US youths' mental health slide began before COVID pandemic, data suggest

COVID-19
Anxious girl looking at phone

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The proportion of US children and adolescents experiencing anxiety or depression rose before and during the COVID-19 pandemic, and the increase was unrelated to the physical or behavioral conditions studied, Children's Hospital of Chicago researchers report.

Published yesterday in JAMA Pediatrics, the study used data from the National Survey of Children's Health from 2016 through 2022, which is administered annually to randomly selected US households and weighted to represent community-dwelling children and adolescents. A total of 21,599 to 54,103 participants took part each year, with response rates of 37.4% to 43.1%.

The analysis aimed to estimate annual rates of anxiety, depression, behavioral or conduct issues, and attention-deficit hyperactivity disorder (ADHD), as well as physical conditions—asthma, cardiac disorders, and severe headache or migraine—affecting major organ systems. 

"After the COVID-19 pandemic, the US Surgeon General issued a warning about youth mental health," the study authors wrote. "Research shows that youth mental health has been on a steady decline, while other findings have been mixed."

National interventions needed

The proportion of youths reporting anxiety or depression climbed over the study period (anxiety, 7.1% in 2016 to 10.6% in 2022; depression, 3.2% and 4.6%, respectively). ADHD increased, but the rise didn't reach statistical significance. The percentage of participants with behavioral or conduct problems was 7.4% in 2016 and 7.5% in 2022, and 1.3% and 1.4% had heart conditions, respectively.

Parents and schools need more support to be better equipped to help children suffering from anxiety or depression.

Marie Heffernan, PhD

Conversely, the proportion of youths who had asthma or severe headache or migraine declined from 2016 to 2022 (asthma, 8.4% to 6.5%; headache or migraine, 3.5% to 2.6%).

"These findings suggest that deterioration in youth health was specific to depression and anxiety but not select physical health conditions," the researchers wrote. 

In a Children's Hospital of Chiago news release, lead author Marie Heffernan, PhD, said, "Our findings underscore the critical need to prioritize youth mental health, which continued to worsen even as we emerged from the pandemic. Parents and schools need more support to be better equipped to help children suffering from anxiety or depression."

Senior author Michelle Macy, MD, said, "Continued attention and resources are warranted at a national level to clarify and address the multitude of potential causes of worsening anxiety and depression in children and adolescents." 

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