This chapter looks at trends and patterns in children, adolescents and young people’s mental health status in OECD countries in recent years. The chapter draws on national data and international surveys to document a decline in young people’s mental health status in most OECD countries. This decline was worsened in 2020-2022, but in most cases the declining trend pre‑dated the COVID‑19 crisis. The chapter also presents the perspective of expert youth mental health clinicians and policymakers in OECD countries who believe, nearly unanimously, that there has been a decline in young people’s mental health status. While trends in suicide deaths amongst young people remain stable, in some countries rates of hospitalisation for self-harm have increased, especially for girls. Adolescents in their mid-to-late teens, and girls, appear to have poorer mental health than their younger and male peers.
Child, Adolescent and Youth Mental Health in the 21st Century
Abstract
Multiple signals point to declining youth mental health in OECD countries
Mental health conditions are common amongst children and adolescents, affecting approximately one in five young people in OECD countries.
Youth mental health has declined – and rates of anxiety and depression have increased – in almost all countries where relevant data could be found, including rising rates of depression symptoms, poor mental health, and psychological distress. Out of eleven countries with time series data, in nine countries there was an annual average decline in youth mental health status of between 3% and 16% between 2012 and 2022. Only Japan and Korea saw small improvements in mental health status.
Measures from international surveys on adolescent well-being confirm this declining trend, and of 29 experts interviewed for this report, 28 said they believed young people’s mental health had declined.
Responses to interview question, “Over the last decade or so, do you think that young people's mental health has: 1) stayed the same 2) improved 3) declined 4) cannot say?”
Source: OECD Semi-Structured Interviews with Clinical and Policy Experts on Young People’s Mental Health, 2025.
The COVID‑19 pandemic worsened youth mental health, but the decline began earlier
The COVID‑19 pandemic worsened youth mental health, but the decline began earlier. Canada, the Netherlands, Norway, Sweden and the United States, who collect time series data on youth mental health, saw the highest rates of mental distress in 2021, but the rise in mental distress started well before the COVID‑19 crisis, in 2016-2019. A small amount of 2023-2024 data suggests a slight recovery from the 2021 peak, but it is not yet clear if this is an improving trend or a return to the high rates of distress already observed pre‑COVID.
The mental health status of girls and older adolescents is particularly poor
Self-harm rates may have increased, especially among girls, while youth suicide, based on latest available data from 2020, had not. Amongst the 13 countries able to submit data, self-harm hospitalisations for girls aged 0‑17 increased by 29% between 2015 and 2023.
Girls and older adolescents report poorer mental health than boys and younger children. In 2022, 68% of 15‑year‑old girls reported multiple health complaints, compared to 36% of boys; the proportion of girls “feeling low” more than once a week rose from 28.6% in 2014 to 45.4% in 2022.
There are multiple signals, across OECD countries, of declines in young people’s mental health status. Only very limited evidence of any improvements in mental health status of children, adolescents, or young people could be found, and only in a few countries. It is important to take a cautious approach when interpreting available data, which could for example be influenced by falling rates of stigma around mental health conditions and therefore greater willingness to disclose mental distress. Accurate understanding of cross-country trends in mental health status of young people – especially children and young adolescents – is held back by very limited comparable data. Nonetheless, the aggregate of available data and information suggest that young people’s mental health has been on a declining trend for some time, and worsened further during the COVID‑19 crisis. Older adolescents (in their late teens), girls, and young people in lower socio-economic groups appear to be in poorer mental health, and in many cases have seen more marked declines in their mental health status.
Mental health conditions are common amongst children and adolescents. Indeed, most mental disorders are understood to have a typical onset between age 12 and age 25 (Erskine et al., 2015[1]; Kessler et al., 2005[2]; Uhlhaas et al., 2023[3]). Peak age of onset across all mental disorders has been estimated at 14.5 years, with 62.5% of disorders having their onset before the age of 25 (Solmi et al., 2021[4]). Mental disorders are the main cause of disability among adolescents and young adults in high-income countries (Gore et al., 2011[5]; Erskine et al., 2015[1]). The Institute for Health Metrics and Evaluation (IHME) estimates suggest that the prevalence of mental health conditions peaks in adolescence and early adulthood (Figure 1.2); approximately one in five young people aged 10‑to‑25‑year‑old living with a mental or neurological disorder (prevalence rates may double‑count some individuals who have more than one disorder), slightly higher than the all-ages estimate of one in six (IHME, 2026[6]).
Rate per 100 000 population – OECD countries
Source: IHME (2026[6]), Institute for Health Metrics and Evaluation (IHME) at the University of Washington, www.healthdata.org, accessed on 19 January 2026.
Anxiety disorders are highly prevalent in childhood and early adolescence, while depressive disorders and substance use disorders tend to increase and peak in early to mid-adulthood (OECD, 2025[7]). Prevalence of schizophrenia and bipolar disorder begin to rise in late adolescence and early adulthood, with schizophrenia peaking in the 20‑24 age group, which aligns with understanding that most cases of severe mental illness have their onset in late adolescence and early adulthood (although some symptoms may occur earlier) (Baldessarini et al., 2010[8]; Bolton et al., 2020[9]; Kessler et al., 2005[2]). There is a sharp increase in eating disorders starting in early adolescence (10‑14 years) and peaking during the 15‑19 age group. Substance use disorders are rare in childhood but increase in late adolescence, peaking in early adulthood (20‑24 years).
