OCMH Senior Research Analyst Amy Marsman spotlights recent articles, resources, and research findings impacting youth mental health.
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Childhood Lead Exposure Associated with Increased Depressive Symptoms in Adolescence
While lead exposure in children has been associated with cognitive and behavioral problems, few studies have examined later psychiatric symptoms. A new analysis led by researchers at Brown University’s School of Public Health found that increased concentrations of lead in the blood during childhood were associated with increased depressive symptoms in adolescence, with larger increases when exposure occurred later in childhood. No associations were observed with anxiety symptoms. The research, which was funded by federal grants from the National Institutes of Environmental Health Sciences and published in JAMA Network Open, underscores the long-term behavioral outcomes associated with early environmental exposures, the researchers said. Exposure levels at age 8 seemed to be particularly significant.
Teens Use and Views of AI
According to Pew Research, a majority of U.S. teens say they use AI chatbots, including about three-in-10 who do so daily. Teens turn to chatbots like ChatGPT, Copilot and Character.ai for a variety of things – but information seeking (57%) and schoolwork (54%) top the list. About half use AI for fun or entertainment (47%), and lots of teens (42%) use AI to summarize an article, book, or video. Far fewer are using AI for emotional support or advice (12%). The research includes details on demographic differences found in the survey as well as parent perceptions, which underestimate the amount of teens using AI chatbots.
Data Brief: Children and Youth With Special Health Care Needs (CYSHCN)
This data brief from the Maternal and Child Health Bureau provides 2022–2023 updates on the experiences of CYSHCN from the National Survey of Children’s Health. The brief features data on the prevalence of special health care needs, child and caregiver well-being, family impacts, and health care access and quality.
Medicaid and Variability in Insurance Adequacy
Children with special health care needs who have inadequate health insurance coverage experience difficulty getting needed care, more preventable hospitalizations, and have poorer health. This Research Letter in JAMA Health Forum investigated inadequate health insurance coverage among children with special health care needs (CSHCN). Medicaid is the primary insurer for nearly half of CSHCN (and the secondary insurer for some children with disabilities), however there is substantial variability in the quality and continuity of coverage across states. Quantifying state-to-state variation and predictors of Medicaid insurance continuity and adequacy among CSHCN can inform states considering changes to their Medicaid programs – those hoping to improve health care utilization and health outcomes.
Majority of College Students are Lonely, with Social Media Linked to Loneliness
A study from the University of Cincinnati reveals that the majority (54%) of college students experience loneliness, with heavy social media users experiencing notably higher risk of loneliness. The research, based on survey data from nearly 65,000 students ages 18 to 24 across more than 120 colleges, found that spending just 16 hours per week on social media – roughly two hours daily – correlates with higher loneliness rates. The more hours students use social media, the greater the likelihood of loneliness. The heaviest users are 38% more likely to feel isolated.
The study also identified notable disparities: female and Black students reported higher loneliness rates regardless of social media use, while students living at home experienced greater isolation than those on campus.
Most Children Enrolled in Medicaid Did Not Receive Timely Suicide-Related Follow-up Care
Suicide is the second leading cause of death for children in the U.S. In 2023, nearly 225,000 children aged 10–17 who were enrolled in Medicaid were hospitalized or visited the emergency department (ED) for suicidal thoughts or behaviors. Providing timely follow-up care after children experience suicidal thoughts or behaviors is critical to decreasing the likelihood of re-hospitalization and preventing suicide. Federal officials with the Office of Inspector General (OIG) interviewed experts who said a follow-up visit should occur anywhere from 24 hours to one week after a child’s discharge from the hospital or ED. OIG found in half of cases (i.e., hospitalizations or ED visits for suicidal thoughts or behaviors), children did not receive a follow-up visit in the week after their discharge—a critical time for intervention. The OIG released a full report and report highlights.
Universal Suicide Screening Strategies for Students of Color
Suicide is the second leading cause of death among adolescents and young people ages 10 to 24 in the U.S. Black youth are overrepresented in the overall makeup of suicides: while Black children comprise roughly 15% of the total youth population, they account for 37% of all youth suicides in the U.S. Additionally, suicide among Hispanic youth, specifically young Hispanic females, is increasing. The aims of this pilot study were to determine relevant and appropriate school-based suicide risk screening practices and interventions for Black and Hispanic students in an urban school district setting.
The researchers found that culturally-informed universal screening for suicide risk in the school setting, as compared with need-based screening, identified students who were not already known by school staff to be experiencing mental health challenges or at risk for suicide, and particularly students of color. This study highlights the importance of culturally informed universal suicide risk screening in schools, particularly for minoritized students such as Black and Hispanic youth. Since mental health is stigmatized within racialized communities, which can inhibit help-seeking, the authors cite universal suicide screening as an important step in identifying at-risk students who may not be detected through existing need-based processes, potentially enabling timely intervention and support to suicidal youth.
