Commentary on CDC Report Finds Alarming Levels of Mental Health Symptoms in High School Students

By Alexandra Werntz, Ph.D.

On February 13, 2023, the Centers for Disease Control and Prevention  results of a survey conducted with American high school students in the fall of 2021. According to the data, the kids are not alright.  

More specifically, the report highlights three major takeaways: 

  • “New CDC report raises urgency to invest in schools as a vital lifeline to help struggling youth 
  • Teen girls are experiencing record-high levels of violence, sadness, and suicide risk 
  • LGBQ+ teens continue to face extremely high levels of violence and mental health challenges”

Although the report covers important health-related findings, including sexual health, substance use, and experiencing violence, I wanted to share my thoughts on the mental health results. As a clinical psychologist and therapist to some pretty amazing young people, these findings hit home. And, as the Associate Director of the Center for Evidence-Based Mentoring, these findings highlight how trusted adults can support the mental health and well-being of our youth. The data from this report are clear – teens are suffering. In this nationally-representative sample of high schoolers in the US, 57% of high school girls reported persistent feelings of sadness or hopelessness during the past year. This is up from 36% in 2011. Boys aren’t heading in the right direction either. Compared to 21% in 2011, 29% of high school boys report feeling persistent feelings of sadness or hopelessness during the past year. These findings are mirrored when breaking findings down by racial and ethnic groups; across all racial and ethnic groups, high schoolers are more frequently reporting experiencing sadness. Sadly, more and more youth are seriously considering suicide; 30% of girls and 14% of boys reported seriously considering suicide in the last year. And, 24% of girls and 12% of boys reported making a suicide plan in the past year. Across the board, young women and men are seriously struggling in the wake of the pandemic.  

The data are even bleaker when considering sexuality. Compared to 35% of heterosexual teens, 69% – the vast majority! – of lesbian, gay, bisexual, and questioning teens reported persistent feelings of sadness or hopelessness during the past year. These students are also more likely to consider suicide, with 45% thinking about suicide as an option and 37% creating a plan for suicide. It is important to note a major limitation of the data in that the researchers did not ask about gender identity, so we cannot speak to the mental health of youth who identify as trans based on this data. However, we can guess that trans youth are also struggling at similar levels, if not more so.  

This is not a thorough review of the findings, but I wanted to highlight the staggering rates of sadness, hopelessness, and thoughts of suicide in our teens. Although I hope that these rates have fallen in the past year-and-a-half since these data were collected, we can still assume there are high rates of youth who are struggling. And unfortunately, there are not enough highly-trained school counselors, therapists, and psychiatrists to effectively treat all of these teens.  

What can mentors do?  

There have been calls for mentoring programs and other paraprofessional organizations to step up and target the youth mental health crisis head-on (McQuillin et al 2022). As the CDC report indicates, caring adults such as mentors can be instrumental in helping youth feel connected to others and their community, which can buffer against these negative mental health outcomes. As many readers of the Chronicle know, mentoring programs broadly produce relatively modest effects on youth outcomes. However, the effect sizes nearly double when programs are targeted toward improving specific youth outcomes (Christensen 2020). Recent work from our team also highlights the importance of balancing youth voice with encouraging working towards specific goals as an optimal balance in approach to youth mentoring relationships (Werntz et al 2023)). Thus, if mentoring programs and organizations want to support the mental health crisis in an evidence-informed way, we have a few concrete recommendations.  

First, mentors need basic mental health training and ongoing supervision.  

The evidence is clear: many youths are struggling. And, the youth who are enrolled in mentoring programs likely experience a greater frequency of mental health challenges than the nationally-representative sample (Jarjoura et al., 2018). Thus, for mentors to be effective in supporting mental health, mentors need to understand the basics of common mental health challenges among youth and how to support youth in expressing their feelings. Mental health challenges can worsen when youth do not understand how to express feelings in a safe way or to a safe adult; thus, having a trained and supervised caring adult in their life might mitigate some of this distress and may offer struggling youth an outlet. Mentors are more effective when they receive ongoing training and supervision from staff who are prepared to support mentors as they support youth with mental health challenges. We recommend programs partnering or contracting with folks with mental health training and licenses in order to provide oversight and consultation when these issues arise.  

Second, mentors can serve as low-intensity mental health support. 

Stepped care models (i.e., a staged approach to delivering health services based on the severity of symptoms or impairment in functioning) can help bridge gaps in treatment, and mentors can be part of this.  of treatment exist outside of the US, with notable examples in the UK and Australia. In these models, folks are linked with the care that is appropriate for their current level of severity. For example, for individuals who are basically doing well but want to work on improving their overall well-being or who have specific health goals (e.g., improving sleep or exercising more), low-intensity and self-motivated interventions are a good first step. These individuals might consider a brief behavioral health appointment or use an evidence-based digital mental health application like Headspace. However, low-intensity interventions are not appropriate for all situations. On the other hand, an individual in a mental health crisis might need to be seen in an emergency room or need hospitalization. Thus, the care is triaged based on need. Mentors can be a part of this stepped care plan for mental health treatment. For mentors who are trained to support youth mental health and emotional expression, they may be the “first line of defense” for youth who are struggling. Mentors can also support the use of evidence-based technology-delivered interventions, so they don’t even have to teach the skills but instead can support the translation of skills from the application to the real world (Rhodes, 2020). And, if a mentor isn’t able to provide adequate help, the youth may need to be sent to a provider with more extensive training in providing clinical interventions. However, it is possible that many youths will experience benefits from low-intensity support like having a mentor. Mentors are obviously less expensive and also may be seen as more palatable (and culturally congruent) compared to therapists, too (Vázquez & Villodas, 2019).  

Third, mentors can extend the effectiveness of existing treatments.  

Mentors can also support youth who are already receiving traditional mental health services. In fact, our team is currently testing a model where trained mentors are embedded within the youth’s mental health care team with their therapist. Between therapy sessions, the mentor’s job is to review the skills from the previous therapy session and help the youth implement those skills into their daily life. This is called supervised practice, and mentors have the unique ability to exist in their mentee’s world in ways that therapists cannot; thus, they can support the use of skills in the youth’s real world. Stay tuned for our findings in the future! Similar models can also be found across the US, with a notable example in Massachusetts where community health workers can specialize in therapeutic mentoring. Individuals in this role are embedded within the youth’s care team and support a treatment plan developed by the youth’s clinician. Therapeutic mentors are trained, supervised, and are largely covered by healthcare plans. We are excited to see how this model can grow and evolve over time.  

Take away: Mentors can serve as caring, supportive adults in youths’ lives 

Although the CDC report focuses on how schools can serve as the context to improve the mental health of youth, we wanted to highlight the role that mentors can play. Per their report, “safe and trusted adults—like mentors, trained teachers, and staff—can help foster school connectedness, so that teens know the people around them care about them, their well-being, and their success.” I want to argue that mentors can do more than help youth build connection to their schools. Instead, mentors can play a critical role in allowing teens and youth that they matter, that people care about them, and that their feelings are valid. I encourage mentors and program staff to think critically about how mentors can receive training and support to help reduce the mental health burden our youth are currently facing.  

Note: If you or someone you care about is in crisis, call or text 988 or use the online chat feature at 988 connects to a trained crisis counselor, is free and confidential, available 24/7/365.