Top Health Spotlight

Teens Girls Are Facing a Mental Health Epidemic. We’re Doing Nothing About It

Teen girls are in crisis.

In a just-released report, the Centers for Disease Control (CDC) found that nearly one in three high school girls considered suicide in 2021, a 60% increase since 2011. More girls also now report feeling so sad and hopeless they couldn’t engage in their normal activities for at least two weeks in the last year.

Although it’s tempting to blame these concerning numbers on the pandemic, mental health issues among teens have been on the rise since at least 2012. Teen depression doubled between 2010 and 2019, well before COVID-19 lockdowns. It then continued to rise during the pandemic years at about the same rate
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Is it just that teens became increasingly comfortable admitting to problems? No: Behaviors linked to depression such as self-harm, suicide attempts, and deaths by suicide also increased, especially among girls. For example, the CDC reported in 2017 that emergency-room admissions for self-harm among 10- to 14-year-old girls tripled between 2009 and 2015.

However, when I and other researchers first sounded the alarm about the rise in teen depression, we were often dismissed. “Don’t panic,” a prominent psychiatrist soothed parents in the New York Times in 2018. The idea of a teen mental health epidemic, he counseled, “is simply a myth.” A National Public Radio piece claimed, against evidence to the contrary, that there was no consistent trend in teen depression rates.

We are now paying the price for this denial. We have had hard evidence that teen mental health was in crisis for at least 5 years, but too many dithered over details instead of doing something.

Some might argue that taking action wouldn’t have done any good—isn’t depression often caused by intractable issues such as poverty, child abuse, and substance use? Yes, but these factors were actually getting better for children and teens over this time, so they can’t be the primary cause of the rise in teen depression.

What was the cause? Consider the life of a typical teen girl. In 2009, she would have hung out with her friends mostly in person and used social media only occasionally. By 2016, social media use was nearly mandatory—90% of teen girls used it every day—and hanging out in person had gone out of style. This is not a good formula for mental health. Social media is not only considerably less fulfilling than seeing friends in person but comes with numerous risks including sexual exploitation, body image issues, and cyberbullying, all of which girls experience more.

Here, too, there has been denial. Screen time is only weakly linked to well-being, said researchers in a highly-cited study—except that when you zero in on girls and social media use, there’s a considerable link to depression. Maybe it’s climate change, said some—even though teens’ concerns about the environment peaked in the 1990s, well before the current rise in teen depression.

Even the alarming just-released CDC report did not go far enough. The report included three suggestions for improving teen mental health. One, providing more mental health services at schools, is indisputably needed.

The other two suggestions were making schools more inclusive and improving health education. Although these two areas could certainly be improved, schools are arguably doing a better job in these areas they were 10 years ago. For example, the CDC report specifically suggests schools have groups supporting LGBTQ+ students—but these groups are now much more common than they were in 2011 when rates of teen depression were considerably lower. Nowhere does the report suggest a role for social media or other new technologies (though the Surgeon General’s December 2021 report on the teen mental health crisis did).

We can’t go back in time five years to prevent the crisis from getting to this point, but we can take action. Parents, tell your kids they can’t have social media until they are 16 – or at all. If they already have it, use parental controls to restrict their social media use to an hour a day, and consider tapering that down to nothing. Kids and teens can communicate with their friends in other ways that don’t have so many risks.

But we cannot leave this all up to parents. Children are not required to have parental permission to open a social media account, nor are they required to prove their age. Despite the current minimum age of 13 to use social media, preteen children apparently routinely use TikTok. Even parents who have gone to great lengths to restrict their children’s access to social media have found their children addicted and harmed.

There is now bipartisan support for more regulation of children and teens’ access to social media, which might include raising the age minimum to 16, requiring verification of age, and eliminating algorithms that push harmful content and keep teens on social media apps for longer than is healthy.

These common-sense suggestions have the potential to help countless teens. Alternatively, we could continue to be in denial, whistling past the graveyard —a graveyard that contains the broken wreck of our children’s mental health.

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