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August 16, 2024
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More teens missing school due to safety concerns since 2013

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Key takeaways:

  • Feelings of sadness and hopelessness among teens have decreased from record high levels in 2021.
  • The percentage of teens who missed school due to safety concerns doubled from 2013 to 2023.

Youth mental health has improved since 2021, but school safety has become a growing concern among students and an increasing cause for absenteeism, according to the CDC’s most recent Youth Risk Behavior Survey.

Debra Houry, MD, MPH, the chief medical officer and deputy director for program and science at the CDC, described the improvements seen in some of the survey’s metrics as “progress we can build on,” in a press release from the CDC, adding “this work is far from complete.”

IDC0824LopezArvizu_Art

Data were derived from Youth risk behavior survey: Data summary and trends report: 2013-2023. https://www.cdc.gov/yrbs/dstr/index.html. Published Aug. 6, 2024. Accessed Aug. 13, 2024.

Commenting on the survey results and whether they reflect trends she has seen in her own practice, Carmen Lopez-Arvizu, MD, child and adolescent psychiatrist, director of outpatient psychiatric services at Kennedy Krieger Institute and assistant professor of psychiatry and behavioral sciences at The Johns Hopkins School of Medicine, said barriers to access high-quality evidence-based treatments and mental health stigma still persist as obstacles to care.

Carmen Lopez-Arvizu, MD
Carmen Lopez-Arvizu, MD

“We have seen an increase in the visibility of mental health in the sense that more people are open to discuss it and seek help,” she told Healio. “The part that I have not seen is the understanding that mental health treatment is a process. It is not ‘fixed’ in one visit; it requires commitment from the family to attend appointments regularly and engage in treatment.”

Results from the 2023 Youth Risk Behavior Survey — which is conducted every 2 years among a nationally representative sample of U.S. high school students on topics including sexual behavior, substance use, violence and mental health — showed more teens are experiencing feelings of poor mental health compared with teens in 2013, but conditions appear to have improved from 2021, which showed the highest rates of teens experiencing sadness or hopelessness and seriously considering suicide in the past decade. The CDC press release noted that in 2021 many students were still experiencing disruptions in schooling due to the COVID-19 pandemic.

The percentage of students reporting persistent feelings of sadness or hopelessness increased from 30% in 2013 to 42% in 2021, decreasing to 40% in 2023. Similar decreases were seen from 2021 to 2023 among girls (57% to 53%) and Hispanic students (46% to 42%).

The percentage of students who seriously considered attempting suicide rose from 17% in 2013 to 22% in 2021, decreasing to 20% in 2023.

The group that experienced the highest rates of persistent feelings of sadness or hopelessness were LGBTQ+ students (65%), more than double the rate of cisgender and heterosexual students (31%). LGBTQ+ students were also three times as likely to seriously consider attempting suicide compared with cisgender and heterosexual students (41% vs. 13%).

The survey data also indicated that high school students feel less safe in school than they did 10 years ago. In 2023, 9% of teens reported being threatened or injured with a weapon at school, compared with 7% in 2013, and the percentage of students who did not attend school because of safety concerns nearly doubled (7% in 2013 vs. 13% in 2023).

The proportion of students who reported being bullied at school has declined slightly from 20% in 2013 to 19% in 2023, but more students in 2023 reported experiencing electronic bullying than in 2013 (16% vs. 15%).

As Healio previously reported, a poll from the American Psychiatric Association found less than half of Americans believe most school staff have received mental health training. Unfortunately, Lopez-Arvizu said schools can only do so much to address violence and bullying when they lack the resources to do so.

“Through the years school based mental health services have dwindled,” she said.

Benjamin Schindel, MD, MPH
Benjamin J. Schindel, MD, MPH

One of the most important things health care providers can do to address these issues is to ask their patients about it, Benjamin J. Schindel, MD, MPH, neurodevelopmental disabilities specialist at Kennedy Krieger Institute and assistant professor in the departments of neurology and pediatrics at The Johns Hopkins University School of Medicine, told Healio.

“Data from studies of suicidal thoughts and behaviors have shown that not only does asking about suicide — and mental health more broadly — not ‘plant the seed’ of suicidal thinking, but actually provides an opportunity for children and adolescents to talk about what is going on in their lives,” Schindel said. “Often patients will not bring up these feelings themselves, so when a health care provider offers an opportunity to talk about mental health confidentially and in private, it can be one of the most meaningful parts of a patient visit.”

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