Conduct disorder (primarily characterised by issues around disruptive behaviour, impulse control, violation of social norms and in some cases aggression) and attention deficit hyperactivity disorder (ADHD) (characterised by patterns of inattention and/or hyperactivity/impulsivity that interferes with functioning and impacts negatively on social and academic/occupational activities), and autism are also particularly prevalent in early age (American Psychiatric Association, 2013[10]).
Some new mental health conditions specifically related to new online risks have been recognised, specifically “video gaming disorder” which is defined in the Eleventh revision of the International Classification of Diseases (ICD‑11) as a pattern of persistent or recurrent gaming behaviour (“digital gaming” or “video gaming”). Gambling disorder – a pattern of persistent and recurrent gambling behaviour – is also included in ICD‑11, and can include predominantly online gambling. The Health Behaviour in School-Aged Children (HBSC) survey suggested that globally, 22% of adolescents played digital games for at least four hours on days when they game, and 12% are considered at risk of problematic gaming. Problematic gaming risk is notably higher among boys (16% vs. 7% for girls) (Boniel-Nissim et al., 2024[11]). It should be noted that this survey cannot be used to estimate the rate of adolescents with a clinical diagnosis of gaming disorder. Increased accessibility through online platforms may have put more young people at risk of gambling disorder. The European School Survey Project on Alcohol and Other Drugs (ESPAD) data covering European youth suggests that online gambling is rising, and that in 2024 risky gambling affected 8.5% of student gamblers, up from 4.7% in 2019. Boys remain more likely to take part in online gambling than girls (30% in 2024, compared to 16% of girls), but girls’ gambling behaviour increased between 2015 and 2024 while boys’ declined slightly (ESPAD, 2025[12]).
A range of recent international studies and commissions have pointed to declining mental health status amongst young people. The 2024 Lancet Psychiatry Commission on youth mental health highlighted that “Accumulating research evidence indicates that in many countries, the mental health of emerging adults has been declining steadily over the past two decades” (McGorry et al., 2024[13]), while the OECD has pointed to “strong signs that the mental well-being of children and young people has declined” (OECD, 2025[7]). In 2025, a systematic analysis of the Global Burden of Diseases highlighted an increase in the burden of mental health among adolescents and young people aged 10‑24 between 1990 and 2021 (Wang et al., 2025[14]). In a review of global mental health prevalence and burden, McGorry et al. (2025[15]) point to increases in the prevalence of mental disorders amongst young people aged 15‑19 from the early 2000s, while for other groups prevalence rates remained steady or declined, and show that prevalence of mental disorders increased amongst all age groups during the COVID‑19 crisis in 2020‑2021, and especially amongst people under age 29. A report by Eurofound found that between 2014 and 2019 self-reported chronic depression increased by more than 1 percentage point (p.p.). (from 4.4% to 5.7% for adolescents and young adults age 15‑34 (Eurofound, 2025[16]).
Available national and international data also point to declines in young people’s well-being, increases in psychological distress, and increases in mental health conditions such as anxiety and depression. Of the ten countries which have collected information on young people’s mental health status over a multi-year period with at least one data point before 2020 and at least one after, only two countries – Japan and Korea – show an improvement in the mental health status of the young people covered Figure 1.3. In Australia, Canada, France, the Netherlands, New Zealand and Sweden, where comparable data was available for young people (of varying ages) and for the total or adult population, the increase in mental distress amongst young people was markedly higher than for the total or adult population. There are also important differences between the measures reported by different countries, and the age ranges covered making direct comparisons between prevalence rates within countries very challenging, and within countries survey instruments maybe have been modified slightly over time. Nonetheless, measures of psychological distress or symptoms of mental ill-health (such as the Kessler 6 or Kessler 10 scales), measured prevalence of mental disorders (for example in Canada), and self-perceived mental health problems or poor mental health status point to increases in mental distress, poor mental health status, and prevalence of anxiety and depression amongst adolescents and young adults in many OECD countries.
Change between 2012 and 2022, or nearest available year(s) – positive growth indicates a rise in the measure of mental distress
Note: Caution should be taken when interpreting changes in mental health status across time. The rates of change cover different types of mental distress and/or disorder, and different age groups, and may therefore not be directly comparable. Some measures of mental health status may be more sensitive to fluctuation than others. In countries where the most recent year was during the COVID‑19 pandemic, the increase may appear more significant given heightened distress in this period. For a full list of surveys and indicators used, please see the data table in Annex 1.A.
Source: OECD based on national sources. Australia (Australian Bureau of Statistics, 2008[17]; Australian Bureau of Statistics, 2023[18]); Canada (Statistics Canada, 2022[19]); France (Santé Publique France, 2023[20]; Léon, 2023[21]); Japan (Ministry of Health, Labour and Welfare (Japan), 2020[22]; Ministry of Health, Labour and Welfare (Japan), 2023[23]); Korea (Park et al., 2023[24]); Netherlands (Centraal Bureau voor de Statistiek, 2025[25]); New Zealand (New Zealand Ministry of Health, 2024[26]); Norway (Bakken, 2022[27]); Sweden (Folkhälsomyndigheten, 2025[28]); United Kingdom – England (NHS England, 2023[29]); United States (CDC, 2025[30]).
