Why it is not a phase and what we can do about it
It is undisputed that today’s young adults, teens and children are in the midst of a national mental health crisis. Post-COVID, there is evidence that all generations are suffering from stress and poor mental health as everyone continues to adapt and recover from the staggering loss of life and rapid world changes. Yet, Gen Zs (birth years 1997 through 2009) are clearly experiencing the worst of it and experts are tracking Generation Alpha (birth years 2010 through mid-2020s) as they enter adolescence and move through school systems.
Of all generations, it is Gen Z (young adults and teens) who are reporting the highest stress levels and poorest mental health. Less than 50% report good health and 90% report stress. As for the Alphas under 13, 20% already have a mental health diagnosis, yet only 20% of these receive treatment.
On this point, WHO is crystal clear: The more risks adolescents face, the more fragile their mental health status, which long impacts their abilities to function and form healthy, meaningful relationships in adulthood.
Today’s teens and children face profound challenges and growing disparities that were greatly accelerated and exacerbated by the impacts of the COVID pandemic. Yet, among all the public health alarms, there are several rays of hope as adults and systems lean into the difficult experiences facing our youngest generations to support their healing and wellness. Here we will explore our young generations, why they are more vulnerable and what we, as their biggest fans who want to love and support them, can do.
Introducing the youngest generations
Generations are social constructs that typically span 15-20 years and share large societal events and impacts (e.g., Vietnam War, crisis in the middle east, school shootings, COVID-19). Reducing generations to stereotypes is limiting, but understanding the different sets of circumstances that each generation is exposed to—and thus shaping their experiences, development, perceptions and behaviors—also provides an opportunity to expose biases and increase empathy and understanding. When talking about the youngest generations, we are talking about Gen Z and Generation Alpha who have defining generational characteristics.
Generation Alpha–sometimes referred to as Gen C (a nod to COVID) or Gen Glass (a nod to technology)—are still being born and defined. With Millennials as parents, they are the youngest among us and expected to include those within the 2010-2025 birth years. Many categorize the generation as 12 and younger and predict them to become the largest generation in history, topping 2 billion.
So far, this generation is the most diverse. Over half identify as part of a racial or ethnic group, with experts predicting the generation will continue to diversify. COVID, climate change, school shootings and AI technology are their exceptional experiences, and many predict their accepting attitudes and prioritization of fairness, equity and mental health are unprecedented.
Gen Zs were born between 1995-1997—think teens and young adults. The Great Recession, climate change, school shootings, social media and COVID are their defining events. They are the first generation of digital natives who know no life without the internet, computers and smartphones, and are the first generation to bump against the long-predicted 50:50 demographic split of white to non-white racial identities. Gen Zs are also the highest-educated generation and hold the largest population of those identifying as LGBTQ+.
Self-reliance and pragmatism seem to be their developing characteristics, with high values placed on diversity and identity expression. Sadly, poor mental health may also become a defining Gen Z factor if much of the generation continues to report unprecedented levels of stress and poor mental health.
Why Gen Zs and Alphas are vulnerable
When COVID disrupted every aspect of life, the safety and stability of families eroded. Children and parents were cut off from school-based connections, engagements and services. Social and peer groups collapsed. Families absorbed the roles of childcare providers and educators. Death tolls, long recoveries, permanent disabilities and job losses started piling up.
Nearly 8 million kids worldwide lost a parent or primary caregiver to COVID. Twenty-nine percent of high school students had a parent or caregiver lose their job. Fifty-five percent of high schoolers reported emotional abuse and 11% physical abuse. Without school-based interventions, children and teens had fewer places to turn.
Families who were already at risk for adverse health outcomes were significantly impacted. COVID alone may not have created the crisis, but it tipped the scales of already existing conditions and disparities that gave rise to this national public health issue.
In 2020, the American Psychological Association (APA) reviewed the findings of their annual Stress in Americaä survey and officially declared the U.S. to be in a national mental health crisis that could yield severe health and social consequences for years to come. To provide supportive counsel and guidance, the APA formed an interdisciplinary group of child development, parenting, racial disparity and education specialists. The group identified that all generations faced numerous and escalating stressors, but the lived experiences of adults provided some protections through a “this too shall pass” narrative. Being in their developmental and coming-of-age years, young adults, teens and children lacked this protective barrier and took in the full force of accelerated disruptions, despair and stress.
Is it bad or is it a phase?
In 2020, the APA identified rising levels of stress and depression among young adults and teens. In October 2021, the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP), and the Children’s Hospital Association (CHA) issued a joint statement declaring a National Emergency in Child and Adolescent Mental Health. In February of 2023, the CDC again sounded the alarm with its release of its Youth Risk Behavior Survey, which provided specific data trends on the behaviors and experiences of high school students.
