Only 39% of U.S. adolescents who experienced a major depressive episode
in 2021 received care
The ripple effects of the adolescent behavioral health crisis are estimated at up to $185 billion in lifetime medical costs and $3 trillion in lifetime lost productivity and wages
NEW YORK, NY, April 16, 2024—The toll of the adolescent behavioral health crisis in the United States is vast and growing; varies in prevalence by location, race, sex, and sexual orientation; and has ripple effects on lifetime medical costs, productivity, and wages, according to a national analysis released today by United Hospital Fund.
Using data from multiple nationally administered surveys, as well as analytic modeling and expertise from Boston Consulting Group (BCG), The Ripple Effects of the Adolescent Behavioral Health Crisis provides a baseline analysis of the number of adolescents in the United States, New York State, and New York City who have a behavioral health condition and which groups are disproportionately affected. Importantly, this report also calculates the burden of unmet need for behavioral health care among adolescents and the resulting impacts on the individual, family, and society. The analysis also includes key informant interviews and outlines potential avenues for intervention.
Major findings, assembled from various sources, include:
In the United States:
- Adolescents were less likely to receive care for major depressive episodes (MDE) than adults—only 39% of adolescents received care in 2021 vs. 56% of adults.
- Based on the 2022 prevalence of adolescent behavioral health conditions and symptoms, the ripple effects of the adolescent behavioral health crisis are estimated at up to $185 billion in lifetime medical costs and $3 trillion in lifetime lost productivity and wages.
In New York State:
- An estimated 1 in 4 adolescents experienced a behavioral health condition in 2022.
- Black and Hispanic high school students were nearly twice as likely to attempt suicide compared to white high schoolers from 2019 to 2021.
In New York City:
- From 2011 to 2021, there was a 42% increase in the rates of adolescents who reported experiencing feelings of persistent sadness and hopelessness.
- When compared with heterosexual students, students identifying as lesbian, gay, or bisexual were more than 4 times more likely to attempt suicide in 2021.
“Over the past decade, the number of adolescents suffering from behavioral health conditions has increased, and the toll is especially profound for communities of color,” said Oxiris Barbot, MD, United Hospital Fund president and CEO. “Solutions won’t be easy or quick, but this report sheds light on potential ways to make a disjointed and under-resourced child behavioral health system more responsive, effective, and equitable.”
Other Key Findings:
- The toll of the adolescent health crisis in the U.S. is vast. Approximately 6.7 million adolescents in the U.S. suffered from one or more behavioral health conditions in 2022, including 340,000 adolescents in New York State. Behavioral health conditions may include depression, anxiety, substance use disorder, disordered eating, behavior problems, and ADD/ADHD.
- Adolescents who report persistent sadness are more likely to engage in risky and health-threatening behaviors. Compared to those without negative mental health symptoms, high schoolers who report persistent sadness are 3 times more likely to use illicit drugs and 2.3 times more likely to engage in binge drinking.
- Adolescents who identify as lesbian, gay, or bisexual (LGB) are at higher risk than those who identify as heterosexual. In 2021, across all three geographies (U.S., New York State, and New York City), when compared to heterosexual students, LGB students were around 2 times as likely to feel persistent sadness, over 3 times more likely to consider suicide, and over 4 times more likely to attempt suicide.
- Access to behavioral health prescribers (i.e. child and adolescent psychiatrists, family medicine physicians, and pediatricians) varies by state. The national average is 207 prescribers per 100,000 youth; New York State has 188; and Nevada (147) and Texas (152) have the lowest availability.
The report discusses several approaches to tackle the crisis, beginning with addressing the shortage of trained behavioral health clinicians. It identifies a spectrum of promising initiatives that may help address adolescent behavioral health needs in tandem with traditional clinical behavioral health interventions. These include initiatives that empower non-clinical staff to intervene early on with adolescents who are experiencing minimal to mild behavioral health conditions, encourage adolescents to share their stories and fight against the stigma surrounding behavioral health, and foster communication between families, schools, and communities to create a more supportive environment.
The Ripple Effects of the Adolescent Behavioral Health Crisis was co-authored by Giovanna Braganza and Amy Lin of United Hospital Fund. It can be downloaded for free here.
About United Hospital Fund
United Hospital Fund works to build an effective and equitable health care system for every New Yorker. An independent, nonprofit organization, we are a force for improvement, analyzing public policy to inform decision-makers, finding common ground among diverse stakeholders, and developing and supporting innovative programs that improve health and health care. We work to dismantle barriers in health policy and health care delivery that prevent equitable opportunities for health. For more on our initiatives and programs, please visit our website at www.uhfnyc.org and follow us on X.