Caution should be taken when interpreting changes in mental health status across time; this data could for example be influenced by falling rates of stigma around mental health conditions and therefore greater willingness to disclose mental distress. In countries where there were only two data points and the second data point was taken during 2021 or 2022 – Australia, France, Japan, the Netherlands – part of the increase may be explained by higher levels of distress during the COVID‑19 crisis. In Japan, change in psychological distress is between two data points, in 2019 and in 2022 (Ministry of Health, Labour and Welfare (Japan), 2020[22]; Ministry of Health, Labour and Welfare (Japan), 2023[23]); In Japan a few studies do point to well-being improvement amongst Japanese youth and adolescents during the COVID‑19 period (Miyake et al., 2025[31]; Yamaguchi et al., 2024[32]), but other point to deteriorations (Takaku, Shobako and Nakata, 2024[33]; Hosozawa et al., 2024[34]), making the falling proportion of Japanese adolescents with psychological distress shown in Figure 1.3 difficult to explain. In Korea, data has been collected biannually between 2005 and 2020 (Park et al., 2023[24]), and in 2012 30.5% of surveyed adolescents reported depression symptoms in the previous two weeks (the highest rates of depression symptoms were recorded in 2007, at 41.3%, but are not shown in Figure 1.3). Like in other countries mental distress in Korea increased in 2020, but did not return to the levels seen in 2012 and earlier. New Zealand also stands out as having a very high rise in psychological distress. The whole New Zealand population saw a rise in psychological distress between 2013/14 and 2023/24, but the increase was most dramatic amongst 15‑24 year‑olds, followed by 25‑34 year‑olds, and has been viewed with concern in New Zealand (Mental Health and Wellbeing Commission, 2025[35]; Mental Health Foundation, 2024[36]).
Internationally comparable data tracking young people’s well-being also points to declines. The HBSC survey includes 27 OECD countries, and has been undertaken in 2014, 2018, and 2022. In all countries, the percentage of adolescents “feeling low” more than once a week, and “multiple health complaints”, has increased (Cosma et al., 2023[37]; OECD, 2025[38]). The rate of 15‑year‑olds reporting at least two health complaints more than once a week increased from 37% in 2014 to 52% in 2022 (OECD, 2025[38]), and the rate of 15‑year‑olds “feeling low” more than once a week increased from 20.5% in 2014 to 32.5% in 2022, with girls seeing bigger increases in “feeling low” than boys (see Figure 1.9). Eriksson and Stattin (2024[39]), who used the HBSC survey to analyse the mental health of 15‑year‑olds across give Nordic countries from 2002 to 2022, found that while young people experiencing psychosomatic complaints (headache, stomach-ache, backache, dizziness) have increased, the rate of young people experiencing both acute physical and emotional distress has increased far less, and point to a need for caution to avoid ascribing all psychosomatic symptoms to mental health problems or equating them to psychiatric diagnoses.
Academic evidence from multiple countries also points to increases declines in young people’s mental health status from around 2005 onwards, with most studies focussed on ages 15‑25:
In Belgium, anxiety and depression increased substantially between 2008 and 2013 for girls age 15‑25 and to a lesser extent for boys the same age (Van Droogenbroeck, Spruyt and Keppens, 2018[40]), and a 2021-2022 report by the French Community of Belgium found that young people were reporting more stress and anxiety during and after COVID‑19, and a shared sense of uncertainty about the future had increased (Fédération Wallonie-Bruxelles, 2022[41]).
In Finland, research tracking the mental states of 15‑year‑olds suggested that after a stable period between 2002‑2003 and 2012‑2013, internalising symptoms including depression, social and general anxiety, stress and poor self-esteem increased between 2012‑2013 and 2018‑2019 (Knaappila et al., 2021[42]). Finland has also seen a rise in disability pensions due to mental health conditions among young adults, indicating long term consequences of worsening adolescent mental health (Sotkanet, 2025[43]).
In Iceland, between 2006 and 2016 there a significant increase in self-reported symptoms of anxiety and depression among Icelandic adolescents age 14‑16, particularly among girls, for whom anxiety and depression increased by 8.6% and 6.8% respectively (Thorisdottir et al., 2017[44]).
In New Zealand, after a period of stable mental well-being between 2001 and 2012 a decline in the mental well-being of adolescents age 10‑19, was clear between 2012 and 2019, with increases in symptoms of depression (13.0% in 2012 to 22.8% in 2019), and declines in emotional well-being (76.0% to 69.1% based on the WHO‑5 survey) (Fleming et al., 2022[45]; Sutcliffe et al., 2022[46])
In Norway, the HUNT study which was undertaken in 1995‑1997, 2006‑2008 and 2017‑2019 showed an increase in symptoms of depression and depression amongst Norwegians age 13‑29, while depression symptoms were stable or declined amongst most other age groups (Krokstad et al., 2022[47]).
In Poland, a study of 15‑year‑olds in Warsaw found that between 2008 and 2016, the percentage of young people experiencing symptoms of depression increased significantly (Bobrowski, Ostaszewski and Pisarska, 2021[48]), whilst a study looking at the period 2000-2011 found a trend towards deterioration of the self-reported emotional and behavioural conditions of Polish 16‑year‑olds (Konowałek and Wolanczyk, 2018[49]).
In the United Kingdom, several studies suggest stable mental well-being up to around 2014 (Pitchforth, Viner and Hargreaves, 2016[50]; Pitchforth et al., 2018[51]; Pitchforth et al., 2017[52]), although prevalence of a self-reported mental health condition increased across the same period (Pitchforth et al., 2017[52]). Data from England for young people age 11‑16 suggest an increase in “probably (mental) disorder” between 2017 and 2023 (see Figure 1.3.).