The good news in the CDC survey is that teens are experiencing less bullying, risky sexual behaviors and substance use. The tough news is that they faired significantly worse in every other health and well-being indicator. Compared to 2011 data, 50% more teens experience persistent sadness or hopelessness, and 21% percent more are having suicidal ideations. The most vulnerable are female and LGBQ+ students, with 20% of females reporting sexual violence and 70% of LGBQ+ students experiencing persistent sadness or hopelessness. Overall, 40% of high schoolers could not engage in regular activities for at least two weeks over the year due to overwhelming sadness or hopelessness.
Why we should pay attention to our youth
Childhood is when we develop the emotional skills, perceptions and daily habits to cope with life problems in positive ways. Poor mental health and stability disrupts this process, leading to negative coping mechanisms, distorted perceptions, emotional dysregulation and harmful relationships that decrease resiliencies and functionality later in life. It is also important to note that parents’ mental health and stability is directly related to children’s mental health and stability. As early childhood experiences shape our brains, poor mental health puts kids at risk for low grades, drug use, violence, unhealthy relationships and risky sexual behaviors that can deepen into unhealthy adult decision-making and behaviors.
What challenges do teens and children face?
Everyone’s experience is different, yet studies all uncover some commonalities impacting youth’s abilities to be confident, hopeful and resilient.
Young adults and teens have grown up mainly during times of disruption and unrest, and more so than other generations, are reporting that current events, the news and the future of our nation are significant causes of stress. Teens cite increasing suicide and sexual assault rates; changes in abortion laws; issues surrounding discrimination, poverty, mass shootings, global warming, immigration and the opioid epidemic as topics of stress.
Half of Gen Z teens say the pandemic has severely disrupted their futures and that the ever-changing life circumstances make planning feel impossible. Fifty-two percent are less motivated to do schoolwork, 49% have less involvement in sports, clubs or activities, 47% report learning less and 45% have a hard time concentrating on schoolwork. Gen Zs in college are more stressed, with 87% reporting that their education is a significant source of stress and 67% saying that future planning feels impossible.
Societal pressures and expectations
Negative peer and parental pressures have long impacted mental health. Increasingly, teenagers report that the expectations associated with academic success and extracurricular participation are sources of stress. The underlying message and belief that intense schedules and classwork is the road to college and independence is driving a culture of perfectionism, ridged habits and motivations of fear that impact sleep, impairs focus, stress relationships and leads to burnout.
Loneliness sets in when a person’s desired amount of social interaction is less than their actual number of interactions. Humans require social interactions to thrive, yet teens struggle to live their desired connected and engaged lives. A study by a senior lecturer at Harvard’s Graduate School of Education found that 51% of 18 to 25 year-olds report loneliness either frequently or almost all the time.
Toxic relationships, the existence of other mental health or emotional disorders, the nature of puberty and adolescence, and past traumas have long put people at risk for loneliness and emotional distress. Add a global disaster, and these low-level feelings of loneliness and emotional distress are ripe to disrupt daily life and wellness.
Experimentation is a part of development with substance use being common among teens. Combined substance use and poor mental health raise extra concern when it comes to developing healthy stressor coping mechanisms and emotional resiliency. While high school students report less substance use overall, 23% drink and 18% vape. The American Academy of Child & Adolescent Psychiatry notes that cannabis use is at an all-time high, with teens more likely to use cannabis today than tobacco. As recreational cannabis becomes legalized and advertisements invite new ways to eat, drink and inhale products that often contain higher and higher levels of THC, the medical and education communities are becoming more concerned about growing teen perceptions that cannabis is natural, safe and not addictive.
Gaming and screens
In 2019, gaming disorder officially became a disease with diagnostic and treatment protocols. Through COVID, gaming increased among children and teens as a way to cope with pain and social isolation. As gaming increased, so did reports of problematic playing. Impaired control over gaming, increased priority given to gaming and the escalation of gaming despite negative consequences are all characteristics of a disorder.
What makes gaming fun can also be harmful when continuous exposure to intense stimulation and perceived dangers cause flight-or-fight responses and hyperarousal brain functions. Eventually, brain fatigue from the constant stimulation causes irritability, jittery feelings, unstable blood sugar levels and impaired immune systems.
A 2018 Pew Research Center survey found that 97% of teens are on social media with 90% using multiple platforms and 60% engaging daily. The upside is that social media allows teens to find their communities and express themselves. The downside is increased exposure to violent or inaccurate information and unrealistic or distorted views of the world and other people’s lives. With undeveloped impulses, teens also put themselves at risk of sharing intimate photos or making statements without considering all the consequences. Studies are beginning to connect the amount and frequency of social media use with the levels of harm that lead to anxiety and depression.
What can we do to help our youth
The good news is that young brains are still developing, and there is much knowledge and research on how to support better mental health. We know kids who feel connected to school and families have better mental health outcomes. Building strong connections between adults, youth and friends promotes resiliency. Taking proactive and protective measures to promote and prioritize mental health can make huge impacts.
Open communication filled with compassion, empathy and honesty helps youth make better decisions, learn from mistakes, and avoid the pitfalls of shame and guilt. Parental involvement that supports kids and their mentors, coaches and teachers opens communication and builds healthy relationships. Celebrating childhood milestones and acknowledging kids’ efforts, hardships and sacrifices promotes security and trust.
