OCMH Senior Research Analyst Amy Marsman spotlights recent articles, resources, and research findings impacting youth mental health.
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Profound Economic Impact of Positive Childhood Experiences (PCEs)
The HOPE National Resource Center, in collaboration with partners at the Centers for Disease Control and Prevention (CDC), Johns Hopkins University, Boston University, and Prevent Child Abuse America, published a study that found positive childhood experiences (PCEs) reduce medical spending costs, and provide additional healthy years that are worth billions in economic value.
In the cross-sectional study, the research team analyzed Behavioral Risk Factor Surveillance Survey (BRFSS) data for nearly 21,000 adults in four states – Kansas, Montana, South Carolina, and Wisconsin – and found that PCEs were associated with an estimated $3.1 billion in lower medical spending costs as well as $212.8 billion in additional healthy life years (years not lost due to disability, ill health, or early death) for a total of $215.9 billion in economic value. They also calculated the savings reaped from PCEs amount to $782,000 for every adult (over their lifetime).
Large Numbers of Underage Kids are on Social Media; Peer Relationships are Key
Most research on adolescent social media use focuses on teens ages 13 and up, the minimum age required to create an account. But new research from Northwestern University is shedding light on a younger, largely overlooked group: children ages 8 to 12. Using data from ECHO, an ongoing National Institutes of Health program that regularly surveys thousands of U.S. children, the researchers found more than two thirds of preteens report using social media.
This research builds on the 2025 study of 13-18 year olds that found peer relationships were the strongest predictor of well-being, regardless of social media use – nearly 3 times as large as the association between social media use and poor mental health. According to reporting, the current study will be published shortly. The lead author’s presentation slides from a recent webinar are available to download.
Guide for Clinicians to Manage Adolescent AI Chatbot Use for Mental Health
The iSPARC research center at UMass Chan Medical School has released a tip sheet for clinicians working with adolescents who use AI chatbots for mental health support. The guide outlines practical strategies for opening nonjudgmental dialogues; educating kids on the distinctions between AI chatbots and evidence-based therapeutic interventions; and identifying warning signs that require professional involvement. Further, it emphasizes the importance of developing safety protocols and alternative coping strategies, engaging parents or caregivers, and offering crisis resources.
The recommendations aim to help mental health providers address the complexities of AI-powered digital interactions to safeguard adolescent well-being. Clinicians are advised to routinely assess and monitor chatbot use, understanding both the potential benefits and risks.
Daily Impact of Screen Time With Friends on Adolescent Well-Being
This study highlights the motivations for adolescents to engage in digital interactions with friends, particularly when feeling lonely, and the emotional benefits of such interactions. Youth completed daily diaries for 15 consecutive days, reporting on time spent interacting with friends via digital platforms and outcomes including stress, affect, depressive symptoms, loneliness, and sleep quality. The findings suggest that digital engagement may increase positive feelings without compromising psychosocial well-being, while also serving as a coping mechanism for loneliness. These findings emphasize the importance of focusing on the quality and purpose of screen use rather than just its duration.
Proceedings of a Workshop: Digital Tools for Youth Mental Health
The National Academies’ Forum for Children’s Well-Being convened a leadership summit to examine both the promise and the challenges of digital interventions. This Proceedings of a Workshop—in Brief synthesizes perspectives from leaders highlighting how digital interventions can support prevention, extend care, and strengthen connections. Discussions emphasized the importance of designing with youth, building trust, and aligning digital innovations with real-world systems of care.
Speakers explored emerging models—such as self-guided tools, blended care, and virtual platforms—while underscoring persistent challenges, including gaps in youth-specific evidence, engagement and retention, fragmented reimbursement structures, and barriers to scaling across systems. Participants highlighted the need for shared evaluation frameworks, sustainable funding approaches, and cross-sector collaboration to move from pilot efforts to broad implementation.
New Data Available in Child Welfare Interactive Data Tool Shows Large Decline in Children Entering Foster Care
Child Trends has updated its child welfare data interactive with 2024 national and state data on foster care, maltreatment, relative caregiving, permanency, and older youth in care. The tool provides information on national trends and profiles for all 50 states, Washington, DC, and Puerto Rico. The data show a continuous decline in children entering foster care since 2016, which may be due to policy shifts that aim to prevent unnecessary foster care.
Large Increases in Suicidal Ideation Among College Students
A new analysis led by researchers at Johns Hopkins Children’s Center found suicidal ideation and depression symptoms have steadily increased among college students over the past 15 years, particularly among women, minorities and students experiencing financial stress.
