Illustration of three teen girls wearing backpacks facing away towards a dark red, ink stained background
Illustration: Annelise Capossela/Axios

The teen mental health crisis is worsening by almost any measure. But it’s affecting girls almost twice as much as boys, according to new federal data.


The big picture: A pronounced gender gap in who is experiencing suicidal thoughts, sexual assault and persistent feelings of sadness or hopelessness point to the need for more tailored interventions and support.

  • But schools — the de facto frontline responders — may not be equipped to provide it.


Driving the news: CDC report released Monday found teenage girls are in the midst of the worst mental health decline in a decade, with nearly a third reporting they’ve seriously considered taking their lives.

  • 1 in 5 girls said they recently experienced sexual violence in 2021, a 20% increase since 2017 when the CDC first began tracking the statistic.
  • Teen girls were nearly four times more likely than boys to say they had ever been forced to have sex.


Threat level: Trauma experienced in childhood can fuel substance use, affect brain development and lead to chronic illnesses such as heart disease or cancer, per the National Child Traumatic Stress Network.


Where it stands: While parents and legislators are increasingly recognizing the responsibility schools have in addressing mental health concerns, districts are hard-pressed to keep counseling, screenings, teletherapy and other services that have been sustained with federal COVID relief dollars.

  • “We have to take notice of that or we’ll lose a whole generation,” said Tara Wallace, a child trauma therapist in Topeka, Kansas, a state ranked second-to-last in the U.S. for youth mental health by Mental Health America.


Flashback: The mental health crisis among teen girls predates COVID, lockdowns and other stressors during the pandemic.

  • A Pew Research study in 2019 found that teen girls in the U.S. were three times more likely than boys their same age to have depression.
  • Before COVID, 1 in 5 children had a mental health disorder but only a fifth got care, per the CDC.


Yes, but: There’s no single factor that lead to this mental health decline in teen girls, said Debra Houry, the CDC’s chief medical officer.

  • The pandemicsocial media, stressors at school, online misinformation and societal conflict can all play a role.
  • Past studies have suggested girls tend to dwell on their negative emotions as a coping mechanism and are more likely than boys to be perfectionists to the point of burnout and intense self-critique.


What they’re saying: Schools intervening early can improve outcomes, but the level of services available depends on investment from states, said Angela Kimball, a senior vice president at mental health care advocacy group Inseparable.

  • These interventions include teaching coping skills, connecting families to resources, training teachers how to understand and identify mental health and addiction and having on-site school counselors or psychologists, said Laura Gray, a child psychologist at Children’s National Hospital in D.C.
  • Low Medicaid reimbursement rates are another barrier, Wallace told Axios.
  • “A lot of individuals in private practice are no longer accepting [Medicaid patients] because they can’t afford to,” Wallace said. “They want to help the families. They want to help the kids, but they can’t afford to live.”


The bottom line: Making sure the youth mental health crisis doesn’t get worse will depend on targeted intervention efforts to groups facing severe risks, and a sustained push to ensure schools can provide them.

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 988. Crisis Text Line also provides free, 24/7, confidential support via text message to people in crisis when they text HOME to 741741.