The Girls Are Not Ok.

What teenage mental health declines can teach all of us.

Photo by Alexander Grey on Unsplash

More bad news about the mental health of teenage girls: The second year of the Covid pandemic brought with it a 22% increase in acute mental health emergency room visits among teenage girls, according to insurance records — which do not fully capture the scope of ER visits and hospitalizations. Girls whose families were so worried they brought them to the ER were struggling with depression, suicidal thoughts, eating disorders, and other problems severe enough that their parents sought emergency care.

Teenage boys, on the other hand, saw ER admissions for mental health decrease.

These latest statistics come after a devastating CDC report documenting stunning rates of hopelessness, sexual violence, and suicide attempts and ideation among teenagers, and among teenage girls in particular. And politically liberal teenagers seem to be doing worst of all: Liberal girls have seen the greatest mental health declines, but liberal boys have seen a greater decline than conservative girls.

What might be going on?

• First, there was the pandemic (duh). This decrease in teenage mental health pre-dated Covid-19, but the pandemic really seems to have sent things into overdrive. Human beings are social animals; when you remove our in-person connections to one and other, and force those connections into the virtual world, we suffer tremendously. While many of us have gone back to our normal lives, teenagers saw their social and emotional growth badly impacted. I don’t think we yet know the longer-term consequences of that; we do know that the short-term ones have been disastrous.

• Second, there is the troubling fact that home is not always a safe place for young people. The girls with parents who care enough to take them to the ER are probably the luckier ones. According to another CDC study, more than half of American adolescents described parental behavior during the pandemic that researchers qualified as emotional abuse. It’s far from a perfect study — the question they asked was “During the COVID-19 pandemic, how often did a parent or other adult in your home swear at you, insult you, or put you down?” and even adolescents who said that this happened “rarely” were put in the same emotional abuse category as those who said this kind of mistreatment happened “most of the time” or “always.” Still, a stunning 55% of adolescents indicated that their parents had in at least rare circumstances sworn at them, insulted them, or put them down. And even though there’s a world of difference between a single angry utterance (“for fuck’s sake, McKenzie, do your homework”) and being consistently berated, insulated, put down, and cursed at, more than 10% of adolescents also said they experienced physical abuse at home. There’s little doubt that the reality of the pandemic — trapping people in their homes — meant that women and children were trapped with abusers who, in pre-Covid life, they could at least escape for some of the time. And there’s little doubt that the stressors of the pandemic exacerbated abuse. It shouldn’t surprise us that this culminated in mental health declines among girls, who also reported more abuse than boys.

• Then there is the internet. Listen, I am a big fan of the internet — I am on it right this minute, and so are you. But it seems pretty clear that as social media has taken the place of a lot of in-person activity, the mental and physical health of teenagers, and teenage girls in particular, has declined. 97% of teens use the internet daily, which isn’t that surprising or necessarily bad, but more than a third of teens say that they are on social media “almost constantly” and nearly half say they are online “almost constantly.” Girls are more online than boys, and Black and Hispanic teens are much more likely than White teens to say that they are online “almost constantly.” And if you’re online constantly, what you’re not doing is socializing in person with your friends, playing sports, running around outside, dating, reading a book, or doing 1,000 of the other, more emotionally-healthy activities that all humans need. Kids in the least-privileged households — who have the most over-stretched parents, or abusive or neglectful parents, or who don’t have safe places to go outside, or who don’t have parents who force them to moderate their internet use — are the ones who are spending huge chunks of their childhoods online. This does not bode well for academic, social, and emotional development of vulnerable young people.

• The gender divide in teenage social media use is also fascinating, and perhaps provides some insight into the mental health gap.