Child, Adolescent and Youth Mental Health in the 21st Century

Executive summary

Youth mental health has been deteriorating for over a decade

Across most OECD countries, the mental health of children, adolescents and young adults has worsened over the past decade. National surveys and international data series show rising psychological distress, depressive symptoms, and reports of poor mental health among adolescents and young adults. In nine of 11 countries with comparable time‑series data spanning 2012‑2022, youth mental health indicators declined by an annual average of 3% to 16%. While the COVID‑19 pandemic intensified these pressures, underlying declines were already evident from the mid‑2010s onwards. Although a small number of countries show early signs of stabilisation or partial recovery in 2023‑2024, it is too early to determine whether these reflect a more durable improvement or a return to already elevated post‑pandemic levels.

Internationally comparable data reinforce this trend. Between 2014 and 2022, the proportion of adolescents reporting frequent low mood and multiple health complaints increased in every HBSC‑participating OECD country. Girls and older adolescents show particularly poor outcomes; in 2022, more than two‑thirds of 15‑year‑old girls reported multiple symptoms of poor well‑being, and self‑harm hospitalisations among girls aged 0‑17 rose by 29% between 2015 and 2023 across 13 countries. Thankfully, suicide rates among young people have remained relatively stable in most countries.

Multiple interrelated drivers are shaping the decline in youth mental health

The analysis presented in this report, supported by scientific evidence and interviews with 29 clinical and policy experts, indicates that no single factor explains the deterioration in youth mental health. Instead, young people are navigating multiple, intersecting pressures that accumulate across different domains of their lives. Some of these risk factors, such as digitalisation and changing climates, are new while others, such as inequality, poverty, school pressures and bullying are long-standing drivers of poor mental health but may be worsening or exacerbated by contemporary trends.

Digitalisation plays a central but complex role. Excessive or late‑night digital device use is strongly associated with disrupted sleep, which is itself a well‑established risk factor for poorer mental health. Social media use has been linked with symptoms of anxiety, depressed mood and poor body image, although positive impacts, including access to peer support and communities, are also found. Online bullying, exposure to harmful content, and the “amplification” of distressing news contribute further to emotional distress. For example, young people are reported as being increasingly concerned about global instability and crises and are exposed to distressing content about often‑distant events through digital media. Climate change, geopolitical instability and conflict can generate anxiety even among those not directly affected.

Longstanding risk factors for poor mental also remain very influential. Socio-economic disadvantage continues to shape young people’s mental health, influencing both exposure to risk factors and availability of supportive resources. Financial hardship, unstable housing, perceived downward social mobility, and academic pressures all weigh heavily on well‑being. Bullying and cyberbullying, which have increased in prevalence, are strongly associated with depression, anxiety and self‑harm.

These mental health pressures interact rather than operate in isolation. Experts consistently highlighted cumulative exposure as a key characteristic of the current youth mental health landscape, with direct or indirect exposure to multiple risk factors resulting in a sense of persistent pressure and reduced optimism about the future amongst young people.

Stronger prevention, early support and multi‑sectoral action are needed

Protective environments can substantially improve mental health outcomes across childhood and adolescence. Positive family relationships, supportive schools, secure housing, and opportunities for social connection all play vital roles. Evidence shows that social and emotional learning, mental health literacy, and early childhood interventions can strengthen coping skills and reduce the onset or severity of mental health conditions.

However, prevention and early intervention remain underdeveloped and uneven across OECD countries. Many young people often only access support once difficulties have escalated. Experts interviewed for this report judged that existing provision is often insufficient, and that the support structures that are in place often rely too much on high‑threshold, clinical responses rather than early, accessible and youth‑friendly support.

Promising models demonstrate alternative approaches to building mental health resilience and holistic mental health support. Community‑based and peer‑supported services, such as Australia’s headspace network and the Netherlands’ @ease centres, provide low‑threshold, holistic and non‑stigmatising support, reaching many young people who might otherwise disengage from traditional services.

Digital policies are expanding rapidly, including school phone bans, age‑verification requirements and social media restrictions. The evidence base for their mental health impacts is mixed, with some early studies showing improvements in concentration or reduced online risk exposure, and others finding limited or no effects on well‑being. As these policies multiply, careful evaluation will be essential to ensure that they are proportionate, effective and do not inadvertently reduce access to supportive online communities.

A major challenge for policymakers is the limited availability of timely and comparable data. Fewer than one‑third of OECD countries collect regular, nationally representative time‑series data on youth mental health. Measures of digital use remain coarse, and many countries lack detailed information on socio-economic vulnerabilities, school environments and service access. Improved monitoring will be essential for tracking trends, evaluating policies and understanding young people’s lived experiences.

Decisive action is needed to stem the decline in youth mental health

Taken together, the findings of this report highlight the need for co‑ordinated, cross‑sectoral action to promote youth mental health, prevent the onset of mental health difficulties, and strengthen the systems that support young people. OECD countries should:

• Strengthen prevention and resilience‑building, including school‑based social and emotional learning, mental health literacy, and evidence‑based parenting programmes in early childhood.

• Expand access to low‑threshold, youth‑friendly support, including community‑based and peer‑supported services that offer early assistance before difficulties escalate.

• Address upstream determinants of mental health, such as child poverty, housing insecurity and academic pressure, ensuring that broader social and economic policies actively support youth well‑being.

• Evaluate digital policy interventions rigorously, ensuring that school phone bans, age‑verification tools and social media restrictions are assessed for both intended and unintended effects on mental health.

• Improve data collection and monitoring, particularly through regular national surveys, more granular measures of digital engagement, and systematic inclusion of young people’s perspectives.

A comprehensive approach that combines early action, holistic support and stronger evidence will be essential to safeguarding the mental health of the younger generation and enabling them to thrive in the decades ahead.