In the United States, at least one study found that rates of depression and anxiety had increased amongst children under age 17 in the period 2016-2022 (Lachaab, 2024[53]), while others have found no change in prevalence but observed an increasing and shifting demand for mental health care for adolescents (Mojtabai and Olfson, 2020[54]), or highlighted shifts towards greater demands for care for depression, anxiety, trauma- and stressor-related disorders amongst individuals under 17 between 2013 and 2021 (Mojtabai and Olfson, 2025[55])
There is some evidence that externalising conditions, such as conduct disorder, substance use and violence decreased over the past two decades, with studies variously showing declines in absolute prevalence, or declines in demand for care for these disorders (Knaappila et al., 2021[42]; Bobrowski, Ostaszewski and Pisarska, 2021[48]; Mojtabai and Olfson, 2025[55]).
Although not all academic studies clearly indicates declines in young people’s mental health status, almost no studies report any measurable improvement in young people’s mental health or well-being. Nationally representative data for Korea and Japan suggest that there had been an overall improvement in depression and psychological distress, respectively, among young people (see Figure 1.3.). A number of studies from Korea suggest that young people’s mental health improved during the COVID‑19 pandemic specifically, before returning to pre‑pandemic levels (Lee, Hong and Kim, 2022[56]), and that though overall adolescent mental health improved during the pandemic it declined for lower income adolescents (Cho et al., 2024[57]). Further studies were identified that seemed to indicate stable mental health status amongst at least some young people during the pre‑COVID period. For the Netherlands, both Duinhof et al. (2014[58]) and de Looze (2020[59]) report emotional well-being amongst Dutch adolescents remain broadly stable up to 2017, with some small fluctuations over time.
A series of semi-structured interviews were undertaken with youth mental health clinical and policy experts to inform this report (Box 1.1). Expert clinicians and policymakers both consistently indicated that they believed the mental health status of young people had declined in recent years (Figure 1.4). Many experts did point to rising awareness of mental health conditions, and falling stigma, as factors that may influence the way in which young people respond to questionnaires measuring mental distress and prevalence, talk about their own emotional states, and their help seeking behaviour.
Nonetheless, experts generally said that they believed there had been an underlying deterioration in mental health status. One policymaker from Central Europe, when discussing trends in youth mental health, said: “increases in reported symptoms are partially because youth self-identify as experiencing certain symptoms more often now than they did, let’s say 20 years ago… [regarding psychosomatic symptoms] a significant or some portion of this increase can be attributed to higher mental health literacy and willingness to report mental health issues… [but] I believe that there is more distress in general in this population group.”
Responses to interview question, “Over the last decade or so, do you think that young people's mental health has: 1) stayed the same 2) improved 3) declined 4) cannot say?”
Source: OECD Semi-Structured Interviews with Clinical and Policy Experts on Young People’s Mental Health, 2025.
To bring new insights into the state of young people’s mental health in OECD countries, the key factors influencing young people’s mental health status, and potential policy responses, a series of semi-structured interviews with policy and clinical experts were carried out in the course of 2025.
In order to connect with clinical experts in youth mental health, the European Psychiatric Association (EPA) sent out a call for expressions of interest in participating in the semi-structured interviews to their Board, Scientific Sections, and Early Career Psychiatrists Committee. Twelve experts were subsequently contacted to participate in interviews. Experts from the European Society for Child and Adolescent Psychiatry (ESCAP), and the European Federation of Psychologists’ Associations (EFPA) also participated in interviews.
In addition, Delegates to the OECD Health Committee were invited to submit names of expert policymakers working on child, adolescent and youth mental health and mental health professionals working with children, adolescents and young people. All OECD countries were encouraged to nominate relevant policymakers who could participate in these semi-structured interviews. Non-European countries were encouraged to nominate relevant mental health professionals (e.g. President of Association of Psychiatrists or Psychologists), and it was noted that for European countries engagement with European-level professional associations was ongoing to inform the report.
Most interviews took place online, in a video interview. A small number of participants submitted written responses. The interview questions were a mix of open-ended questions, and “multiple choice” responses; the interview questions are included in Annex 1.B.
Interviewees were not asked to represent their country or region’s perspective or policy, rather they were asked to respond based on their own expertise and experience. The small sample size for the interviews, and the fact that participants were speaking to their individual knowledge rather than a nationally representative perspective, means that interview responses should not be attributed specifically to countries. Therefore, when quoting expert responses, the text refers to the geographic region in which the expert is based and tabulated Figures do not list responses by country or region.
All experts who were interviewed were given the opportunity to review the draft report and provide comments, and if quotations taken from their interviews were included they were specifically asked if the agreed that this was accurate, and could be included in the text.
The COVID‑19 pandemic had significant mental health impacts. As the OECD documented at the time, young people’s mental health worsened significantly during 2020‑2021; young people were 30% to 80% more likely to report symptoms of depression or anxiety than adults in Belgium, France and the United States in March 2021 (OECD, 2021[60]). Consistent evidence, including from Belgium, Chile, France, Germany, Italy, Mexico, Slovenia, Spain, Switzerland, Türkiye and the United States points to declines in young people’s mental health during the COVID‑19 pandemic compared to pre‑pandemic levels (Ezpeleta et al., 2020[61]; OECD, 2021[60]; Ravens-Sieberer et al., 2023[62]; Bojórquez-Chapela et al., 2023[63]; Rus Prelog et al., 2022[64]; Parola et al., 2020[65]; Pedrini and Meloni, 2024[66]; Akkaya-Kalayci et al., 2020[67]; Caqueo-Urízar et al., 2023[68]).
