What’s wrong with the kids today?

Over the past decade, the number of teenagers reporting feelings of helplessness, depression, and suicide have increased at an alarming rate, especially among young women, LGBTQ+, and minorities.  The mental health establishment wants more programs, some blame social media, but a culture that pushes endless doom and gloom is likely the cause of it all.

The latest data from the Centers for Disease Control and Prevention concerning America’s youth is shocking, saddening, and frightening all at once.  In a report released on Monday, the Youth Risk Behavior Survey for 2011 to 2021, the CDC found that “mental health among students overall continues to worsen, with more than 40% of high school students feeling so sad or hopeless that they could not engage in their regular activities for at least two weeks during the previous year—a possible indication of the experience of depressive symptoms. We also saw significant increases in the percentage of youth who seriously considered suicide, made a suicide plan, and attempted suicide.”  The underlying metrics are equally devastating, making it difficult to capture them all.  Essentially, there is not a single mental health trend that has moved in a positive direction over the past 10 years.  This includes 42% of high school students who “experience persistent feelings of sadness or hopelessness,” in 2021, up from 28% in 2011.  22% “seriously considered attempting suicide,” up from 16% percent.  18% actually made a suicide plan, up from 13%, and 10% continued that plan into an attempt, up from 8%.  Young women and LGBTQ+ appear to have been hit hardest by whatever demons are plaguing America’s youth, with some 57% and 69% respectively reporting sadness and hopelessness in 2021.  The figure for young women represents an almost 60% increase over 2011 while boys were up 38%.  Overall, the “percentage of students across every racial and ethnic group who felt persistently sad or hopeless increased.”

It might be easy to dismiss these numbers as merely self-reported, believing that America’s youth are making these claims without really believing them, but actual data on clinical diagnosis and hospitalizations follows a similar same trend.  Teens with major depression rose 161% for boys and 145% for girls since 2010 while the seven years prior actually saw a slight decline.  The percentage of the increase aside, young women were hit harder than men in absolute numbers; overall close to 30% of girls experience major depression compared to less than 15% of boys.  It might also be easy to blame this on the pandemic and the accompanying lockdowns, but the rate was rising well in advance and had doubled prior to.  The number of teens admitted to the hospital for non-fatal self harm is also on the rise, increasing 48% for girls and 37% for boys since 2010.  This metric was flat for boys in the seven years prior, though there was a slight increase for girls leading into the period.  Overall, close to 750 out of every 100,000 girls aged 15-19 harm themselves badly enough to be admitted to the hospital compared to around 250 boys.  This data comes right after we learned that the actual rate of suicide rose over the past couple of  years, particularly among ethnic minorities, black children to be precise.  According to USA Today, “Black children and youth ages 10 to 24 saw the highest increase – 36.6.% – of all age and racial groups measured.”  Ultimately, whatever data point you choose – self-reporting, actual diagnosis, hospitalization, or outright death – increases across the board suggest that this phenomena is real and actual people are being harmed, perhaps irreparably.

Obvious questions present themselves:  Why is this happening and what can we do about it?  Before I share my thoughts on the potential root causes, it is worth noting what the medical establishment wants to do about it:  More of the same.  The paradox of the mental health industry has always been that the rapid increase in awareness, diagnosis, and treatment over the past five decades has been accompanied by a corresponding increase in mental health problems, rather than the decrease one would expect.  It would be like finding more cases of polio after wide availability of the vaccine, and yet the industry itself appears immune to this obvious disconnect.  The answer is always more programs.  “Young people are experiencing a level of distress that calls on us to act with urgency and compassion,” explained Kathleen Ethier, director of adolescent and school health at the CDC, upon the release of this frightening report. “With the right programs and services in place, schools have the unique ability to help our youth flourish.” “High school should be a time for trailblazing, not trauma,” agreed Dr. Debra Houry, the agency’s chief medical officer and deputy director for program and science. “These data show our kids need far more support to cope, hope and thrive.”  It never occurs to them, or they will never admit, that these same kids have been raised on more programs, services, and support than any generation in history.  According to the Kaiser Family Foundation, 96% of public schools have mental health programs in place.  This includes 84% of schools that offer “individual-based interventions like one-on-one counseling or therapy,” 70% that offer “case management or coordinating mental health services,” and 66% that offer “referrals for care outside of the school.”   More than a third of schools actually provide mental health screening for every student.  These programs are supported by both local and federal funding with increases in the federal portion as part of the American Rescue Plan in 2021 and the Bipartisan Safer Communities Act in 2022.  The majority of this infrastructure is relatively new.  The Comprehensive Mental Health Services for Children and Their Families program was not passed into law until 1992.  There were only 200 School Based Health Centers in the early 1990s, but the number rapidly increased to 1,380 by 2000.  The same period saw an accompanying rise in Expanded School Mental Health Programs.

Correlation is not causation, of course, but the rapid declines in teen mental health over the past decade have occurred while these programs were in place, making the idea that new programs are a viable means to address the issue suspect to say the least.  One could conceivably argue that embedding mental health in everything is a primary cause, but of course any complex phenomenon is likely to have a multitude of factors, some of which are hard to entangle.  Interestingly, the same period saw sharp declines in what was generally considered risky behavior for teenagers.  The percentage of high school students who had sexual intercourse declined from 47% in 2011 to 30% in 2021.  Those currently having sex dropped from 34% to 21%.  Substance abuse dropped dramatically as well, 39% of students drank alcohol in 2011 compared to 23% in 2021; marijuana use declined over the same period, from 23% to 16%, suggesting that young people in question are both more mentally unstable and risk averse at the same time.   The decade in question also witnessed the rapid rise of smartphones and social media on a grand scale, combining ease of access with an explosion of ways to interact in the virtual world rather than the physical, some of which like increases in bullying and shaming are self-evidently harmful.  Jonathan Haidt, author of The Righteous Mind and The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure, believes this combination is the root cause and is working on a new book to prove his case.  Recently released excerpts point to correlations between time spent using social media and self reported mental health problems.

