Office of Children's Mental Health Senior Research Analyst Amy Marsman spotlights recent articles, resources, and research findings impacting youth mental health.
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Teens’ Sleep Health and Mental Health Strongly Linked
Findings from the National Sleep Foundation’s (NSF) annual Sleep in America® Poll found teens’ sleep health and mental health were strongly linked. The findings include 80% of teens are not getting enough sleep; teens who have trouble falling or staying asleep two or more nights a week have significantly more depressive symptoms; and almost three fourths of teens say their emotional well-being is negatively impacted when they sleep less than usual.
Sleep Awareness Week is March 9-15, 2025, and the NSF has a variety of research and resources already available. The 2025 poll is expected to be released at that time.
Memory Study Finds Sleep is Therapy for Emotions
According to a Science Alert story, being able to erase bad memories and traumatic flashbacks could help in the treatment of a host of different mental health issues, and scientists have found a promising new approach to do just this: weakening negative memories by reactivating positive ones. The study used memory encoding over the course of several days and concluded that sleep, a noninvasive intervention, offers an opportunity to reduce suffering from painful memories or traumatic experiences.
National YRBS Data Show Less Sleep, Less Exercise, Less Healthy Eating for Teens
The Centers for Disease Control and Prevention (CDC) recently released details from the 10 years of the Youth Risk Behavior Survey (YRBS) on physical activity and sleep. The report reveals that fewer students are getting enough physical activity and sleep; fewer students are eating fruit, vegetables, and breakfast daily; and female students and LGBTQ+ students are less likely than their peers to engage in most of these health behaviors. Healthy eating, regular physical activity, and adequate sleep are essential for improving students’ mental and physical health; and preventing chronic health .
[Note: The YRBSS and the YRBS interactive data explorer, one of OCMH’s primary data sources, have been subject to interruptions caused by the Trump Administration’s Executive Orders and subsequent court rulings that required the CDC to restore the data and related webpages. We are aware of Administration disclaimer on the website and continue to monitor the availability of these critical data sources.]
Adolescent Smartphone Use During School Hours
Screen use among U.S. youth remains a concern, with adolescents aged 13 to 18 years spending 8.5 hours daily on average using screen-based media. Smartphone use during school has become a concern, and school-based smartphone bans have been increasingly considered. Smartphones may distract from classroom learning and opportunities for real-world interactions. Emerging consensus is that measuring adolescent screen time alone is insufficient to appreciate its effects. That is, what adolescents are viewing (content) and what activities are potentially being displaced (context/timing) are salient factors.
This study used passive sensing to characterize the duration and content of smartphone use during school. Authors found that adolescents spent an average of 1.5 hours on smartphones during the 6.5 hours of school, or 23% of the school day. In this sample, 25% of adolescents spent more than 2 hours on their phone during school.
Medicaid’s Role in Child, Youth, and Adult Mental Health
Medicaid is the single largest payer of mental health services in the United States. Medicaid expansion has been an essential piece of the puzzle in addressing the mental health crisis. State Medicaid expansions have been shown to lead to an increase in annual mental health outpatient visits. Health coverage is also associated with overall peace of mind and lower financial stress, especially among adults with chronic conditions. This is according to a report from Georgetown University’s Center for Children and Families.
10 Things to Know About Medicaid
According to KFF, Medicaid covered nearly 4 in 10 U.S. children and nearly half of children with special health care needs. Longstanding research shows that Medicaid eligibility during childhood is associated with positive effects on health (including reduced avoidable hospitalizations and mortality) and impacts beyond health, such as improved long-run educational attainment.
Home Visiting Addresses Maternal and Child Health Disparities
Perinatal home visiting is a popular strategy for promoting maternal and child health. Wisconsin’s Family Foundations Home Visiting (FFHV) Program is a statewide network of agencies that provide evidence-based home visiting services to pregnant women and families with children under age five.
The Institute for Child and Family Well-Being recently published a study in the Wisconsin Medical Journal that shows the potential of the FFHV Program to promote maternal health equity. The authors concluded that the FFHV program targets services to populations and communities disproportionately at risk of maternal and infant health disparities, and that additional strategies should be considered to bring home visiting to scale in Wisconsin.