When issues arise, seek to understand your child’s perspective and ask questions about their experiences, perceptions and feelings. Should you see a decline, don’t hesitate to reach out to professionals for helpful guidance, tools, and language on what is happening. Often a child’s medical doctor is the fastest way to establish care as mental health screenings are now a regular part of child well-check exams.
Why aren’t kids getting care?
With rates of 45 to 60% of young adults, teens and children experiencing mental health, emotional, and behavioral health issues, why is it that only 20 to 35% are in care and treatment, which is known to greatly reduce disease impacts and slow progression?
For one, the industry is struggling to meet the surge in poor mental health and there is a shortage of trained professionals, particularly adolescent psychiatrists. Minnesota, as with the rest of the country, is categorized as having a severe shortage. Only the northeast and Hawaii fair better with a high shortage ranking.
Additionally, the industry recognizes the need to expand culturally competent care that is more welcoming to diverse populations. BIPOC and LGBTQ+ populations need safer spaces to dialogue about their experiences and the therapists who represent them. Those who live in rural areas are more likely to find limited psychological services.
Additionally, the time, effort and money it takes to engage in ongoing care can be a barrier to families. Seeking help typically means regular appointments to work through issues or manage medications. Others are put on wait lists as the industry adjusts to the rising surge. For others, there is an unconscious stigma that stops them from addressing issues or admitting there is a problem. For some, recognizing a problem equals exposing a weakness or a shameful defect. Others carry beliefs that mental health therapy never works or that nothing can be fixed or helped.
More today than ever, people are beginning to talk about their mental health and therapy experiences and encouraging others to take steps toward wellness. Health insurance companies are now paying more for visits and many no longer restrict the number of annual visits. Telehealth is also becoming more widely available to work better with people’s busy schedules and expand access.
How to talk with your child
The best conversations are those that are ongoing. Establishing a practice of check-ins can give a forum for kids to talk about struggles and a foundation for listening. Remember that as parents, you are not the reason your child struggles and that it is not your job to fix your child or their struggles. Remember, your child’s mental health is theirs to own, and good mental health carries an ongoing practice of skills and habits.
Be your child’s go-to
Make it a safe, nonjudgment zone that avoids lectures and punishments. Kids need to know and feel they can tell you anything for them to open up. Keep telling them that you only want to understand their experiences and help them.
Take yourself out of it
Don’t let your fears interrupt listening and understanding. Take deep breaths and give them the grace to tell their story how they know how to describe it. Remember that not all things they say are what they mean. They are still practicing articulating their experience, so provide them the space and grace to do so. You might have to accept some silence and start again in a few days.
Use facts, curiosity and humor to defuse and invite
Saying something like “You’ve been edgy lately” invites defensiveness and opportunities for denial. To soften, you can present your factual experience followed by a curiosity question. “I’ve noticed [blank] and wondering [blank?]’ as it gives them a grounding point to speak to directly.
Equally, parents have a supportive role to play in the lives of their young adult children over 18. Launch years can be particularly challenging and stressful as young adults try out their adult legs.
Watch for danger signs
Mental health and emotional issues can present in a variety of ways. Remember that teens and children are roller coasters of experiences and emotions. Hormone shifts and peer relationships can cause regular ups and downs. However, consistent and multiple signs of stress worsening over time might indicate the need for larger conversations and action. Should you think your child would benefit from the support of a professional, don’t wait to reach out and begin to search, as it may take a while to move through wait lists or find a good fit. Remember, you can always cancel appointments 24 hours in advance should things improve, but getting an appointment last minute is difficult. Having something booked and on the calendar is always a good safety net for ‘just in case’.
Although not complete, here are a few of the more common symptoms of distress to look out for.
- Changes to daily routines, moods, friends, grades
- Quitting activities they usually enjoy
- Obsessions with new activities, goals, or friends
- Frequent comments about worries, fears or concerns
- Refusal to talk or open up about anything in their life
- Signs of physical harm or withdrawal
How to find a good therapist
Finding a good therapist can also be a barrier to care. If you don’t feel comfortable talking with a friend, try your medical doctor, who can often make a referral. If you have health insurance, visiting their portal or app will help you find someone in your network and nearby.
Understanding your benefits and payment responsibilities will also help you plan. Otherwise, several reliable online databases offer search tools:
- American Psychological Association
- American Association of Marriage and Family Therapists
- Association of LGBTQ+ Psychiatrists
Work associations, school resources, organizations and associations for specific diagnoses also often have searchable databases.
Remember that trust is essential. A good therapist will meet you and your teen where you are and help validate feelings and concerns while challenging and expanding perceptions. The road to better health can also be a roller coaster as your family takes on the work of exploring and redefining your experiences and your relationships. However, for many, the wellness and peace that comes with engaging in personal development and understanding is worth the effort.
While Alliance for Healing does not treat patients under the age of 12, we are here to help refer you to other trusted professionals if you are looking for therapy for a younger child. In addition, Psychology Today is a great resource for finding therapists in your area.