A number of studies found that the mental health status of young people – and the general population – worsened in 2020 and early 2021, before showing some improvements in late 2021 and early 2022. A nationwide survey of children and adolescents aged 7‑17 years in Germany found that overall mental health problems increased during the pandemic, with levels of anxiety and depression as much as doubling in late 2020/early 2021 compared to pre‑pandemic levels (from a pre‑pandemic level of 15% to a high of 30% for anxiety, and a pre‑pandemic level of 15% to a high of 24% for depression) before declining steadily in the following months. The last survey wave in autumn 2022 showed improvements, but not a return to pre‑pandemic values (Ravens-Sieberer et al., 2023[62]). Bojórquez-Chapela et al. (2023[63]) found similar trends for Mexican youth age 15‑24, with decreased prevalence of symptoms of common mental disorders in late 2021/early 2022, as compared to late 2020/early 2021. Demand for mental health services increased in Ireland and Portugal following the peak of the pandemic period (Barbabela, Duarte and Leão, 2023[69]; McNicholas et al., 2021[70]). In Ireland referrals to Child and Adolescent Mental Health Services fell in early 2020, before increasing consistently from September 2020, with both routine and urgent referrals increasing by as much as 50% compared with previous years (McNicholas et al., 2021[70]).
Only study could be found which suggested improvements in youth mental health during some periods of the COVID‑19 pandemic. In Korea, Lee et al. (2023[71]) found that compared to pre‑pandemic levels, the prevalence of stress, depression, and suicidal ideation, plans, and attempts for adolescents of both sexes age decreased in 2020 compared to the pre‑COVID‑19 period. By 2021, this prevalence had returned to a level similar to before the pandemic. The authors suggest that school closures could have relieved pressure on adolescents, in terms of reducing the burden of school work and reducing academic and social pressure. With regards to the increase in depressive mood and stress amongst adolescents in the second year of the pandemic (2021), the authors suggest that this may be related to both the enduring stress of the pandemic, and a return to school in person or in a hybrid mode. Furthermore, adolescents – and especially girls – from low-income families had poorer mental health status throughout the period studied (2017-2021), including comparatively poorer mental health during both years of the pandemic.
While there is solid evidence that the COVID‑19 crisis worsened young people’s mental health, some time series data suggest that the declining trend in youth mental health started prior to pandemic. Figure 1.5. shows trends in relative level of mental distress amongst young people over time in six OECD countries. To improve comparability between countries – given that different survey methods and different time periods are covered – the first value for each country was normalised to 100. Figure 1.5 therefore shows change relative to the first available value. In all countries except Korea, there is a clear increasing trend observable from around 2015-2017, which then appears to accelerate during the pandemic period in 2020 and 2021, before declining in 2022. Between-country differences in responses to the COVID‑19 crisis, such as different levels of social restrictions or school closures, may have influenced patterns of mental distress during the 2020-2022 period. OECD analysis of the impact of the COVID‑19 crisis on mental health (of all ages) suggested that mental distress was highest during periods of higher deaths and more stringent COVID‑19 control measures (OECD, 2021[72]).
Nationally available measures of mental distress amongst young people between 2012-2016 and latest available year – the first value for each country was normalised to 100
Note: Data use different measures of mental distress, and cover different age groups, which limits comparability. For full details on data sources see Annex 1.A.
Source: OECD based on national sources. Canada (Statistics Canada, 2025[73]); Korea (Park et al., 2023[24]); the Netherlands (Centraal Bureau voor de Statistiek, 2025[25]); Norway (Bakken, 2022[27]); Sweden (Folkhälsomyndigheten, 2025[28]); United States (CDC, 2025[30]).
At the time of writing only a few countries had survey data that went beyond the immediate pandemic period. In two countries – the Netherlands and the United States – data appears to show an improvement in youth mental health following a peak of mental distress in the pandemic, which is consistent with the previously discussed academic literature looking at youth mental health specifically during different phases of the pandemic. Only in Sweden does the increasing trend of mental distress appear to continue to rise from 2021 onwards, with levels of ‘anxiety, worry or distress” higher in 2024 (59% of young people age 16‑29) than any preceding year (Folkhälsomyndigheten, 2025[28]). Sweden’s measure of mental distress, which is relatively broad, may be more sensitive to fluctuations or changing norms around language on social and emotional states than other survey questions or instruments; however, measures of “severe psychological distress” using the Kessler 6 scale also suggest that the mental health of Swedes age 16‑29 was worse in 2024 (18% severe mental distress) than any preceding year (for example, 16.2% in 2022, and 12.8% severe distress in 2020) (Folkhälsomyndigheten, 2025[28]). It will be very important to track young people’s mental health status in the coming years, as further data becomes available, to see whether the “improving” trend post-pandemic is maintained.
With a few exceptions, there have not been notable increases in deaths by suicide amongst young people in OECD countries. Between 2001 and 2021, in OECD countries there was, on average, a steady-to declining trend in suicide deaths across all age groups, including amongst younger age groups, although suicide deaths amongst young people under age 20 did decline less than suicides in older age groups (see Figure 1.6). With some fluctuations between 2001-2019, deaths by suicide declined by 14% amongst 10‑14 year‑olds, by 9% amongst 15‑19 year‑olds, and by 17% amongst 20‑24 year‑olds and y 22% in the population as a whole.