50-State Early Childhood Policy Progress and Landscape Report
The Alliance for Early Success released its annual 50-State Early Childhood Policy Progress and Landscape Report, which tracks developments and trends in state early childhood policy and advocacy. The 2024 report shows that support for state early childhood policies and funding continued to be strong in the past year. All states with a 2024 legislative session reported a policy win, and 83% reported a win that included an increase in state funding. Many appropriated state funds to close federal funding gaps, signaling the importance of investing in the early years as a public good, worthy of state revenues. Survey results also show that the political climate for improving early childhood policies remains favorable.
Parents' Earnings Increase with Universal Pre-Kindergarten
This paper asks whether universal pre-kindergarten (UPK) raises parents’ earnings and how much earnings effects matter for evaluating the economic returns to UPK. During children’s prekindergarten years, UPK enrollment increases weekly childcare coverage by 11 hours. UPK enrollment increases parent earnings by 21.7% during pre-kindergarten, and gains persist for at least six years after pre-kindergarten. Gains are largest for middle-income families. Under the conservative assumption that families value UPK at the cost of provision, each dollar of government expenditure on UPK yields $10.04 in benefits.
Parent Stress About Loss of Housing is Linked with Child Mental Health
In this cross-sectional study of nearly 37,000 children, caregivers’ stress about eviction or loss of housing was associated with increased odds of depression and anxiety among children. These findings underscore the importance of policies and interventions to address housing instability and its mental health consequences for children.
Ableism in Mental Healthcare Settings
A new study from the Yale School of Public Health explores the experiences of people with disabilities in the mental health care system and finds ableism and discrimination against people with disabilities are common. People with disabilities (PWD) are at elevated risk for mental health concerns but face multiple barriers when seeking services. When they do access mental health care, PWD are often confronted with ableism. For example, information may not be provided in an accessible format, such as braille. Providers' lack of knowledge about disability and mental health is also pervasive.
Researchers Identify Most Effective Suicide Prevention Policies
Suicide rates have been on the rise over the past two decades. For people ages 10-24, suicide increased by 62% between 2010 and 2020. A new study from researchers at New York University determined which public policies effectively prevent suicide deaths. Overall, the researchers found that policies that improve economic security, limit access to alcohol, and restrict access to lethal means have the strongest evidence for suicide prevention.
As explained in Campus Safety, the analysis found most policies that demonstrate suicide prevention evidence do not mention suicide and were not passed to prevent suicide. The researchers explain, “They are policies that are intended to address other issues—for instance, increasing minimum wage to promote economic security or reducing alcohol consumption—but they have spillover benefits in that they also prevent suicides.”
Hospitals May Miss Opportunities to Identify More People With Suicide Risk
Pew Charitable Trusts reports on research showing health care providers can play a key role in preventing suicide, given that almost half of those who die by suicide visit a health setting in the month before their death. However, a recent study of accredited nonpsychiatric hospitals shows that 35% of U.S. hospitals are missing opportunities to identify more people experiencing suicidal thoughts or behaviors and connect them to care. The study quantified how many hospitals screen all patients ages 12 and older, regardless of the reason for their visit, for suicide risk. This practice – comprehensive universal suicide screening – is an evidence-based practice where all patients are asked whether they are experiencing suicidality using a validated screening tool. A separate study of emergency departments found that universal screening followed by evidence-based interventions reduced total suicide attempts by 30% for the year in which the study was conducted.
Pediatric Mental Health Boarding: 2017 to 2023
Annually, approximately half a million children receive care in emergency departments (EDs) for acute psychiatric emergencies. Many of these children require admission to an inpatient psychiatric facility for stabilization and treatment. This means they are unsafe for discharge home and must “board” in the ED or an inpatient floor until a psychiatric bed is available. Boarding for pediatric mental health (MH) conditions is common at U.S. children’s hospitals while patients await care at a psychiatric facility. There was a sustained increase in the volume of boarding encounters and length of stay since the onset of the COVID-19 pandemic. Median length of stay for boarding encounters increased from 3 to 4 days, according to the study.
Related commentary, The Waiting Game: Boarding for Pediatric Mental Health Emergencies, explains the lack of access to outpatient services is a key driver behind a dramatic increase in ED among youth and argues that the impact of this stark increase in mental health boarding cannot be overstated, as boarding leads to substantial potential hospital and patient quality and safety issues. Medication errors are common, with up to 40% of boarding patients experiencing a medication error.
Suicide Risk and Social Connectedness in LGBTQ
Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ), especially transgender and gender-diverse (TGD) youth are at high suicide risk. This study utilized data from LGBTQ youth aged 12-17 in the Emergency Department Screen for Teens at Risk for Suicide study. The study revealed that high levels of family connectedness, a known protective factor, may be particularly helpful in mitigating suicide risk in TGD youth.