As Mr. Haidt put it, “Nearly all researchers now agree that there are correlations between (crude measures of) time spent using social media and (crude self report measures of) mental health problems, but there is heated disagreement about the size and significance of these effects.” He points to studies which suggest that social media usage, particularly on phones, over two hours per day serves as a sort of tipping point.  Below that threshold, usage can be healthy or even beneficial, but above it there is a negative impact on mental health.  There is likely some truth to this and clearly social media is a factor, but I do not believe it captures the real underlying cause for two reasons.  First, studies like this make it impossible to separate cause from effect.  Generally speaking, doing anything more than two hours per day, every day is not healthy.  It could be that heavy teen social media users are simply more prone to both usage and negative health effects.  We see a similar phenomenon in studies about the negative impacts of video games.  There is a healthy amount one can play that quickly blossoms into an unhealthy amount, but those that play an unhealthy amount are likely to have other problems from poor parenting to innate mental health issues.  Putting this another way, a video game cannot lock someone in a room for 72 hours and force them to play until they die.  People who go to such extremes already have issues.  Second, these studies do not account for the content of the usage, meaning not all uses of social media are created equal.  If heavy social media users were swimming in a virtual sea of rainbows, unicorns, and other positive messages, it’s not likely we’d have a problem.

Instead, there is something about extreme usage of social media that inevitably includes negative content.  Why is that, when it certainly needn’t be that way in principle?  This leads to what I believe is the real underlying cause, one few discuss as openly as we need to, and one that explains the disconnect between declines in mental health and risky behavior at the same time.  Content is a product of culture, and over the past two decades our culture has transformed practically overnight from one marked by unbridled optimism about the future to one mired in an almost nihilistic pessimism.  America is a country that found reason for hope and optimism in the depths of the Civil War and the Great Depression.  For over two hundred years, it was a widely held belief by broad majorities regardless of political persuasion.  Teddy Roosevelt proclaimed “our greatest victories are yet to be won, the greatest deeds yet to be done.”  Franklin Delano Roosevelt said “there’s nothing to fear but fear itself” while facing the largest, most brutal, and bloody war in the history of the world.  Ronald Reagan spoke of America as a “shining city on a hill.”  The one thing uniting these three disparate President’s in three radically different eras was the unshakeable belief that America’s best days remained in the future, and the past was only prologue to the heights we would achieve as a nation.  Younger Americans at the time, absorbed these messages and went on to further the American experiment, overcoming the unique challenges of their own generation, but sometime after 9-11 this innate optimism started to fade.

Even during times of extreme challenge like the Civil Rights movement, it was widely believed that change could happen for the better, but Americans today are exposed to a near constant stream of doom and gloom, from the nature of the country itself to the fate of the planet.  Today’s children are taught from a young age that America is essentially racist, sexist, homophobic, and xenophobic, a land ruled by a white supremacist patriarchy so powerful it infects people of other races and causes them to become white supremacists against their own best interests.  Further, they are told that these conditions are immutable and cannot be solved no matter what anyone does.  All of us, even minorities, are irredeemably racist to the core; a professor recently detailed how a college course taught that “All non-black people, and many black people, are guilty of anti-blackness” and “There is no way out of anti-blackness.”  These lessons on the insolvable horrors of America are accompanied by fears that humanity itself is hurtling toward extinction and the human race might not survive the century, along with everything else.  The threat of global warming, overpopulation, mass extinction, scarcity of resources, and more are pounded into their minds by both their education and popular culture, to the point where prominent politicians regularly question whether they should have children because the planet might not be around long enough for them to grow up.  Underlying it all is the implicit message that they cannot succeed no matter what they do.  They are trapped by a life that is unfair and something beyond their control will prevent them from pursuing their dreams, the victim of malevolent, impersonal forces moving against them.  Generally speaking, lower rates of sex, alcohol, and drug use would be considered a good thing, but in this context it also suggests that they are fundamentally less adventurous, which is certainly an unusual trend for the young, suggesting that there is a connection between the two. The young experiment because the world is new to them and they are excited to explore it. In other words, they are, or sadly were, optimistic.

Given all of this, is it any wonder the young are depressed today?  A person cannot grow up exposed to a steady stream of overwhelming negativity from almost everyone in a position of power without suffering for it.  If we care about the future, this is the problem we need to solve through a renewal of optimism and Americanism.  The irony of the young in America today is that they inhabit a world filled with things older generations scarcely dreamed of when we were kids.  As a proud member of Generation X, I grew up on the early video games from Atari to Nintendo, playing them until my fingers bled, but never could I have imagined what these devices would become or how ubiquitous they would be.  So much so, that it’s difficult to explain to a younger person what life was like before the age of Google Maps, Uber, Instacart and all the rest.  Advances in technology have been accompanied by an explosion in consumer choice across almost every product and service imaginable.  Again, it’s difficult to explain that outside a specialty store, supermarkets in the 1980’s had only a couple of different kinds of pasta sauce.  The same is true of the longer lifespans an average person can expect to enjoy.  When I was a young, 65 was a pretty good run and 80 was ancient.  Kids today grow up in a world of almost obscene plenty where life is longer and more enjoyable then ever, and yet they’re convinced by the generations before them that their life sucks and the world is ending.  I cannot blame them for believing that, but I can question why an older generation that should know better would do this, while doing everything in their power to deny it and identify every other root cause except the obvious.  Regardless, it is in our power to fix it, if only we can find the will to believe our better days are indeed ahead.