The researchers examined survey results from more than 560,000 U.S. college students and found an increase in every item on the Patient Health Questionnaire-9 (PHQ-9), which is one of the most widely used screening tools for depression. The period of analysis was from 2007-2022. All PHQ-9 items increased in average score during that time span.
The largest percentage increases over this 15-year period were seen in suicidal ideation (+153.9%), agitation/restlessness (+79.6%), and trouble concentrating (+77.7%). These increases were most pronounced among women, intersex, and financially stressed students, and those belonging to several racial groups. Suicidal ideation increased across all demographic groups without significant differences by race.
Suicides Dropped 11% Among 15-34 Year Olds Since 988 Lifeline
The 988 Suicide and Crisis Lifeline launched in 2022. In the subsequent three years, contacts to the lifeline more than doubled, with disproportionately higher use among adolescents and young adults. This study analyzed quarterly suicide mortality among individuals aged 15 to 34 years to determine whether population-level suicide mortality changed after launch of 988.
The researchers found an 11% reduction in suicide among this age group. This translates to 4,372 fewer deaths by suicide. Further, the researchers discovered suicides among young people dropped most sharply in states that actively embraced the 988 crisis and lifeline.
Changes in Youth Hospitalizations for Eating Disorders Before and After COVID-19
This analysis of 41 pediatric hospitals found a sharp increase in the number of patients requiring medical stabilization for eating disorders immediately after the start of the COVID-19 pandemic, followed by decreases, resulting in a return to normal patterns in 2025. Five years after pandemic onset, the volume of adolescents and youth adults with eating disorders admitted to the hospital appeared to have returned to pre-pandemic levels. This volume was even below that estimated by the pre-pandemic pattern, although this difference was not statistically significant. Authors provide study limitations.
A Cross-National Analysis of Suicide Among Children Aged 5 to 9 Years
While rare, suicide among children ages 5-9 do occur. Research on suicide mortality rates among this age group is also sparse, particularly outside the US. In the US, hanging is the predominant method (86%). Comparisons across countries are needed to characterize variation and inform prevention priorities. Using the World Health Organization (WHO) Mortality Database (2012-2023), the authors of this study examined cross-country suicide rates, sex differences, methods, and temporal trends among children age 5-9 years.
Among other findings, the research shows an increase in suicide among girls ages 5-9 in the US through 2020.
Early ADHD Diagnosis and Educational Outcomes
This research investigated whether the age of attention-deficit/hyperactivity disorder (ADHD) diagnosis was associated with educational outcomes. Using a cohort study of more than 580,000 individuals, the researchers found that earlier age of ADHD diagnosis was associated with better grade point average at age 16, higher probability of academic than vocational studies, and lower probability of school dropout at age 20 compared with diagnosis during the last years of compulsory basic education.
The findings suggest that earlier ADHD diagnosis is associated with better educational outcomes, while individuals first diagnosed toward the end of compulsory education may be at high risk of school dropout.
Diagnosis of Girls with ADHD Surpassed Boys in Canada – but not in the US
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children and adolescents. It remains unclear how recent increases in ADHD diagnoses relate to changes introduced in Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5), or whether the COVID-19 pandemic contributed to short-time surges or longer-term shifts. Most ADHD studies have focused on prevalence rather than incidence, which may obscure emerging patterns. Using 2 decades of data from British Columbia, Canada, this study examined whether ADHD diagnosis rates changed over time in association with DSM-5 implementation and the COVID-19 pandemic. The authors found that the incidence of ADHD increased and appeared to accelerate following the implementation of DSM-5 changes and the pandemic. Aside from the possible role that these changes may have played, increasing public and clinical awareness of ADHD may have contributed to greater recognition and help-seeking.
Role of Candidate Biomarkers and Biological Factors in Future DSM
Biomarkers are indicators of normal biological processes that can be objectively measured. Biomarkers can be found in genetics, MRI and PET scans, EEGs, and some blood assays. They may have an important role in the future of psychiatric assessments and treatment, possibly through the use of more neurobiological approaches to mental health.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) remains largely a symptom-based, descriptive approach to classifying psychiatric disorders. KFF reported on the potential for biomarkers to be incorporated into future DSM. A subcommittee studied the biomarker issue to help bridge the gap between psychiatry and neuroscience and move the DSM toward a psychiatric system informed by objective measures. The group examined whether any biomarkers are ready for integration into the DSM, and for clinical practice.
