Anita Slomsky writes in a recent JAMA includes an article: “Teen Girls Are Faring Worse Than Boys on Nearly All Mental Health Measures—Here’s Why.”
Child and reproductive psychiatrist Misty Richards, MD, MS, puts it bluntly: “Our teen girls are not okay.”
The program director for UCLA’s Child and Adolescent Psychiatry Fellowship recently cared for a girl who attempted suicide after receiving a college rejection letter. “Her self-worth was measured in achievement and external accolades, and she felt she couldn’t be anything other than perfect,” Richards said in an interview.
“We’ve had to create a backup call system in the emergency department at UCLA to get more help for the numbers of teenagers—specifically teen girls with suicide attempts or serious injurious behavior like cutting—who are in absolute crisis. We’ve never seen numbers like this before.”
In interviews with JAMA, Richards and other clinicians nationwide said that teen girls are experiencing unprecedented levels of mental distress.
Survey data back this up. In the 3 decades that the Centers for Disease Control and Prevention (CDC) has tracked high school students’ health and well-being, there has never been a time when teen girls have reported more sadness, hopelessness, and suicide attempts. The latest biennial CDC Youth Risk Behavior Survey, administered in the fall of 2021, was the first conducted since the start of the COVID-19 pandemic. The data show that mental health has worsened for all adolescents, but especially for girls.
According to the survey findings, which included data from more than 17 000 students in 152 public and private schools, 57% of teen girls reported feeling persistently sad or hopeless in the past year—a nearly 60% increase from 36% in 2011. In contrast, 29% of teen boys reported feeling this way in 2021, an increase from 21% in 2011.
During this 10-year period, a nearly 60% increase also occurred in the percentage of teen girls who seriously considered suicide. In 2021, 30% of girls had these thoughts compared with 14% of boys, an increase from 19% and 13%, respectively, in 2011. And 13% of girls reported having had a suicide attempt in 2021 vs 7% of boys.
“The disparity in mental health between boys and girls is not new, but the large and rapid rise in poor mental health among girls over the last decade compared with boys is particularly alarming,” said Kathleen Ethier, PhD, who directs the CDC Division of Adolescent and School Health.
Even before the COVID-19 pandemic, experts were sounding the alarm that US youth were experiencing a mental health crisis, especially related to anxiety and depression. “The COVID-19 pandemic enhanced the cracks that were already present in the lack of psychiatric care and in the maladaptive coping skills of our youth,” Richards said.
And although the latest data highlight the fragile mental health of teen girls, boys aren’t doing particularly well either. The survey measured depression by asking teens to report whether they felt sad or hopeless, which is often how girls express depression, according to Martha Fairbanks Perry, MD, section chief of adolescent medicine and a professor of pediatrics at University of North Carolina School of Medicine. The survey, however, may not accurately detect rates of depression in boys, whose symptoms tend more toward increased irritability, anger, or aggression. “But even if the gap between girls’ and boys’ rates of depression is not as wide as the survey portrays,” Perry said, “the gap has widened, which means that teen girls’ mental health has worsened.”
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