According to the 2023 State of Mental Health in America Report, youth experienced numerous hardships during the COVID-19 pandemic. The CDC’s Adolescent Behaviors and Experiences Survey (ABES) found that 67% of U.S. high school students reported that schoolwork was more difficult, 55% experienced some emotional abuse in the home, 11% experienced physical abuse, and 24% reported they did not have enough food to eat during the COVID-19 pandemic, all of which can have a detrimental effect on mental health.
16.39% of youth (age 12-17) reported suffering from at least one major depressive episode (MDE) in the past year.
The percentage of adults reporting serious thoughts of suicide is 4.84%. The estimated number of adults with serious suicidal thoughts is over 12.1 million. 11% of adults who identified as two or more races reported serious thoughts of suicide in 20204 – 6% higher than the average among all adults.
6.34% of youth in the U.S. reported a substance use disorder in the past year. 2.85% had an alcohol use disorder in the past year, while 4.85% had an illicit drug use disorder.
59.8% of youth with major depression do not receive any mental health treatment. Asian youth with MDE were least likely to receive specialty mental health care, with 78% reporting they did not receive mental health services in the past year. This was followed by 68% of multiracial youth and 68% of Black or African American youth with MDE who did not receive care. In Kentucky, Hawaii, and Texas, three-quarters of youth with major depression did not receive mental health treatment.
For purposes of an IEP, the term “Emotional Disturbance” is used to define youth with a mental or behavioral health condition that is affecting their educational performance. IEPs are critical for ensuring that youth with disabilities can receive the individualized services, supports, and accommodations to succeed in a school setting. However, without sufficient resources for schools and teachers to help students with mental health conditions, identification of students with emotional disturbance may contribute to disparities for marginalized youth. Of note, 7.25% of all multiracial youth with a disability and 6.73% of Black youth with a disability were identified with emotional disturbance, compared to 5.15% of all students. Youth identified with ED were also more likely to live in households below the poverty line14 and often have experienced trauma, which may underly behavioral difficulties identified as emotional disturbance.
Youth identified with ED are also much more likely to experience disciplinary removals than students with any other disability. In 2019-2020, there were 291,261 disciplinary removals for students with emotional disturbance, totaling 0.84 removals for every one student with ED. Among students of all disabilities, the average rate is only 0.22 removals for every one student with a disability. Schools must be given the resources they need to appropriately address trauma and mental distress among students. Research has shown that when implemented correctly, practices such as restorative justice in schools can reduce exclusionary discipline and narrow disparities for youth of color.16 Investing in programs such as community schools can also help to provide social services and resources to support whole families and prevent mental health conditions.
In 2018, for the first time in the history of such research, the rate of suicides for Black children between the ages of five and 12 had exceeded that of white children, and more than a third of elementary school-aged suicides involved Black children. Over 70 percent of youth with major depression still need treatment.
Compared with general populations, African Americans are less likely to be offered evidence-based medication therapy or psychotherapy.
Nationally, 1 in 10 youth who are covered under private insurance do not have coverage for mental or emotional difficulties – totaling over 1.2 million youth.
Nationally, only 28% of youth with severe depression receive some consistent treatment (725+ visits in a year). Consistent treatment is determined if a youth visits a specialty outpatient mental health service, including a day treatment facility, mental health clinic, private therapist, or in-home therapist more than seven times in the previous year. According to the American Academy of Child and Adolescent Psychiatry, all patients should be seen at least monthly for six to 12 months following their initial treatment.
According to The American Psychiatric Association, mental health disorders are among the topmost costly health conditions for adults 18-64 in the U.S., along with cancer and trauma-related disorders.
Compared with whites, African Americans are less likely to receive guideline-consistent care, less frequently included in the research, and more likely to use emergency rooms or primary care rather than mental health specialists.
Racial/ethnic minority groups with behavioral health issues are more readily referred to the juvenile justice system than to specialty primary care; compared with white youth, minorities are also most likely to end up in the juvenile justice system due to harsh disciplinary suspension and expulsion practices in schools. (American Psychiatric Association)
Physician-patient communication differs for African Americans and Whites. One study found that physicians were 23% more verbally dominant and 33% less patient-centered in communication with African American patients than white patients.
Black people with mental health conditions, particularly schizophrenia, bipolar disorders, and other psychoses, are more likely to be incarcerated than people of different races. Barriers to care in the African American community include the importance of family privacy, lack of knowledge regarding available treatment, denial of mental health problems, concerns of stigma, medications, and not receiving appropriate information about services; dehumanizing services has also been reported to hinder African Americans from accessing mental health services.
International Journal of Environmental Research and Public Health's study on Intersectionality and Social Marginalization of Self-Reported Health Statuses of young people found that the more intersectionality encountered (i.e., sexuality, poverty, ethnicity, refugee, or rural), the more at risk they would be and vulnerable they would be for mental health and other poor health outcomes.
A published study in the American Journal of Orthopsychiatry and the Journal of The Society of Social Work and Research finds that improving mental health for young people will require many changes, including training providers to closely consider the mental health narrative while assessing developmental treatment plans and symptoms. The research team believes it is critical to keep young adults engaged and invested in their own healing.
According to the Center for American Progress, mental healthcare was already inequitable, and then came the coronavirus. In 2016 11.8 million Americans had an expressed need for mental health services that went unmet 38 percent could not afford the cost of treatment.
According to the Mental Health America State of America 2020 report, youth mental health is worsening, and more major depression episodes (MDE) have occurred. Less than 1% of students in the US are identified with emotional disturbance despite the millions of youths with depression and severe impairment as a result.
Barriers to care include lack of insurance and underinsurance, mental illness stigma often greater in minority populations, lack of diversity among mental health care providers, lack of culturally competent providers, language barriers, distrust for the health care system, and inadequate support for mental health service safety net for most vulnerable patients. (American Psychiatric Association)
Rates of mental illnesses in African Americans are similar to those of the general population. However, disparities exist regarding mental health care services. African Americans often receive poorer quality of care and lack access to culturally competent care.
Only one in three African Americans Who need mental health care receive it.
SEL advances educational equity and excellence through authentic school-family-community partnerships to establish learning environments and experiences that feature trusting and collaborative relationships, rigorous and meaningful curriculum and instruction, and ongoing evaluation. SEL can help address various forms of inequity and empower young people and adults to co-create thriving schools and contribute to safe, healthy, and just communities.
Only 6.2 percent of psychologists, 5.6 percent of advanced-practice psychiatric nurses, 12.6 percent of social workers, and 21.3 percent of psychiatrists are members of minority groups. In research studies, Black people have indicated that mild depression or anxiety would be viewed as “crazy” in their social circles. Many interviewed also believe that discussions about mental illness would not be appropriate even among family.
Compared with whites with the same symptoms, African Americans are more likely to be diagnosed with schizophrenia and less frequently with mood disorders. Differences in how African Americans express signs of emotional distress may contribute to misdiagnosis.