complete,” said Debra Houry, chief medical officer with the agency, in a press release last week. “Every child should feel safe and supported, and CDC will continue its work to turn this data into action until we reach that goal.”
Only about half of teens felt close to people in their school, with key demographic groups reporting being especially vulnerable: Girls, LGBTQ and Native youth were forced into or experienced risky behavior more than their peers across nearly all metrics, including substance use, physical and sexual violence, depression, and suicidality.
The general rise in aggressive behavior, while concerning, is not particularly surprising to experts.
“We are still seeing a long-tail of effect from the height of the pandemic with kids having been isolated… The ninth grader of today is still a bit less mature, not as good at problem solving, not as clear in their communication with peers, especially when it comes to conflict,” said child psychologist and Boston-area schools consultant Deborah Offner.
Students’ sexual activity and drug use overall mirrored rates from 2021, significantly declining over the last decade. Fewer teens have ever had sex, from about half to one in three. But those that have engaged in more risky behavior: fewer used condoms or were tested for STIs.
While overall declines in depressive symptoms and suicidality are not “giant,” said Offner, “as we emerge from the depths of the COVID-19 pandemic, kids in my orbit are overall doing better on average than they were a few years ago. Most of that is [thanks to] the reentry into the social environment of school and activities.”
Recommending stronger health education and opportunities for young people to build relationships, belonging at school, the CDC urged schools to prioritize adolescent well-being. Some ideas for schools include facilitating mentorship or advisory opportunities for older students to be role models for younger students, who may be feeling lost in their first years in high school, and training all school staff to be strong listeners, “because you never know who a kid is going to tap into,” Offner said.
Below are five key findings from the report:
1. Violence and bullying increased 2% and 4%, respectively, from 2021 to 2023, with about one in ten avoiding school for safety concerns and two in ten being bullied.
Sexual violence was as prevalent in 2023 as it was in 2021: roughly one in ten teens. Girls and LGBTQ youth were more likely than their peers to experience sexual and physical violence.
The frequency of bullying at school, students report, increased 4% since 2021, bumping back up to pre-pandemic levels. LGBTQ students experienced bullying the most of any subgroup, with three in ten having been bullied and two in ten missing school because of safety fears.
2. 2023 saw a 2% decline in the share of kids persistently sad, hopeless or making suicide plans, but significantly more experience depression symptoms than did in 2013.
Four in ten teens on average reported consistent depression symptoms, up from three in ten just a decade ago. While 4% fewer girls experienced such symptoms than and 3% less seriously considered suicide than in 2021, the proportion of girls experiencing depressive symptoms is much higher than their peers: over five in ten, 53%.
Among LGBTQ youth, six in ten felt persistently sad or hopeless, and two in ten attempted suicide.
Offner said while social media is often scapegoated as the core driver of depressive symptoms, the most common reasons youth cite as causes of internal conflicts are family or friend-related, like witnessing parents’ economic uncertainty or emotional instability, and working through friendship disagreements.
Many, she added, are also feeling climate anxiety and worried about material needs more than other generations – their parents placing intense pressure to succeed academically and go onto lucrative careers.
However social media does serve as a “social comparison accelerator,” she said, where teens may compare themselves to others or feel bad about being excluded from activities.
Native teens – the subgroup spending least amount of time on social media according to the CDC, with about half using it several times a day – are still the subgroup experiencing highest rates of poor mental health and persistent depressive symptoms.
3. One third of teens experienced racism, and nearly two in ten reported being unfairly disciplined.
With the CDC asking for the first time, 32% of high school students reported being “treated badly or unfairly in school because of their race.” Asian, multiracial, and Black students reported this more often than peers, at 57%, 49%, and 46% respectively.
On average, 19% of teens were “unfairly disciplined” at school in 2023, with male, Native, Black and multiracial students reporting at a rate 3-13% above average. One in three Native youth reported being unfairly disciplined, more than any other race or ethnicity.
4. No significant changes in teens’ sexual behavior since 2021. Overall, students are having less sex than in 2013.
While three in ten teens reported having had sex, down from about five in ten a decade ago; only a third used some form of oral birth control, and half used condoms.
Six percent of teens polled had four or more sexual partners in 2023, compared to 15% the decade prior.
Some reasons for the decline may be increased immaturity, said Offner, which is impacting kids’ relationship experience. She has also witnessed more young people express ownership of their bodies and wanting to go slowly in their sexual experiences, “I think they’re learning from the mistakes of previous generations, too.”
5. Alcohol, marijuana, and illicit drug consumption is declining. But vulnerable student populations — LGBTQ, Native youth, and girls – used more than their peers.
In 2023, about 22% of teens reported drinking alcohol, a significant decrease from 35% ten years prior. The number is slightly higher for girls, with about one in four drinking. While the proportion of Black kids drinking increased from 2021 to 2023, their rate is still under average, at 17%.
Roughly the same amount used marijuana as did two years ago, about 17%, down from 23% in 2013.
Only about one in ten used illicit drugs, like psychedelics and stimulants, or misused prescription opioids. Teens’ illicit drug use has declined 6% overall in the last decade.
Offner observed teens today are a little more health cautious, and have witnessed more siblings and peers practice sobriety intentionally. “It’s much more acceptable to say that you don’t use them or aren’t interested in using them,” she added.
If you or someone you know is having thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline. Additional resources are available at SpeakingOfSuicide.com/resources. For LGBTQ mental health support, you can contact The Trevor Project’s toll-free support line at 866-488-7386.