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Summary of Child, Adolescent and Youth Mental Health in the 21st Century

Core Content

This OECD report provides a comprehensive analysis of the mental health status of children, adolescents, and young people (under 25) across OECD countries. It highlights a consistent and concerning decline in youth mental health over the past decade, with the COVID-19 pandemic exacerbating existing trends. The report underscores the need for multi-sectoral, preventive, and integrated approaches to address this crisis.

Main Findings

• Mental Health Decline: In most OECD countries, mental health indicators for young people have been declining, with nine out of 11 countries showing an annual average decline of 3% to 16% in mental health status between 2012 and 2022.
• Prevalence of Mental Health Conditions: Mental health conditions are common among children and adolescents, with most mental disorders beginning between the ages of 12 and 25. The peak age of onset is estimated at 14.5 years, and about 62.5% of disorders manifest before age 25.
• Anxiety and Depression: Anxiety disorders are prevalent in childhood and early adolescence, while depression and substance use disorders increase and peak in early to mid-adulthood.
• Suicide and Self-Harm: Suicide rates among young people have remained relatively stable, but hospitalisations for self-harm, particularly among girls, have increased. In 13 countries, self-harm hospitalisations for girls aged 0-17 rose by 29% between 2015 and 2023.
• Gender and Age Disparities: Girls and older adolescents, especially those in their mid-to-late teens, experience poorer mental health compared to younger peers and boys. In 2022, 68% of 15-year-old girls reported multiple health complaints, compared to 36% of boys.
• Impact of the Pandemic: The mental health decline was already visible before the pandemic, with the pandemic intensifying the situation. However, early signs of recovery in 2023-2024 are not yet conclusive.
• Digitalisation and Mental Health: Excessive or late-night use of digital devices is linked to sleep disruption, a known risk factor for poor mental health. Social media use is associated with anxiety, depressed mood, and poor body image, though it can also provide peer support. Cyberbullying and exposure to harmful content have increased, contributing to emotional distress.
• Socio-Economic Factors: Inequality, poverty, and academic pressure remain significant long-standing risk factors. These interact with other pressures, such as climate anxiety and geopolitical instability, to compound mental health challenges.
• Need for Early Intervention: Prevention and early intervention are crucial for improving mental health outcomes. However, many OECD countries lack sufficient early support systems and rely too heavily on clinical responses.
• Data Gaps: Less than one-third of OECD countries collect regular, nationally representative data on youth mental health. This limits the ability to track trends, evaluate policies, and design effective prevention strategies.

Key Recommendations

• Strengthen Prevention and Resilience: Implement school-based social and emotional learning, mental health literacy, and evidence-based parenting programs in early childhood.
• Expand Access to Support Services: Develop low-threshold, holistic, and peer-supported services to ensure early assistance before mental health issues escalate.
• Address Upstream Determinants: Tackle root causes such as child poverty, housing insecurity, and academic pressure through broader social and economic policies.
• Evaluate Digital Policies: Assess the mental health impacts of school phone bans, age-verification tools, and social media restrictions to ensure they are proportionate and effective.
• Improve Data Collection: Conduct regular national surveys, use more detailed measures of digital engagement, and systematically include young people's perspectives to better understand and respond to mental health trends.

Conclusion

The report stresses the importance of coordinated, cross-sectoral action to reverse the declining trend in youth mental health. It calls for a more integrated and preventive approach that includes schools, families, and digital environments. Robust and comparable data is essential for informed policymaking and monitoring progress in addressing this critical issue.

Main Viewpoints

• Mental Health as a Foundation: Mental health is vital for individual well-being, social participation, and economic prosperity.
• Complex and Intersecting Risk Factors: No single factor explains the decline; rather, it is the result of multiple, interacting pressures.
• Role of Digitalisation: While digital technologies offer opportunities for connection and learning, they also pose risks, especially for vulnerable groups.
• Need for Holistic and Preventive Approaches: Specialist mental health services alone are insufficient; multi-sectoral and early interventions are necessary.
• Importance of Data: Timely and comparable data is essential for tracking trends, evaluating policies, and designing effective strategies.

Key Information

• Scope: Focuses on children, adolescents, and young people under 25 in OECD countries.
• Data Sources: Includes national surveys, international data series (e.g., HBSC), and expert interviews.
• Expert Consensus: 28 out of 29 interviewed experts believe youth mental health has declined over the past decade.
• Prevalence of Conditions: One in five young people in OECD countries have a mental or neurodevelopmental disorder.
• Policy Context: Supports the OECD Recommendation on Integrated Mental Health, Skills, and Work Policy.
• Digital Policy Challenges: School phone bans and age-based social media restrictions are expanding, but their mental health impacts are not yet fully understood.
• Call for Action: OECD countries are urged to take decisive steps to improve youth mental health and well-being.