Teen girls are facing an increased risk of suicide − and stress related to sexual identity might be contributing to it
Education policy researchers, noting the alarming national rise in suicidal thoughts and behaviors among teenage girls, explored a well-known but overlooked source of stress that now affects more teenagers compared with a decade ago: stress related to sexual identity.
The authors conducted research showing that the increase in suicidal thoughts and behaviors corresponds with a dramatic rise in the number of female high school students who identify as LGBQ. Between 2015 and 2021, the percentage of high school girls identifying as LGBQ jumped from 15% to 34%. During this same period, all females who reported they thought about suicide increased from 23% to 29%. Girls who identified as LGBQ consistently reported much higher rates of thinking about, planning, and attempting suicide. In 2021, about 48% of LGBQ females considered suicide, compared with roughly 20% of heterosexual females. The authors note that while more young people feel able to openly identify as LGBQ, many still face substantial challenges that can affect their mental health.
Research has consistently shown that LGBQ youth face unique stressors, including discrimination, rejection by family members and friends, and bullying and harassment. Other research shows that discrimination against LGBTQ people is linked with anxiety, depression, and suicidal thinking.
Gender Difference in the Onset of Adolescent Depressive Symptoms
Depressive symptoms are prevalent in adolescents, especially girls, underscoring the need for early detection and targeted interventions. Identifying initial symptoms is vital for tailored prevention and intervention efforts. This research provides insights into the distinct depressive symptomatology of girls and boys. The analysis identified "loneliness" as the initial symptom in girls and "fatigue" for boys. The findings suggest that addressing interpersonal loneliness is crucial for adolescent girls, whereas somatic fatigue should be a focus for adolescent boys, highlighting the need for gender-specific approaches in early intervention strategies.
ADHD Prescription Patterns
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood, affecting approximately 6.5 million U.S. children. ADHD requires a multimodal treatment approach that combines behavioral, educational, and pharmacological treatments. In this issue of Pediatrics, the recent national stimulant shortage on prescription patterns for children with ADHD is explored.
In the aftermath of the COVID-19 pandemic, a nationwide shortage of stimulants wreaked havoc on what had previously been a predictably accessible treatment for children with ADHD – with families and clinicians scrambling to find necessary medical treatment every month. The study findings suggest that the shortage did not primarily force children to stop stimulant therapy, but rather led them to other stimulant or nonstimulant (alternative) medications. The authors recommend future research evaluate whether these switches led to adverse events.
Vaping
Electronic cigarettes, also known as e-cigarettes or vapes, are the most commonly used tobacco product among U.S. youth. Data from the 2024 National Youth Tobacco Survey showed that 5.9% of middle and high school students used electronic cigarettes in the past 30 days. Among young adults ages 21-24, 15.5% use e-cigarettes, the highest rate of all age categories. This report uses data from the 2019–2023 National Health Interview Survey (NHIS) to present 5-year trends in electronic cigarette use and to show how prevalence estimates changed between 2019 and 2023 for men and women and by age and race and ethnicity.
2023 Data Updates - Wisconsin Interactive Statistics on Health (WISH) Injury Module
The WISH system from the Wisconsin Department of Health Services (DHS) provides a variety of data on health indicators in Wisconsin. Mortality, emergency department visits, and hospitalization have all been updated with 2023 data in the Injury-Related Health Outcomes module. The WISH injury mortality module provides more recent information on suicide deaths (count and rates are available for 2023) than the suicide data dashboard, which provides data through 2022. The reason for this is because the dashboard provides additional data regarding circumstances around the death based on information from the National Violent Death Reporting System as well as death records. For nonfatal self-harm data, users can access DHS’ self-harm data dashboard which also includes 2023 data.
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OCMH Research and Data Resources
Key Facts in Youth Mental Health: https://children.wi.gov/Pages/ResearchData/KeyFacts.aspx
Fact Sheets: https://children.wi.gov/Pages/ResearchData/FactSheets.aspx
Data Sources: https://children.wi.gov/Pages/Resources/DataSources.aspx
Research News in Youth Mental Health: https://children.wi.gov/Pages/OCMHNewsletters.aspx
Youth Mental Health Initiatives: https://children.wi.gov/Pages/Resources/ChildrensInitiatives.aspx
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