Teen mental health has been on the decline for well over a decade, since long before the pandemic began. From 2007 to 2017, the number of teens who reported having at least one major depressive episode in the past year rose more than 60%. From 2011 to 2020, the number and proportion of emergency room (ER) visits among youth and young adults for mental health reasons doubled, with the sharpest rise seen among teens. 

And in each of the past five years (2018–2023), weekly ER visits by teens for mental health issues have soared during the school year, reaching up to twice the number of visits that occurred during the summer. As the school year rapidly approaches, it’s important for parents, employers, and health plans to take steps to help teens address their mental health and well-being. That starts with gaining a better understanding of teen mental health today. 

To that end, in October 2023, Calm conducted a survey of more than 1,000 teenagers (ages 13 to 17) and their parents and also hosted several in-depth interviews with them. Our goal was to learn how teens think about and engage with mental health:

• How are teens doing?
• How do they define mental health?
• What actions do they take to address their mental health?

How are teens doing?

Teens of all ages reported feeling a wide range of emotions, but more teens are feeling negative emotions than positive ones. Here are some examples:

• 70% of 17-year-olds reported feeling tired, and 52% of them reported feeling excited.
• 67% of 16-year-olds reported feeling stressed, and 41% reported feeling confident.
• 55% of 15-year-olds reported feeling overwhelmed, and 35% reported feeling proud of themselves.
• 61% of 13-year-olds reported feeling tired, and 60% reported feeling happy.

Furthermore, while positive emotions are fairly constant across age groups, negative emotions become more prevalent as teens age.

The survey also showed differences by race. For example, Black and Latinx youth are much more likely than youth of other races to be tired (+10 points). Black teens are less likely to feel confident than other teens (-7 points), and Asian American and Pacific Islander (AAPI) teens are more likely to feel stressed (+10 points) than teens of other races.

What’s stressing out teens?

The future, school, and family and social stressors are weighing most heavily on teens. The following are some findings from Calm’s survey:

• 66% of teens are stressed about “my future,” and 45% are stressed about “figuring out who I am.”
• More than 60% of teens are stressed about doing well in school (63%) and the volume of schoolwork they have (64%).
• More than half (53%) of teens are feeling stressed about their parents’ opinions and expectations of them.
• And about a third of teens are stressed about disagreements with friends (34%) and comparing themselves to peers they see on social media (37%).

School stressors peak at age 15, while future and social stressors grow throughout the teenage years, especially stress about social media. Stressors also vary by race. Latinx teens are the most stressed by social media and comparison (+18 points), and AAPI teens are the most stressed by the volume of schoolwork they have (+11 points) and about how they’re doing in school (+12 points).

Teens and parents define mental health differently

When asked what mental health means to them, teens focused primarily on their emotions. For many teens, mental health is all about owning and balancing the emotions they feel, negative and positive. “Mental health is taking care of the way I feel about things in the world around me, and the things that affect my emotions,” said one 15-year-old. “I think mental health means that you can sometimes be sad . . . and sometimes happy,” said a 17-year-old.

By contrast, parents we spoke to tended to define mental health as being at ease with yourself and what life throws at you. Participants in our survey said they see mental health as being able to function independently, manage life without excessive stress, and feel safe and secure in their lives.  

Teens are ready to take action to improve their mental health

Teen participants universally said they were introduced to the idea of mental health in school, between the fourth and seventh grades. In elementary school, anti-bullying discussions and goal-setting sessions were common, and in middle school, discussions focused on topics such as depression and suicide. They reported having built a deeper awareness of mental health through influencers they follow on social media (e.g., YouTube or TikTok) who speak openly about their mental health struggles, as well as through television shows and popular music.

Early introduction of mental health likely breaks down the mental health stigma for teens, helping them take action to improve their mental health:

• 68% of teens say that mental health is an important part of who they are.
• 74% say that talking about mental health makes you strong.
• 71% of teens say improving their mental health is something they take the lead on.
• 59% of teens say the way you feel is something you have control over.

