A policy brief published on January 27^th by the UCLA Center for Health Policy Research reveals a set of statistics that are a genuine cause for alarm for parents of teenagers living in California. Data collected throughout 2019 by researchers for the annual California Health Interview Survey (CHIS) show that what many parents, teachers, and community leaders feared might happen appears to have happened: the coronavirus pandemic has had a significant negative impact on the mental health of teenagers in the state.

Before we get into the details of the report, we want parents in California to know that adolescent psychiatric treatment centers are considered essential services and are open and operating during the pandemic. High-quality residential and inpatient treatment centers for teenagers employ state-of-the-art cleaning and air filtering technology, follow social distancing and facial covering guidelines, and establish strict admission criteria for teens in need of mental health support.

That’s important information to know, because another thing parents of California teens need to understand is that mental health treatment works. When an individual in psychological distress – long-term or acute – gets professional treatment sooner rather than later, they have a better chance at mitigating the psychological distress they experience. Early identification, diagnosis, and treatment of a mental health disorder can give teens the tools to to manage their mental health symptoms without significant disruption to their family, academic, or social lives.

The UCLA Policy Brief

The report, published in the form of a policy brief, offered details on rates of psychological distress among California teens during 2019. In order to understand the contours of what many mental health experts consider the beginning of a mental health emergency in the state, researchers analyzed survey data through the lens of the landmark World Health Organization publication, A Conceptual Framework for Action on the Social Determinants of Health.

With the WHO template as a guide, the UCLA Health Policy Center research team cross-referenced self-reported levels of psychological distress with ten additional factors:

1. Income
2. Gender
3. Race/ethnicity
4. Current Health Status
5. Nutrition and Eating Habits
6. Behavioral Habits, i.e. sedentary or active lifestyle
7. Alcohol Use
8. Drug Use
9. Tobacco Use
10. Social Media Use

This level of analysis will help determine who most needs support, where they need it, and how to best deliver that support. In the words of study author D. Imelda-Padilla Frausto, PhD:

“With almost half of California’s adolescents experiencing moderate to serious psychological distress, there is an urgent need to protect their psychological and emotional well-being by addressing the structural and social factors related to inequities in mental health.”

Understanding who is most at-risk will help policymakers and legislators collaborate with community leaders and mental health providers to prioritize the most vulnerable populations. They can use this detailed data to direct support not only to populations that traditionally receive inadequate funding and support, but also target populations that may not seem in immediate danger, but do, in fact, need an immediate increase in support.

Let’s take a look at the data.

The Brief: Which California Teens are in Distress

Researchers used data from adolescents age 12-17 who answered questions on the 2019 California Health Interview Survey about their psychological state and various demographic, socioeconomic, and lifestyle factors. Here’s what they found with regards to the demographic and socioeconomic factors.

Teen Mental Health: Age, Gender, Income, and Race

• Serious and Moderate Psychological Distress (age 12-17):
  • 45% of teens reported experiencing psychological distress
    • 29.7% reported serious psychological distress (SPD)
    • 15.7% reported moderate psychological distress (MPD)
  • Older and Younger Adolescents:
    • 35.9% of adolescents age 15-17 reported SPD
    • 22.9% of adolescents age 12-14 reported SPD
  • The Impact of Gender (age 12-17):
    • 36.6% of females reported SPD
    • 22.4% of males reported SPD
    • 36.4% of gender-nonconforming teens reported SPD
    • 27.7% of gender conforming teens reported SPD
  • The Impact of Income
    • 58% of adolescents in families with income under the federal poverty level (0-99% of FPL) reported either MPD or SPD
      • This is the highest rate of reported distress across all income levels
    • 30.6% of adolescents in families with income under FPL reported SPD (income 0-99% FPL)
    • 22.9% of adolescents in families with income at 100-199% FPL reported SPD
    • 37.5% of adolescents in families with income at 200-299% FPL reported SPD
    • 29.9% of adolescents in families with income at over 300% FPL reported SPD
  • The Impact of Race
    • 42.9% of multiracial adolescents reported SPD
    • 36.6% of non-Latinx white adolescents reported SPD
    • 27.1% of Latinx adolescents reported SPD
    • 20.9% non-Latinx Asian adolescents reported SPD
    • 13.9% of non-Latinx Black adolescents reported SPD

After analyzing the data on adolescents with regards to gender, income, and race, researchers evaluated the data with regards to various lifestyle factors. Here’s what they found.

