The State of Teen Mental Health in the US in 2020

Our Teens Need Help: There Are Inpatient Treatment Options for Teens with Mental Health Issues

At the end of 2020, the non-profit mental health advocacy organization Mental Health America (MHA) published a report called 2021: The State of Mental Health in America. The report helps anyone interested in mental health issues understand the big picture. It offers reliable prevalence data from all fifty states, based on the most recent data available. Accessing and reporting data is a challenge. Not every study and survey asks the same questions on the same topics, which makes comparing various sets of statistics problematic. The analysts at MHA drew their data on teen mental health from the last complete version of the National Survey on Drug Use and Health (NSDUH), published in 2019. That report included data for the year 2018.

The report contains vital information on:

1. Overall trends and statistics on mental health and mental illness for the general population.
2. Trends in anxiety and depression for the general population.
3. Specific trends in depression, alcohol and substance use, and suicidal ideation for the adolescent population.
4. Trends in the treatment of depression and alcohol/substance use for the general population.
5. Specific trends in the treatment of depression, and alcohol/substance use for the adolescent population.

While using data from 2018 may sound like the report is out of date, that’s not necessarily the case. Reporting on incomplete data sets, such as those gathered in 2019 and 2020, would result in inconsistent and inaccurate information. That’s why a report labeled 2021 can refer to data collected in 2018 and call it the most recent reliable data available. What we know in 2021 – meaning what we have real data to support – is based on data from 2018.

Therefore, this report is both up-to-date and accurate.

Let’s take a look.

How Are We Doing? How Are Our Teens Doing?

Does Your Teen Need Support at a Residential Treatment Center for Youth?

If you’re the parent of a teen with a mental health issue, keeping current on the prevalence rates of mental health issues among teens can help put your mind at ease. That’s one reason why this report is helpful. It’s important to understand that you’re not alone. It’s also important to understand that millions of teens each year develop mental health problems like depression, anxiety, and alcohol/substance use disorders. That’s helpful information, too. But what may be both more important helpful is understanding that many of these teens receive effective, evidence-based treatment for their mental health or alcohol/substance use disorders.

Depending on the severity of the symptoms of their disorder, teens may receive treatment in outpatient programs, intensive outpatient programs (IOP), partial hospitalization programs (PHP), or programs at residential treatment centers (RTCs). Teens with the most severe conditions typically participate in some variation of inpatient treatment. Teens with severe depression often participate in residential programs for teenage depression, teens with severe anxiety often participate in residential programs for teenage anxiety, and teens with severe alcohol/substance use disorder often participate in residential programs for teen addiction.

If your teen receives a diagnosis for a mental health or addiction disorder, evidence shows that the earlier they receive treatment, the better their chances at making a full, sustained recovery. If you suspect your teen has a mental health issue that developed during the coronavirus pandemic, we recommend that you arrange a full assessment with a mental health professional. They can confirm or rule out the presence of a mental health disorder. If they confirm the presence of a mental health disorder, then they will most likely give you a referral for professional treatment. At that point, you can begin to seek treatment at one of the types of programs mentioned above.

Now – with all that said – let’s look at the data from the MHA report.

Mental Health in 2020: Facts and Figures

We’ll start with statistics on depression in the adolescent population. These figures are based on data collected by MHA from the Substance Abuse and Mental Health Services Administration (SAMHSA) in their National Survey on Drug Use and Health.

Depression in Adolescents Age 12-17

• Teens with at least one major depressive episode (MDE) in the past year:
  • 13.84% (3.5 million)
    • That’s an increase of 206,000
  • Only 50% of cases of depression that begin during teen years are diagnosed before adulthood
• Teens with at least one severe major depressive episode in the past year:
  • 9.7% (2.3 million)
    • That’s an increase of 126,000
  • Rates were highest among teens of more than one race:
    • 12.4% (98,000)
  • Teens with MDE who did not receive treatment of any kind:
    • 59.6% (1.9 million)
      • In states with the best access to and most available mental health services, over 33% of teens with MDE did not receive any treatment
    • Teens with severe MDE who did receive consistent treatment (7-25 visits per year):
      • 27.3% (614,000)
        • In states with the best access to the most available mental health services, fewer than 33% of teens with MDE received consistent treatment

What we want you to notice here is the treatment gap, which is the difference between the number of teens who needed treatment and the number of teens who got the treatment they needed. As you can see, almost two million teens with a depressive disorder did not receive any care at all, and fewer than thirty percent of teens with severe MDE received consistent treatment.

That’s a big gap – and as a nation, we can do better.

Now let’s look at the rates of alcohol and substance use among teens.

