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This story includes the topic of suicide.

If you or someone you know may be considering suicide, contact the 

It's hard to overstate the disruptive impact the pandemic has had on people.

Its effect on mental health is a big one, and for teenagers, that hit particularly hard.

Kathleen Ethier knows this well. She leads the Division of Adolescent and School Health at the Centers for Disease Control and Prevention, which this month published 

 that points to some very grim findings. From January to June 2021, CDC researchers collected data on the behaviors and experiences of 7,705 public and private high school students across the U.S.

Almost half of teens reported consistently feeling sad or hopeless — almost every day for two weeks or more in a row, to the point that they stopped doing their usual activities — in the 12 months before taking the survey.

One particular finding was sobering: 47% of lesbian, gay and bisexual teens said they had "seriously considered committing suicide."

Ethier, who has worked at the CDC for more than 20 years, tells NPR's Ayesha Rascoe

that the numbers show how the pandemic accelerated an already worrying decline in teen mental health.

But, even as the numbers warn of a crisis, the survey also provided hope for possible improvement. It found that teens who feel connected to others at school report better levels of mental health.

Ethier spoke to NPR about mental health among teens and some of the survey's findings.

This interview has been edited and condensed. To hear the broadcast version of this story, use the audio player at the top of this page.

On the big-picture results from the survey:

We've known for a while that mental health among young people was going in the wrong direction. Prior to the pandemic, we were seeing increases in persistent feelings of sadness and hopelessness. What we really saw in the survey was the extent to which the pandemic has been incredibly disruptive for young people and their families. And then, although all students were impacted by the pandemic, not all students were impacted equally. I think that this directs us [to which] groups are most vulnerable. But also, toward some hope for things that we can do to try to address this crisis.

most vulnerable to poor mental health outcomes:

Asian students, Black students and multiracial students were most likely to say that they had experienced racism in school at some point in their life. They were more likely to have poor mental health outcomes than their peers who had not experienced racism. We also found that young people who experienced racism were less likely to say that they felt connected to others at school. 

[For] LGBTQ youth, we had been seeing that difference for many years, and I think [the decline in mental health over the years] comes down to the experience of stigma and trauma and bullying. 

The finding that I think we have to dig further into is something we've been seeing for many years:

It's that our adolescent females are experiencing poor mental health. I think we know that they may experience more negative feedback through social media so they may be more impacted by it. We know that they experience sexual violence. There's a number of factors that are contributing to that, but I don't think we understand it quite as thoroughly as we should.

On how feeling connected at school plays a critical role:

The research shows that young people who feel connected to others at their school, who have others at their school who care about them, who are interested in their well-being, who are interested in their success. Young people who feel that way — anywhere in 7th to 12th grades — 20 years later have better outcomes in terms of their mental health, in terms of substance use, in terms of experience and perpetration of violence, and in terms of sexual health. It has a really broad-ranging impact.

There are really specific things that schools can do to increase connectedness. Some of them are intuitive, like getting rid of bullying and making sure that make sure that young people feel safe and feel supported. But then there are some things that you might not think about, like classroom management. I think a well-managed classroom does not mean it's an overly controlled classroom. Teaching teachers how to find that line where students feel valued, they feel heard and they feel like they are participating while also having structure and making sure bad behavior is not tolerated, I think that's the line to be walked here.

[Another] set of things that really help with school connectedness are activities, policies and practices that support LGBTQ youth. That includes things like having clubs that support them, having anti-harassment policies, identifying safe spaces. We see improvements in mental health and decreases in suicidal thoughts and behaviors [with these interventions] not only in the students who identify as lesbian, gay, bisexual or questioning, but also in their heterosexual peers.

So, something about protecting the most vulnerable youth means that the school is better for everyone.

On current efforts by some state legislatures to curtail expressions of gender and identity in schools:



Although I'm not able to comment on any particular state law or policy, I will say that when you make schools more toxic for any student, you make schools more toxic for all students. Any time we are not making efforts to improve the safety and supportiveness of school environments for very vulnerable youth, we are putting all of our students at risk.


Health

COVID-19

Ayesha Rascoe

Author

Fernando Narro

NPR's Ayesha Rascoe asks Kathleen Ethier, director of the CDC's Division of Adolescent and School Health, about a new survey on teen mental health.

The kids are not all right. The CDC finds mental health among teens has declined

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