Note: Due to gaps in data New Zealand, Norway, the Slovak Republic and Türkiye were excluded.
Source: World Health Organization (2026[74]), WHO Mortality Database: Self-inflicted injuries (Dataset), https://platform.who.int/mortality/themes/theme-details/topics/indicator-groups/indicator-group-details/MDB/self-inflicted-injuries, accessed 19 January 2026.
In 2020, the start of the COVID‑19 crisis period, suicide death rates increased amongst under‑25‑year‑olds, specifically, by 1% amongst 15‑19 year‑olds, and by 2% amongst 20‑24 year‑olds. Suicide deaths for 10‑14 year‑olds increased by a worrying 54%, but it should be stressed that these are very low absolute numbers, and therefore more sensitive to relatively small changes. All-age suicide deaths declined by 1% between 2019 and 2020, according to latest available data. At present, suicide data by age for the years post-2020 is available for only a limited number of OECD countries; it will be important to track data on suicide in the coming period to assess whether the apparent increases in youth suicides in 2020 are a trend specific to the COVID‑19 crisis, or a broader pattern.
Death by suicide remains a rare event, especially amongst young children. This means that at the country level there can be significant fluctuations between years, especially in countries with small total populations or low overall suicide rates. However, at the country-level there are some distinct and heterogeneous patterns that appear in youth suicide trends across the last two decades, including countries that have seen increases in suicide rates amongst some groups of young people (see Figure 1.7). In Lithuania, youth suicides (age 10‑24) declined significantly, especially between 2008, when there were 20.2 suicide deaths per 100 000 population, and 2018, when suicide deaths had fallen to a rate of 10.5 per 100 000 (IHME, 2026[6]). In Australia, suicide deaths amongst young Australians, especially age 18‑24, rose between around 2012 and reached a peak in 2020, before declining in the following period (Australian Institute of Health and Welfare, 2025[75]). In Korea, the youth suicide rate rose from 0.8 deaths per 100 000 population to 6.4 deaths for 10‑14 year‑olds between 2000 and 2019, and from 1.9 to 9.9 deaths for 15‑19 year‑olds across the same periods (Statistics Korea Statistics Research Institute, 2023[76]). Between 2017 and 2022, the suicide rate for adolescent girls aged 10‑14 nearly tripled in Korea [ibid].
Deaths per 100 000 amongst young people age 10‑24
Note: To improve comparability between countries IHME data was selected, which “smooths” some variations between years. IHME data for “Self-harm mortality” was cross-checked with national data and/or WHO Mortality data to confirm overall trends.
Source: IHME, (2026[6]), GBD Compare, http://www.healthdata.org/data-visualization/gbd-compare.
During the expert interviews undertaken to inform this report, both clinicians and policymakers in OECD countries pointed to rises in self-harming behaviour as a concerning pattern amongst young people, especially during the COVID‑19 and post-COVID period. National studies confirm worrying rates of self-harm and suicidal ideation amongst young people, including in England, Finland, France, Ireland, Spain, the United States (Dooley et al., 2024[77]; Varo et al., 2025[78]; Griffin et al., 2019[79]; McCabe, Egan and Theiler, 2023[80]; Mäkitie, Kosola and Ilmarinen, 2025[81]; Trafford et al., 2023[82]), with the COVID‑19 crisis appearing to contribute to increasing rates and higher rates amongst girls and young women (Mäkitie, Kosola and Ilmarinen, 2025[81]; Trafford et al., 2023[82]; Drees, 2025[83]). In Ireland, a 2021 survey over a quarter of adolescents described their mental health as “bad” or “very bad”, with high rates of self-harm (39%) and suicidal ideation (42%) (Dooley et al., 2024[77]).
Recently collected data on hospitalisations for self-harm in some countries suggest a rise in self-harming behaviour by girls in recent years (see Figure 1.8). The gender gap in self-harm hospitalisations is consistent across all age groups, as reported in Health at a Glance 2025 (OECD, 2025[38]). This indicator only captures a proportion of those exhibiting self-harming behaviours, notably those severe enough to warrant hospitalisations and/or where the individual is in a position to seek help.
Note: OECD13 includes imputation of values for Australia for 2023 (carried forwards) and Canada for 2015 (carried backwards).
Source: OECD Mental Health Data Collection Pilot 2024‑2025.
In France, there has been a particularly marked increase for suicide attempts or self-harm amongst adolescents, and young girls (Drees, 2025[83]). 2024 data show that compared to 2023 there has been an increase in self-harm hospitalisations of +22% amongst girls age 10 to 14, +14% amongst 15‑to‑19‑year‑old girls, and +4% and +9% amongst 20‑24 and 25‑29 year‑olds, respectively. Looking at hospitalisations in psychiatric beds, women are twice as likely to be hospitalised as men for suicide attempts or self harm, and over half of the female hospitalisations are for women under 30. Amongst young women under 25, hospitalisations for self-harm in psychiatric beds have been significant and sustained since 2015‑2017. There were smaller increases in self-harm hospitalisations amongst boys and young men, +17% among 15‑19 year‑olds, +8% among 20‑24 year‑olds and +7% among 25‑29 year‑olds. Women are also more likely to be re‑admitted for repeated self-harm events than men.