Though it will take time, given the growing body of biological insights across scientific fields, the subcommittee recommends starting a structured and dynamic process of integrating biomarkers into future DSM revisions. This would support the goals of more accurate diagnosis and subsequent individualized treatments.
Workshop Proceedings: Digital Tools for Youth Mental Health
Youth are increasingly seeking mental health support online yet face quality concerns, access barriers, and fragmented systems of care. As digital technologies rapidly reshape mental health care delivery, there is growing recognition of both their promise and their challenges in supporting youth well-being. The National Academies' Forum for Children's Well-Being convened a leadership summit to examine both the promise and the challenges of these tools. The forum’s mission is to promote equitable mental, emotional, and behavioral flourishing of children and youth through evidence-based collaboration. This Proceedings of a Workshop—in Brief synthesizes perspectives from leaders highlighting how digital interventions can support prevention, extend care, and strengthen connections.
Discussions emphasized the importance of designing with youth, building trust, and aligning digital innovations with real-world systems of care.
Solitary Screen Time Exacerbates Later Socioemotional Problems in Young Children
Child development experts and research are clear. In-person social interactions are needed for children to develop language skills, emotional regulation, and healthy relationships. This study tests the hypothesis that unsupervised, solitary screen time amplifies the relationship where children with low language skills have heightened socioemotional difficulties.
The participants were 546 preschoolers (ages 4-5) who attend childcare centers in Denmark. Teachers twice completed assessments of child adjustment difficulties (i.e., conduct problems and emotional problems), approximately six months apart. Teachers assessed child language abilities (i.e., communication skills and productive vocabulary) and parents reported solitary screen time (i.e., the amount of time children spent alone viewing handheld devices or television).
Results confirmed the hypothesis that those with poor communication skills and smaller vocabularies developed more behavior problems if they had solitary screen time.
Early Childhood Nicotine Exposure
Although poison center surveillance continues to report pediatric nicotine exposures annually, no national study has assessed trends across all routes of exposure since 2016 when cartridge- and disposable-based e-cigarettes became prominent. Unintentional nicotine exposures occur predominantly in children younger than 5 years, particularly exploratory toddlers (ages 1-2). This retrospective study analyzed national poison center data from 2016 through 2023 to characterize trends in pediatric nicotine exposures across product types and exposure routes. While traditional tobacco product exposure has decreased, e-cigarette exposure has gone up by nearly 243%. The analysis also found that while ingestion is still the predominant method of exposure, inhalation-based exposure has also increased, suggesting that children are beginning to activate the devices themselves.
National Survey of Youth and Sports
The Aspen Institute’s Project Play initiative partnered with Utah State University and Louisiana Tech University for a first-of-its kind national youth study to understand children’s experiences in sports. Almost 4,000 youth participated in the survey, which assessed sports-related perceptions of youth who currently play organized sports, formerly played or have never played. This story reports key findings from the full report. Key recommendations are that sports providers create and market low-stakes, intramural-style leagues that explicitly de-emphasize winning and prioritize social connection and physical health.
Home visiting programs play a critical role in helping families strengthen parenting skills, nurture parent-child relationships, and promote healthy child growth and development. Studies show that home visiting programs are successful in improving maternal and child outcomes related to birth weight, cognitive development, and child abuse and neglect, among others. Child Trends recently reported on the increase in mothers enrolled in home visiting who breastfed their baby: 36% in 2017 to 45% in 2024. Related, Child Trends highlighted the role home visiting programs can play in nutrition-related support.
Gender Euphoria and Mental Health in TGNB Young People
Researchers have studied gender dysphoria – the feelings of distress that may arise from one’s gender not aligning with their sex assigned at birth – among transgender and nonbinary (TGNB) people. However, less is known about gender euphoria – the positive feelings about one’s gender expression and experiences of gender affirmation. The Trevor Project finds that TGNB young people who report higher levels of gender euphoria had 47% lower odds of depression, 37% lower odds of anxiety, and 37% lower odds of suicidal ideation. 82% of TGNB youth said they experienced gender euphoria by “feeling validated when strangers treated them like their gender in public.”
Bullying, State Policy, and Mental Health Symptoms in Gender-Diverse Youths
The authors of this study examined whether bullying and state policies related to gender identity were associated with subclinical psychotic-like experiences in gender-diverse youths in the US. Using a large, nationally representative cohort of children ages 9 to 13, self-reported bullying was associated with greater rates of psychotic-like experiences in gender-diverse youths – and it was consistent across four years.