Substance/Alcohol Use Disorder in Adolescents Age 12-17

• Teens with substance use disorder (SUD):
  • 3.83% (954,000)
• Teens with alcohol use disorder (AUD):
  • 1.69% (490,000)
• Teens with illicit drug use disorder (marijuana, opioids, amphetamine, other):
  • 2.85% (712,000)

Although the statistics show us that almost a million teens had a substance use disorder (SUD), almost half a million had an alcohol use disorder (AUD), and almost three-quarters of a million teens had an illicit drug use disorder, those numbers are down from the last reliable data set. The decrease is small – only 0.3 percent – but it’s progress in the right direction.

If your teen has an alcohol or substance use disorder, there’s something you should know. Addiction is a medical condition that responds positively to evidence-based treatment. You can find residential programs for teenage drug/alcohol addiction at many of the same places you can find residential programs for depression, anxiety, and other mental health disorders.

Next, we’ll present a unique data set from the MHA report.

The MHA Report: Data from The Pandemic

This next set of stats comes from Mental Health America itself, rather than SAMHSA and the 2018 NSDUH. Analysts at MHA collected data from 1,560,288 people between January and September 2020 through their online mental health screening and support program.

We include this data because it offers insight into the period during which the coronavirus pandemic dominated public and private life in the U.S.

Here are the overall numbers for 2020. We include the figures for adults to give you an idea of the overall context in which the figures for adolescents occur.

Mental Health in 2020: General Population (Adults Included)

• 315,220 people took the MHA anxiety screen, a 93% increase over 2019
• 534,784 people took the MHA depression screen, a 62% increase over 2019
• Scores from over 80% of people who took the anxiety screen indicated moderate to severe symptoms
• Scores from over 80% of people who took the depression screen indicated moderate to severe symptoms
• 70% of people whose scores indicated moderate to severe symptoms of anxiety or depression reported that one of the top three factors in their anxiety or depression was loneliness and/or isolation
• 10.8% of people with a mental health issue are uninsured, which limits access to appropriate, evidence-based treatment. This includes people with alcohol/substance use disorders (AUD/SUD).

Now we’ll offer the numbers on the adolescent population from the same survey and screening process conducted by MHA.

Teens in 2020: Total Screenings, Anxiety, Depression, Suicidal Ideation

• The total number of youth age 12-17 who took online MHA assessments was 9% higher in 2020 than in 2019
• 82.88% (68,584) of teens who took the anxiety screen reported moderate to severe anxiety symptoms
• 90.20% (140,988) of teens who took the depression screen reported moderate to severe depressive symptoms
• 48% (15,110) of teens reported thoughts of suicide or self-harm nearly every day between January and September 2020
• 51% (22,271) of LBTQI+ teens reported thoughts of suicide or self-harm nearly every day between January and September 2020

These numbers reflect what most of us suspected at the beginning of the pandemic. They’re what we witnessed firsthand during the pandemic. They’re what we see in other publications now that we’re in the slow denouement of the pandemic. What we mean is that our teens had a hard time. Data shows that the stress and isolation caused an increase in depression, anxiety, and suicidal ideation among teens in the U.S. and worldwide.

Note: if your teen engages in suicidal ideation – meaning they think or talk about suicide – take it seriously. Do not ignore it. Call 911 or go to the nearest emergency room.

Rebounding From A Challenging Year (And A Half)

There’s little doubt that 2020 and the first half of 2021 were among the most stressful and difficult years in recent history. We’re still grappling with the pandemic: although our population is on the way to herd immunity, we’re not there yet. That means the stress – which we thought would fade in a gradual and predictable manner with the arrival of the vaccines – is still with us. That’s a fact we have to face: we’re not totally out of the woods yet.

Another fact we have to face is all the data on teen mental health. Teens are resilient. Many will claim now they’re “fine” or “much better than last year.” That may not be entirely true. They may put on a strong, brave face because they don’t want to make waves. They may not understand the emotions they feel. And if they don’t, that means they probably need help managing them. When – and if – your teen shows signs of anxiety, depression, or alcohol/substance use, then the wisest thing for you to do is take those signs seriously.

If you think your teen needs help, please arrange for a full assessment with a mental health professional. If your teen doesn’t have a mental health or addiction disorder, then you can put your fears to rest. You can address any new issues you see simply by offering love, sympathy, and support. And of course, with clear behavioral expectations and logical outcomes if those expectations are not met. On the other hand, if your teen has developed a mental health disorder, then you can arrange for an appropriate course of treatment at a mental health treatment center for teens.

Treatment works. Decades of evidence show that the sooner a teen who needs treatment gets treatment, the better the outcome.

Finding Help: Resources

If you’re seeking treatment for your teen, please navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.

In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting for you right now.