Explorations of the explanations for self-harm amongst young people found that intrapersonal motivations (emotion regulation, anti-dissociation and self-punishment) were more common than interpersonal motivations (Tang et al., 2025[84]), and that non-suicidal reasons for self-harm include coping with distress and self-harm as a form of “personal mastery” (Edmondson, Brennan and House, 2016[85]). There are likely bi-directional links between self-harming behaviour and poor mental health (Tang et al., 2025[84]). It is also notable that some countries, such as England have seen prior peaks and then declines in non-fatal self-harming behaviour in prior periods (Bergen et al., 2010[86]).
Overall, adolescents in their mid-to-late teens, girls and young women, and young people with lower socio-economic status have poorer mental health. Some of these dimensions are unsurprising given longstanding understanding of developmental pathways and risk factors for mental health; however, others, such as what appears to be a faster decline in adolescent girls’ and young women’s mental health as compared to boys’, may be newer trends.
Data from the HBSC survey which covers 27 OECD countries show that girls had a lower well-being score across all ages, with a gap of 6.7 points at age 11 rising to a 13.6 point gap at 15 (Health Behaviour in School-aged Children study, 2023[87]). Overall mental well-being, as measured by the WHO Well-being Index, was first included in the HBSC survey in 2022 and shows that well-being declines with age; the average well-being score (out of 100, where 100 is the highest possible score) fell from an OECD average of 65.3 for 11‑year‑olds, to 57.4 for 13‑year‑olds, to 53.7 for 15‑year‑olds (Health Behaviour in School-aged Children study, 2023[87]). In 2022 68% of 15‑year‑old girls reported having multiple health complaints in OECD countries, compared to only 36% of boys.
The proportion of children and adolescents reporting “feeling low” at least once a week also rises with age, is consistently higher amongst girls than boys, but has increased faster amongst girls. In 2022, 15‑year‑old girls were on average more than twice as likely to report feeling low than boys of the same age (Figure 1.9. ). Between 2014 and 2022, the proportion of young people reporting that they “felt low” increased across all age groups and for both sexes. The absolute increases in the number of girls feeling low were larger for girls at every age (+9.7, +14.7, +16.8 percentage for girls at 11, 13 and 15 vs. +4.1, +4.7, +7.3 percentage for boys), and proportional increases were larger for girls at age 11 and 13. At age 15, boys’ proportional rise is slightly larger (59.9% vs. 58.9%), albeit from a higher starting point. The rise was also more pronounced among older adolescents. For both sexes, 15‑year‑olds experienced the largest proportional increase, with rates rising from 28.6% to 45.4% among girls and from 12.1% to 19.4% among boys (increases of around 59% for each), compared with smaller proportional rises among 11‑year‑olds (+69% for girls, +42% for boys) and 13‑year‑olds (+64% for girls, +45% for boys).
Percentage of girls and boys “feeling low” more than once a week, age 11, 13 and 15
Note: 27 OECD countries covered in the HBSC surveys 2014 and 2022.
Source: HBSC (2023[87]), Health Behaviour in School-aged Children study – Data browser (findings from the 2021/22 international HBSC survey), https://data-browser.hbsc.org/.
These trends – girls and older adolescents reporting comparatively poorer well-being than younger children – are consistent with understanding of typical developmental pathways in adolescence. In adolescence, well-being tends to decline, coinciding with pubertal developmental shifts including neurobiological changes such as hormonal shifts and brain maturation, along with psychosocial stressors such as the transition to secondary education and changing social dynamics with peers (Elgar et al., 2017[88]; Patalay and Fitzsimons, 2018[89]; Cyranowski et al., 2000[90]). Gender differences in well-being trajectories are also well-documented, and attributed to factors including earlier onset of puberty, and the interaction of hormonal and neurodevelopmental changes with social and societal factors which may impact girls more significantly than boys during adolescence (Bisegger et al., 2005[91]; Cyranowski et al., 2000[90]). Nonetheless, underlying biological pathways should not be seen as the only explanation for the well-being gap between girls and boys; research suggests that girls are more influenced by experiences in school and at home, by socio-economic disadvantage, by academic stress, peer relationships and body image than boys (Phillips et al., 2023[92]; Patalay and Fitzsimons, 2018[89]; Apsley and Padilla-Walker, 2020[93]; Patalay and Fitzsimons, 2018[89]).
National data on prevalence of anxiety and depression also suggest that there has been a greater increase for girls and young women than for boys and young men in a number of countries. For example, analysis of the Belgian health interview survey of adolescents aged 15‑25 found that anxiety and depression increased substantially between 2008 and 2013 for girls and to a lesser extent for boys (Van Droogenbroeck, Spruyt and Keppens, 2018[40]). In Iceland, between 2006 to 2016, there was a significant increase in self-reported symptoms of anxiety and depression among Icelandic adolescents, particularly among girls. The proportion of girls reporting high anxiety symptoms increased by 8.6%, while for boys, it increased by 1.3% (Thorisdottir et al., 2017[44]). In the United Kingdom, incidence of eating disorders and self-harm increased amongst teenage girls – but not boys – during the COVID‑19 pandemic (Trafford et al., 2023[82]).
In New Zealand, Sutcliffe et al. (2022[46]) found that declines in adolescent mental health and well-being between 2012 and 2019 had been “rapid and unequal”, with adolescent mental health needs rising across all demographic groups but especially amongst females, Māori, Pacific and Asian students and those from high-deprivation neighbourhoods. A growing body of evidence also indicates that certain demographic groups face greater risk of mental ill-health amongst under‑25s, notably young people with lower socio-economic status or family poverty, ethnic minority and Indigenous population groups, LGBTQI+ youth, though patterns can be expected to vary across countries (Sutcliffe et al., 2022[46]; Ahmad et al., 2021[94]; Oppedal, 2017[95]; Alexandre, Ribeiro and Cardoso, 2010[96]; Chen Wang and McLeroy, 2023[97]; Lothwell, Libby and Adelson, 2020[98]; Mustanski, Garofalo and Emerson, 2010[99]; Rich et al., 2022[100]).