These findings suggest that social stigma, including bullying and unsupportive legislation related to gender identity, impact gender-diverse youths’ mental health. The need for supportive environments and policies is highlighted.
Impacts of Undermining a Youth's Sexual Orientation or Gender Identity
This one-page resource summarizes the research on the dangers of conversion practices, also known as “conversion therapy,” aimed at changing a young person’s sexual orientation or gender identity (SOGI). It highlights key findings, including that exposure to such efforts doubles the risk of suicide attempts and triples the risk of severe depression, while all major medical and mental health associations universally oppose these practices. The resource emphasizes that harm occurs regardless of intent or who carries out the practice.
Connectedness During the Perinatal Period and Child Well-Being
In this paper, the authors present a new theoretical model highlighting the connection between parents' social connectedness with child developmental outcomes across the perinatal period. The transition to parenthood is a time rife with stress and adjustment, along with changes to adults' social lives. Given the unique neurobiological and psychological changes that occur during pregnancy and postpartum, the authors propose that feelings of social connection are especially important for protecting mental health and well-being during the perinatal period, which could also affect the developing child. This paper articulates a new theoretical model demonstrating the potential transgenerational impact of social connection, which offers numerous avenues for future research.
Bridging the Mental Health Care Gap
A new national report released by Inseparable highlights the mental health workforce shortages across the US and explains why the shortages persist. The report cites several interconnected forces behind the workforce shortage, including low reimbursement rates.
State Snapshots are also available. The Wisconsin snapshot shows that less than half of needs are met (41.8%); the lack of state psychiatric hospitals and crisis systems are both rated at catastrophic levels, the worst rating. A number of policy options are also graded. For example, requiring commercial insurers to cover telemental health services at in-person rates shows no progress in the state.
The report offers policymakers practical tools to build and sustain a stronger mental health workforce. These options include actionable state-level strategies to expand capacity, strengthen the pipeline of new providers, support those already delivering care, and leverage data and technology to improve access and outcomes.
Integrating Mental Health as Part of Overall Care
Mental, emotional, and behavioral concerns are part of daily pediatric practice and include examples like caring for a toddler with aggressive behavior, a school-age child with anxiety and school refusal, or an adolescent with depression and social isolation. Yet, fewer than half of children with mental health needs receive appropriate care, with lower rates among marginalized communities. Many clinicians have hesitancy or lack clear, actionable pathways for addressing these concerns, despite growing demand.
The AAP announced a new clinical report to address these issues. The “Mental Health Competencies” policy and technical report outline the pediatric clinician’s role and provide a detailed care algorithm. The clinical report, “Promoting Optimal Development: Screening for Mental Health, Emotional, and Behavioral Problems,” emphasizes early identification through routine screening to prevent symptom progression.
Report on Federal Expenditures on Children through 2024 and Future Projections
Children under age 18 comprise approximately 22% of the U.S. population. Despite direct benefits for kids, society, and the economy at large, federal investments in children are on the decline. The latest analysis from Urban Institute’s Kids’ Share project finds that only 8% of all federal spending was on children in 2024. By 2035, it is expected to decline to only 6% of the budget.
Insufficient Sleep in Adolescents and the Need for System Changes
Insufficient sleep is one of the most common health risks in adolescents and is associated with worse cognitive performance and academic achievement, as well as depression, other mental health conditions according to this JAMA Editor’s Note. Insufficient sleep increased from 68.9% in 2007 to 76.8% in 2023 among high schoolers. This trend was observed in all demographic groups and was generally consistent across subgroups characterized by behavioral risk factors.
These sweeping patterns suggest that structural and environmental factors may be driving increases in insufficient sleep at the population level. School start times are a major structural factor that leads to insufficient sleep. Digital media is also discussed. The authors advocate for interventions that support adequate sleep duration in adolescents and the issue warrants a concerted systems-level approach that involves schools, families, clinicians, technology companies, and, when appropriate, support from governmental agencies.
Teen Birth Rate Hits Historic Low
NPR reported that the teenage birth rate in the U.S. fell by 7% in 2025, continuing decades of decline, according to a report published by the National Center for Health Statistics. The report’s lead author said, "A 7% decline is really quite extraordianry."
Overall, nearly 126,000 babies were born to mothers ages 15 to 19, according to the analysis of provisional data. The 2025 birth rate for this age group was 11.7 births per 1,000 females. By contrast, the teen birth rate in 2000 was 48 births per 1,000.
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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