Teen Psychological Distress: Health and Lifestyle

• Health Status:
  • 89.3% of adolescents who reported being in good, fair, or poor health reported SPD
  • 16% of adolescents who reported being in excellent health reported SPD
• Nutrition Habits:
  • 32.2% of adolescents who reported being eating less than five servings of fruits or vegetables per day reported SPD
  • 21.2% of adolescents who reported being eating five or more servings of fruits or vegetables per day reported SPD
• Activity Status (active/sedentary):
  • 34.6% of adolescents who reported being sedentary for five or more hours on a typical weekend day reported SPD
  • 10.8% of adolescents who reported being sedentary for less than three hours on a typical weekend day reported SPD
• Social Media Use:
  • 39.1% of adolescents who reported using social media almost constantly reported SPD
  • 10.1% of adolescents who reported using social media less than a few times a day reported SPD
• Alcohol, Drug, and Tobacco Use
  • Alcohol
    • 41.3% of adolescents who reported binge drinking reported SPD
    • 28.3% of adolescents who reported no binge drinking reported SPD
  • Marijuana/Hashish
    • 47.6% of adolescents who reported using marijuana or hashish reported SPD
    • 26.0% of adolescents who reported no marijuana or hashish use reported SPD
  • Tobacco (cigarette or vape)
    • 45.1% of adolescents who reported smoking or vaping tobacco reported SPD
    • 26.0% of adolescents who reported no marijuana or hashish use reported SPD

That’s a lot of information. We’ll offer a brief analysis now.

What the Data Mean

All the data above confirm the prevailing expert opinion. We know income, gender, and race/ethnicity all affect mental health status in the absence of a pandemic, and now we know that pandemic conditions exacerbate those conditions. In addition, this data confirms the effect of lifestyle factors on mental health. In the absence of a pandemic, we know good health, good nutrition, and an active lifestyle all correlate positively with low levels of psychological distress, while poor health, poor nutrition, a sedentary lifestyle, and alcohol, drug, and tobacco use all correlate positively with serious psychological distress. Now we have the data to show that these correlations exist in the presence of a pandemic, as well.

What We Can Do

The main takeaway from this UCLA policy brief is that parents of teens in California need to monitor their teen’s mental health closely. Parents who are curious about specific regional data on teen mental health can see the raw numbers here: UCLA Health Policy Brief Appendix.

The relevance of this report to California parents cannot be understated. Teens with preexisting mental health conditions probably experienced an increase in symptoms. Teens with preexisting alcohol or substance use disorder are likely at increased risk of relapse. On the big-picture, macro level, the authors of the policy brief urge federal, state, and local policymakers – and anyone who works with adolescents and/or their families – to advocate for community initiatives and budget priorities that help:

• Reduce socioeconomic inequalities
• Establish universal access to mental health services in schools
• Increase mental health awareness and literacy among parents and caregivers
• Promote health care models that incorporate both primary care and mental health needs

On a personal, micro level, parents who think their teen may be in psychological distress should seek professional support. The first step is to arrange for a full evaluation at an adolescent psychiatric treatment center, a children’s psychiatric hospital, or from a licensed mental health provider. Depending on the outcome of the evaluation, providers may recommend outpatient treatment, intensive outpatient treatment, or a residential program for teens.

All these types of programs can help teens build practical skills that lead to personal growth, efficient self-management, and emotional independence. Treatment works – and the sooner treatment starts, the better the outcome.