New Dashboard Shows 3-Year-Olds’ Readiness and Development
For the first time, national data offer a holistic view of 3-year-olds’ developmental well-being. The Healthy and Ready to Learn (HRTL) measure, developed for use in the National Survey of Children’s Health, captures development across five key domains—early learning skills, social-emotional development, self-regulation, physical health, and motor skills—that, combined, indicate whether young children are developmentally “on track.” Child Trends’ new dashboard presents the latest HRTL data, highlighting the developmental well-being of 3-year-olds at both the national and state levels. The overall HRTL score for Wisconsin (71.7%) outpaces the nation (64.1%).
Evolution of Firearm Mortality as the Leading Cause of Death in the U.S. Pediatric Population
For decades, motor vehicle collisions (MVCs) represented the leading cause of death among the U.S. pediatric population. Recently, however, firearms surpassed MVCs as the leading cause of death in individuals aged 1 to 24 years. That flip in leading cause of death was subsequently documented in a younger population (aged 1-19 years) after 2019. At the state level, however, there remains significant variability in the leading cause of death. This study describes the evolution of firearm mortality, in four-year intervals, in the U.S. population aged 1 to 19 years at the state and national levels since 2004. The research shows that firearms became the leading cause of death for children in Wisconsin between 2019 and 2023 when more states than not reached the same threshold.
Large Majority of Parents and Teens Support School Cellphone Bans
The Brookings Institute found there is strong support for cellphone restrictions in school among both teens and adults. This survey found that 76% of teens expressed a preference for some form of restrictions on phone use during the school day and 93% of adults supported restrictions. (Related research from Pew Research found lower levels of support among teens.)
Despite this support, nearly half (47%) of teens thought restrictions will have a negative impact on their happiness, and a third (35%) of parents also thought phone limits will negatively impact student happiness. More than half of teens say phone restrictions will have no impact on their ability to make friends (67%), bullying/fighting (65%), sense of community (54%), and relationships with teachers (53%). The researchers suggest further surveying at the end of the school year will potentially add insight into these somewhat contradictory findings.
Half a Million More Students Have Access to School Counselors
The American School Counselor Association (ASCA) announced the student-to-school-counselor ratio continues to narrow, reaching its lowest margin since ASCA began tracking ratios in 1986. Smaller student-counselor ratios are linked with better attendance, academic performance, graduation rates, and fewer disciplinary incidents. Learn more about ASCA, counselor roles, and ratios here.
The updated ratios were calculated using data from the U.S. Department of Education’s National Center for Education Statistics. These data indicate that for the first time the high school range of 195 to 224 students per counselor meets the recommended ratio (250:1). The updated ratio means that about 529,000 more students had access to a school counselor last school year than in the previous year. Elementary and middle schools still do not meet the recommended student-counselor ratios. While the national ratio improved, Wisconsin’s ratio remained the same: 362 students for every one counselor.
School Loneliness and Belonging Among Immigrant Students
First- and second-generation immigrant youth had lower levels of mental health symptoms than nonimmigrant youth. The study also found that levels of mental health symptoms were lower among immigrant youth when school immigrant concentration was high. A sense of belonging in such cases may explain the reduced loneliness.
Increase in Postpartum Depression Among Low-Income Moms post-Dobbs
This cohort study examined whether state abortion bans enacted after the Dobbs v Jackson Women’s Health Organization decision were associated with increased rates of postpartum depression (PPD) among Medicaid enrollees, based on socioeconomic status (SES). The research included 102,597 individuals pre-Dobbs and 61,113 individuals post-Dobbs. They found that women with low SES who lived in states with abortion bans experienced a significant increase in postpartum depression after Dobbs compared to those in states without bans. As such, abortion bans were disproportionately associated with an increased risk of postpartum depression. Since the research focused on those in low-SES communities, the authors point out that the increased rates of depression amplify existing health disparities.
New State Paid Leave Policies Grant Parents Access to Critical Prenatal Care
Timely and regular prenatal care provides an opportunity to identify and manage potential complications for both pregnant people and fetuses during pregnancy, including infection, gestational diabetes, preeclampsia, mental health concerns, substance use, and genetic conditions or other fetal abnormalities. Prenatal care visits also provide an opportunity to screen patients for risk factors like stress, unstable housing, and intimate partner violence, and to provide referrals for resources and education on topics related to pregnancy and neonatal health.
Despite this importance, Child Trends analysis found, in 2023, 7% of women who gave birth in the U.S. received late (beginning in the third trimester) or no prenatal care, according to data from the National Vital Statistics System. This is slightly higher than the previous year (6.8%) and the highest percentage reported in the years for which we have national data on this topic. New York State and Washington, DC have responded with new policies.
