Key takeaways:

- Frequent social media use, bullying and racism were associated with poor mental health among high school students.

- Protective factors included exercise, adequate sleep and engagement at home and school.

A recently published CDC study painted a detailed picture of mental health and suicide risk among high schoolers in the United States.

Analyzing more than 20,000 responses to the 2023 Youth Risk Behavior Survey, researchers from the CDC’s Division of Adolescent and School Health found that 39.7% of students reported experiencing persistent feelings of sadness and hopelessness during the previous year. More than one-quarter (28.5%) reported having poor mental health, 20.4% experienced suicidal thoughts and 9.5% said they had attempted suicide.

Derived from Verlenden JV, et al. MMWRMorb Mortal Wkly Rep Suppl. 2024;doi:10.15585/mmwr.su7304a9.

Suicide risk was higher among racially minoritized students and students who were transgender or questioning, researchers found. Frequent social media use, experiences of racism and feeling unsafe at school were associated with increased suicide risk among students.

Frequent social media use

According to Emily Young, MSEd, MPH, and colleagues, 77% of students reported using social media multiple times per day.

The researchers found that students who used social media frequently were more likely to be bullied at school or online compared with students who used social media less often. Frequent social media use was also associated with higher prevalence of depressive symptoms and suicidal thoughts

“Among LGBQ+ students, frequent social media users were more likely to experience electronic bullying victimizations than less frequent social media users yet demonstrated no significant differences in bullying victimization at school,” Young and colleagues wrote. “In contrast, heterosexual students who used social media frequently were more likely to experience both types of bullying victimization compared with heterosexual students who used social media less often.”

Risk among transgender and questioning students

Transgender and questioning students also experienced higher rates of bullying and poor mental health than their cisgender classmates, according to research from Nicolas A. Suarez, MPH, and colleagues.

Among transgender and questioning students, 40% said they were bullied at school, and nearly three-quarters reported depressive symptoms (72% and 69%, respectively).

A higher proportion of transgender (25.3%) and questioning (26.2%) students reported skipping school due to safety concerns compared with cisgender male students (8.5%). One-quarter of transgender and questioning students said they had attempted suicide in the past year, in contrast to 5% of cisgender male students and 11% of cisgender female students.

Racism in schools

Experiencing racism was also associated poor mental health and increased risky behavior, according to Izraelle I. McKinnon, PhD, and colleagues. One in three students (31.5%) reported experiencing racism at school. Asian students reported the highest prevalence (56.9%), followed by multiracial (48.8%) and Black or African American (45.9%) students. Among non-Hispanic white students, 17.3% reported experiencing racism.

Black students and Hispanic or Latino students who experienced racism at school were more likely to have poor mental health, experience suicidal thoughts and engage in substance use compared with students in their racial and ethnic group who reported never experiencing racism.

Poor mental health and suicide risk were higher among American Indian or Alaska Native (AI/AN) students and Asian students who reported experiencing racism.

The researchers reported that AI/AN, Asian, Black, Hispanic and multiracial students who experienced racism were twice as likely to consider attempting suicide compared with students in their racial and ethnic groups who never experienced racism.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

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Protective factors

In addition to learning what issues contribute to poor mental health and suicide risk among high schoolers, Jorge V. Verlenden, PhD, and colleagues identified some factors at home and at school that may mitigate these risks. Students who had good sleep habits and lived with adults who were engaged in their lives were less likely to experience poor mental health or suicidal thoughts and behavior. At school, being physically active and feeling connected to friends at school decreased students’ suicide risk. In addition, the researchers said mental health concerns were less prevalent among students who played on a sports team.

“This adds to previous evidence on the important role that safe and supportive school environments play in supporting students’ mental health and well-being during adolescence and into adulthood,” Verlenden and colleagues wrote. “However, research has also shown that female, Black, Hispanic and LGBQ+ youth and youth who have experienced racism feel less connected to school than their peers, highlighting the importance of creating opportunities for connectedness and belonging for students at higher risk for feeling marginalized at school.”

In another study that specifically looked at AI/AN students, those who had engaged caretakers and felt connected to people at school were less likely to use substances, experience violence at school or report suicidal thoughts and behaviors.

“Understanding historical context and incorporating Indigenous knowledge when developing interventions focused on AI/AN youths are critical to ensure such interventions are successful in improving AI/AN health and well-being,” Sherry Everett Jones, PhD, JD, and colleagues wrote. https://standingabovethecrowd.com/james-donaldson-on-mental-health-cdc-nearly-10-of-american-high-schoolers-attempted-suicide-last-year/