US youth are in a mental health crisis — we must invest in their care

Imagine a country where two kids in every classroom are experiencing debilitating illness, affecting their ability to concentrate and learn — and potentially threatening their lives. Americans likely would offer sympathy to such a country.  

But there is no need to imagine: The U.S. is that place, and mental health problems are the pervasive illnesses that are deeply affecting children’s education, safety and futures. 

The suicide rate in the U.S. is the highest among wealthy nations, and data suggest that 1 in 5 young women (and 1 in 10 young men) experience a clinical episode of major depression before age 25.  

In December, the Office of the Surgeon General released an advisory detailing the youth mental health crisis in our country. I and my colleagues at the American Psychological Association provided input for this advisory. On Tuesday, I am slated to testify before the Senate Health, Education, Labor and Pensions committee on this calamity. 

To address this crisis, we must acknowledge that our youth mental health system is fundamentally flawed. As noted in the surgeon general’s advisory, mental health issues among children and adolescents reflect children’s individual biopsychological abilities (or vulnerabilities) and the contexts in which kids are raised. This includes their homes, extended families, schools, communities and cultures — and the media (social and otherwise) to which they are exposed.  

Our adult-centric mental health system was built following World War II — a time when we invested substantially in treating returning veterans. Significant funding built the Department of Veterans Affairs and the National Institute of Mental Health and trained psychologists in new psychology departments on college campuses nationwide. But this approach needs reexamining. 

We must improve access to mental health care for children and youth. Suicide rates among children 10 and older have climbed significantly since 2007, now the second leading cause of death among 10- to 24-year-olds, behind unintentional injuries. The stakes of untreated mental and behavioral health symptoms for children and adolescents are exceptionally high and can have profound consequences on the trajectory of a child’s life. 

We must strengthen the mental health care workforce. The federal government invests over $15 billion annually to ensure that enough physicians are trained and distributed throughout the country. The investment in training the mental health workforce is approximately 1/500th of that amount, resulting in a woefully small corps of providers who have been overloaded with patient referrals over the past two years because of the pandemic.   

We must abandon the antiquated notion that mental and physical health are addressed by discrete systems. They are inextricably linked. Science in the past decade has proven that psychological stress influences our immune systems and the expression of our DNA and is linked to inflammatory disease. Yet the separation of primary care and mental health care has created two unequal standards. 

Throughout health care, evidence-based practice has emerged in recent decades to guide decision-making and improve patient outcomes. We must continue to support evidence-based mental health programs. Mental health screening, evaluation and treatment programs across all states and communities need robust support. 

Finally, research is one of the keys to meeting the surgeon general’s urgent call for action. Over time, psychological science has made great strides in addressing youth mental health — but the pace of discovery must accelerate. We need substantially increased funding for the National Institute of Mental Health, the National Institute on Minority Health and Health Disparities and the National Institute of Child Health and Human Development to support research on risk, resilience, prevention and treatment among youth. 

We have an opportunity to make a serious commitment to youth mental health, just as we did 70 years ago to help adults. This is a chance for parents, teachers and youth to stop whispering about their mental health needs and begin shouting for our country to invest in its future and end our children’s suffering. 

Mitchell J. Prinstein, Ph.D., is chief science officer of the American Psychological Association.