These mental health inequalities are influenced by the accumulation and interaction of multiple forms of advantages and disadvantages in young people’s living conditions and opportunities, including socio-economic circumstances, discrimination, community belonging, and access to timely, high-quality care (Public Health Agency of Canada, 2024[101]). Recent OECD analysis highlights persistent inequalities in access and quality of mental health care. In particular, ethnic minority and Indigenous populations often experience more limited access to appropriate and culturally responsive mental health services, alongside poorer experiences of care (Vargas Lopes and Llena-Nozal, 2025[102]). Despite this, inequalities affecting ethnic groups and Indigenous populations tend to receive limited attention in national mental health surveillance systems and policy framework (Vargas Lopes and Llena-Nozal, 2025[102]; Jamieson et al., 2025[103]). While the development of this report did not allow for a detailed examination of these vulnerabilities, including whether certain groups of young people have experienced more pronounced mental health declines than others, addressing these gaps represents an important priority for future research and policy analysis.
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1. Introduction – could you briefly present yourself, and describe your role and area of expertise?
2. What trends have you observed in the mental health status, and mental health needs of young people in your country?
e.g. any change in the type of disorder or condition you’re seeing; any change in the severity; any change in the age, gender, or socio-economic profile.
3. Over the last decade or so, do you think that young people’s mental health has: 1) stayed the same 2) improved 3) declined 4) cannot say?
Please select one response:
1. Stayed the same.
2. Improved.
3. Declined.
4. Cannot say.
4. Have you been tracking or recording young people’s mental health status in your country, e.g. through national mental health surveys.
5. Do you believe that there are any new drivers of good or poor mental health amongst young people?
6. Do you believe that awareness levels of mental health conditions in your country have changed, and/or that levels of stigma have fallen?
7. Do you have any views on the impact of smart phones, internet, social media, and digitalisation generally on young people’s mental health?
8. Do you have any views or concerns about one type of technology in particular? Are you concerned about the impacts on any sub-group of young people in particular?
9. Do you believe that the impact of digitalisation, including social media, on young people’s mental health is: 1) positive 2) negative 3) neutral 4) cannot say.
Please select one response:
1. Positive.
2. Negative.
3. Neutral.
4. Cannot say.
10. What do you believe is the most effective way to build mental health and well-being resilience amongst young people?
11. Do you think that the mental health services in your country are sufficient to meet the mental health needs of young people at present?
12. What are the policy priorities for young people’s mental health in your country?
13. Do you believe that the level of mental health support for young people in your country or region is: 1) the right level 2) too low 3) too high 4) cannot say.
Please select one response:
1. The right level.
2. Too low.
3. Too high.
4. Cannot say.
14. Is there anything you think we have missed from this conversation, that you would like to add?
15. Final housekeeping:
Do you agree we use the responses in this discussion in an anonymised, long-form format, e.g. a short text citation, attributed to “an expert policy maker from France”? [Yes/No]. Do you agree that we can use the responses in this discussion in an anonymised Figure, e.g. a yes/no table by country for the question on whether stigma has fallen? [Yes/No].
If we include a thanks and acknowledgements section, would you like to be thanked or acknowledged by name? [Yes/No].”
1. Introduction – could you briefly present yourself, and describe your role and area of expertise?
2. In your clinical practice, what trends have you observed in the mental health status, and mental health needs of young people?
e.g. any change in the type of disorder or condition you’re seeing; any change in the severity; any change in the age, gender, or socio-economic profile.
3. Over the last decade or so, do you think that young people’s mental health has: 1) stayed the same 2) improved 3) declined 4) cannot say?
Please select one response:
1. Stayed the same.
2. Improved.
3. Declined.
4. Cannot say.
4. Do you believe that there are any new drivers of good or poor mental health amongst young people?
5. Do you believe that awareness levels of mental health conditions have changed, and/or that levels of stigma have fallen?
6. Do you have any views on the impact of smart phones, internet, social media, and digitalisation generally on young people’s mental health?
7. Do you have any views or concerns about one type of technology in particular? Are you concerned about the impacts on any sub-group of young people in particular?
8. Do you believe that the impact of digitalisation, including social media, on young people’s mental health is: 1) positive 2) negative 3) neutral 4) cannot say.
Please select one response:
1. Positive.
2. Negative.
3. Neutral.
4. Cannot say.
9. What do you believe is the most effective way to build mental health and well-being resilience amongst young people?
10. Do you think that the mental health services in your country or area are sufficient to meet the mental health needs of young people? If not, what changes would you want to see?
11. Do you believe that the level of mental health support for young people in your country or region is: 1) the right level 2) too low 3) too high 4) cannot say.
Please select one response:
1. The right level.
2. Too low.
3. Too high.
4. Cannot say.
12. If you could send a message to your country’s policymakers about youth mental health, what would it be?
13. Is there anything you think we have missed from this conversation, that you would like to add?
14. Final housekeeping:
Do you agree that we can use the responses in this discussion in an anonymised format, e.g. “a psychiatrist from France”? [Yes/No].
If we include a thanks and acknowledgements section, would you like to be thanked or acknowledged by name? [Yes/No].”