Colorado youth mental health improved in first post-pandemic survey

Colorado high school students appear to be doing better mentally, with the number reporting signs of poor mental health not only falling from its pandemic high, but in some cases reaching the lowest level since the state began surveying young people in 2013, though it also found young people don't always feel safe at school and body image issues are widespread.

The Healthy Kids Colorado survey found that about 26% of high school students in 2023 reported feeling sad or hopeless enough to stop doing their usual activities for at least two weeks, a possible sign of depression. Students take the survey every two years, so last year's numbers were the first hard data on how young people are doing since the end of the pandemic emergency phase.

While one in four students reporting possible depression is higher than anyone would like, it was an improvement not only over the peak of the pandemic — when 40% of students said the same — but over the years leading up to the 2020 shutdown. the last time fewer students answered this question positively was 2013.

"We are very happy to see overall improvements in many areas. There have been dramatic changes in the right direction around indicators of mental health, suicide risk and substance use," said Jill Hunsaker Ryan, executive director of the Colorado Department of Public Health and Environment, in a news release. "We hope that this is an indication of state and community investments in prevention programming and protective factors that are paying off."

As in previous years, some students were more likely to report discontinuing activities due to sadness or hopelessness:

• 55% of non-binary students, against 32% of female students and 18% of male students;

• 61% of transgender youth, against 24% of cisgender youth; AND

• 56% of students who identified as pansexual, versus 50% who were bisexual, 48% who were gay, and 20% who were heterosexual.

The percentage of students who reported having attempted suicide, planned an attempt, or seriously considered it also hit the lowest levels since 2013. About 6% of students said they had made an attempt in the past year, 9% said they had made a plan and 11% said they had seriously considered suicide, with or without a plan.

Non-suicidal self-harm also declined: 13% of students reported harming themselves in some way, such as cutting, without the intent to die. In 2021, one in five students hurt themselves intentionally.

Colorado youth still have a large unmet need for outpatient mental health care, but the number needing more intensive care appears to be returning to its pre-pandemic pattern, said Lauren Gallanis, a pediatric psychologist at Children's Hospital in Colorado. Typically, fewer children and teens need hospital care during the summer, when they're not experiencing the stress of school, and so far this year seems to be following that pattern, she said.

In May 2021, Children declared a youth mental health "state of emergency" in response to an increase in young patients in crisis. Gallanis said she wasn't sure the emergency is over, but the decrease in children coming in with severe needs has made it easier to find hospital care for those who need it. But the options for children who need outpatient care still remain thin compared to the need, and hospital resources may be strained again when students return to school, she said.

"I think there has been a slight improvement in connecting young people with services. It's not where I'd like it to be," she said.

More than half of students who took part in the survey said their stress level was manageable on most days, which was about four percentage points higher than in 2021. However, 28% of students reported having health mentally weak for most of last month. The survey did not ask these questions in the years before the pandemic.

Most young people also reported having someone to talk to: three-quarters said they could go to an adult with a serious concern, and more than half said they could usually talk to a friend about their feelings. Both were slightly higher than in 2021.

If they were worried about their own or someone else's well-being, 14% said they wouldn't tell anyone. Those who would tell someone said:

• 23% would call a crisis line,

• 29% would make an anonymous report to Safe2Tell or a similar hotline,

• 37% would tell a friend,

• 54% would tell their parents or guardians and

• 50% would tell another trusted adult.

Students can choose multiple answers so that the numbers do not add up to 100%. The survey didn't ask this question in previous years, so no one can tell whether students' perceptions of being able to talk to someone is getting better or worse.

In recent years, young people have had more opportunities to seek help for a mental health problem, and the culture has become more open to discussing emotional struggles, Gallanis said. For example, schools are increasing access to routine mental health interventions, young people can get free therapy sessions through the state's I Matter program, and primary care doctors are more likely to screen for depression and anxiety before they become severe. , she said.

"I think it would be very hard to pick that apart" and say that one thing made the difference, she said.