Most teens take action when they don’t feel right

In addition to feeling empowered to take charge of their mental health, most teens can identify when they need to take action to improve it. Signs they look for include feeling tired or drained, getting sick often, having panic attacks and increased anxiety, feeling irritable or overwhelmed, and sleeping too much or too little. 

When they need to take action to improve their mental health, the majority of teens look to physical ways of working through their feelings. Here are some things they do weekly to help them improve how they’re feeling:

• 90% listen to music
• 66% play video games
• 56% work out
• 48% play sports

They also do mental/emotional check-ins with themselves (40%), perform breathing exercises (35%), and draw or color (41%). Sixty-one percent of teens say their parents almost always know how they’re feeling, but only 41% say they often talk to others about their feelings.

How to help teens’ mental health

The declining state of mental health among teens and all youth prompted the US Surgeon General to issue an advisory, Protecting Youth Mental Health, at the height of the pandemic. He called on all of society—parents, schools, health providers, employers, government organizations and others—to make youth mental health a priority. 

Based on Calm’s survey and the US Surgeon General’s advisory, here are some recommendations for parents, employers and health plans to help address teen mental health during and beyond the upcoming school year. 

Parents: 

• Recognize that your teens see the fluidity of emotions in mental health more than a steady state of emotional well-being. Acknowledge that they’re experiencing a wide spectrum of emotions and help them develop strategies, such as mindfulness, that can help them work through their negative feelings.

• Work to become a positive role model by taking care of your own mental and physical health. For example, demonstrating how you address your stress or anxiety can help your teens develop similar healthy habits, according to the US Surgeon General. Taking breaks, practicing good sleep hygiene, exercising regularly, and eating well are some of the strategies you can share with your teens.

• Help your teen develop healthy relationships with peers and adults who can serve as a support network. Encourage them to ask for support when they need it. Help your teens become aware of their values and establish healthy boundaries with others.

• Help your teen become aware of the potential harms of social media and work with them to establish some parameters around their use of social media to limit their exposure.

Employers:

• As part of your health and benefits plan, make it a priority to provide access to a full spectrum of mental health support—from preventive support to clinical therapy—for employees and their dependents. 

• Offer accessible, easy-to-use, and engaging digital tools, such as Calm, to help parents and teens address stress, anxiousness, and sleep challenges before they escalate into more serious health conditions. Consider preventive tools that offer a wide range of diverse content and formats that are appealing to teens—music, sound, and movement, for example—and that help them further develop healthy mindfulness habits—e.g., breathing exercises, meditation, or wisdom.

• Foster a workplace culture that makes family mental health and well-being a top priority. 

Ask organization leaders to help break down mental health stigma by speaking openly about mental health and making it safe for employees to do the same. Make sure leaders are using their mental health benefits and sharing their experiences with their teams.

Health plans and providers:

• Make prevention a top priority in supporting youth mental health. Provide access to digital mental health tools that address specific life experiences such as teen depression. Calm Health offers evidence-based, clinical content for teens with depression and anxiety, teens who identify as LGBTQ+, and parents of teens struggling with mental health issues.

• Routinely screen teens for mental health challenges and risk factors. According to the US Surgeon General, screenings should account for the different ways mental health challenges can show up, such as changes in physical health, sleep patterns, and behaviors, and should link to appropriate care. 
  
  
• Routinely screen parents and caregivers for depression and anxiety, because the mental health of youth is closely tied to the mental health of their families. Calm Health offers a free mental health screening* that uses questions from the Patient Health Questionnaire 8 (PHQ-8), a screening for depression symptoms, and Generalized Anxiety Disorder (GAD-7), a screening for anxiety symptoms. At the conclusion of the questionnaire, Calm Health immediately recommends a combination of mindfulness content, clinical programs and external resources aligned to the individual’s screening responses.  

Teen mental health is declining, but the majority of teens are building awareness about how they’re feeling and are taking action to feel better. Parents, employers, health plans, and healthcare providers can build on that foundation by taking practical steps, including providing preventive care, to better support teen mental health and well-being. As the school year approaches, it’s a great time to start. 

*This screening is not intended to diagnose depression or anxiety, nor is it a substitute for care by a physician or other healthcare provider. It is available only to US residents age 18 or older.

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