AAP Updates Policy Statement on Adolescent Confidentiality
Adolescent confidentiality is one of the most complex aspects of pediatric care. This complexity is driven by both state and federal laws. State laws determine what types of health care an adolescent has the right to be kept confidential, such as sexual or reproductive health, mental health, or substance use data. Electronic charts, patient portals, and health apps make it even more difficult to navigate.
Federal laws mandate that electronic health data be freely and easily accessible to patients at all times. Confounding this is that parents and guardians usually have access to their children’s health records as proxies on their patient portal.
In updated guidance from the American Academy of Pediatrics (AAP), the organization asserts that protecting adolescent confidentiality is not only a legal obligation, but essential to ensure adolescents seek the care they need. Without knowing that their provider is committed to protecting their confidentiality, adolescents may forgo vital care, potentially leading to negative outcomes such as sexually transmitted infections, unintended pregnancies, worsened mental health, and substance use.
The policy, updated from 2012, focuses on health information technologies and addresses a range of sensitive data. Topics include gender identity and sexual orientation, as well as disparities in confidentiality protections that affect young adults with limited capacity to make health care decisions, children in foster care, and others at higher risk of privacy violations.
State of Play Report
The Aspen Institute has found that three-quarters of parent respondents reported that their children’s mental health, physical fitness, emotional control, and social well-being increases or increases greatly when they are regularly engaged in sport. The 2025 State of Play report found participation rates are up, with 55% of kids ages 6-17 playing sports as of 2023. At the same time, the costs of youth sports continues to grow – up 46% since 2019, according to Aspen Institute Project Play research. Significant access gaps remain among youth from upper- and lower-income homes. Related survey work describes how youth with disabilities need sports more but play less and how parents spend 3+ hours every day on child’s sports.
Young Adults in Transition, Lonely and Connected
This study examined individuals' age in relation to social well-being (i.e., connection, companionship, friendship support, and number of friends) and social ill-being (i.e., loneliness, disconnection).
Utilizing a large, representative sample of Americans (N = 4,812), with participants ranging from the ages of 18-95 (mean age of 43.7), the results demonstrate that although social ill-being is higher for young adults (emerging adults), social well-being is high for both younger and older adults. Further analysis found those with high well-being and moderate ill-being were more likely to be young, educated females who had gone through many life changes in the past year. Participants in the cluster with high well-being and lowest ill-being were more likely to be older adults, facing fewer life changes.
The findings suggests that loneliness among young adults is not bereft of connection, companionship, and friendship, but instead is characteristic of rapid life changes and a lack of relational permanence and routine.
Connected, Lonely and Major Depression
In this cohort study from Hong Kong, young people who had a new onset of a major depressive episode (MDE) were also found to have higher levels of loneliness but were not socially isolated. In other words, lonely but socially connected youth were most likely to have a MDE begin. The research explores whether and to what extent loneliness versus social isolation plays a role in onset of MDE.
How the DSM Can Incorporate Socioeconomic, Cultural, and Environmental Determinants
The Diagnostic and Statistical Manual of Mental Disorders (known as the DSM) is widely used in throughout the world for diagnosing mental disorders. In 2024, a committee developed strategies to incorporate new knowledge into DSM as the field advances, including how to integrate the social determinants of health (SDOH) into the future DSM. In this commentary the authors provide definitions; discuss how DSM and other manuals and frameworks use and/or integrate socioeconomic, cultural, and environmental determinants of health and intersectionality; highlight the deliberations in determining how to identify and integrate methods to assess and quantify SDOH and their implications for diagnosis and treatment of mental disorders in diverse contexts and cultures; and describe primary, secondary, and tertiary prevention.
Brief: State Medicaid Coverage of Behavioral Health Therapy for Children and Youth
Medicaid is the primary payer for behavioral health services for children and youth, yet access to and coverage of behavioral health resources vary by state. To understand these variations, the National Academy for State Health Policy analyzed Medicaid behavioral health therapy coverage in all 50 states and D.C. Their brief highlights key findings on diagnostic criteria, billing approaches, and limits that affect children and youth’s access to behavioral health therapies.
Children with Mental Health Diagnoses often Incarcerated Instead of Getting Treatment
NPR covered a new report from Congress that has raised the alarm about children with mental health conditions being held in juvenile detention rather than getting treatment. The report, Prolonged Incarceration of Children Due to Mental Health Care Shortages, released by the staff of Democratic Sen. Jon Ossoff and Republican Rep. Jen Kiggans, is based on a survey sent to administrators of public juvenile detention facilities around the country. According to the survey, 75 juvenile detention centers in 25 states reported holding youths for days or even months until space became available at a long-term psychiatric residential treatment facility. About half of those who responded to the survey reported they had, at some point, kept children incarcerated when they could have been released into offsite mental health care – due to a shortage of mental health services.
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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