More Boston high schoolers feeling sad and hopeless, data show
Pandemic contributed to mental health difficulties, report says
Bostonians have grown sadder and more anxious over the last decade, with rates of distress higher among youth, people of color, and LGBTQ+ people, according to interviews with experts and a report released Wednesday by the Boston Public Health Commission.
Drawing from surveys, death data, and hospital data, the 99-page report shows that persistent negative emotions increased from 2015 to 2021. The mental health report is the first installment in a series titled the Health of Boston 2024.
It was released at a press conference Wednesday morning at which Mayor Michelle Wu and health and education officials described how $21 million in federal grants were being deployed to improve student mental health. Most of the money comes from the American Rescue Plan Act of 2021, the pandemic economic stimulus law known as ARPA.
“Boston, we have a problem,” said Dr. Joseph Mitchell, president of Franciscan Children’s Hospital, a Brighton-based agency that serves children and adolescents with complex health needs.
Speaking at the press conference at the Joseph Lee K-8 School, Mitchell pointed to “sobering facts” about a nationwide pediatric behavioral health crisis: One in five children in the United States suffers from anxiety and depression, he said, and emergency visits for suicide attempts went up 50 percent “for some populations” during the pandemic.
“We are in the middle of an epidemic, and we risk losing a generation of kids,” Mitchell said.
Dr. Bisola Ojikutu, the city’s commissioner of public health, said that while the report’s numbers date to 2021, “It would not be surprising to me if that trend continues” in subsequent years.
The pandemic contributed to widespread mental health difficulties, but the crisis was festering earlier, Ojikutu said. “This is something that preceded COVID-19 and has been exacerbated,” she said.
Dr. Elizabeth Childs, a Brookline child and adolescent psychiatrist, affirmed that based on her “on the ground” experience, children’s mental health has not improved since 2021. “We are still dealing with the fallout of the pandemic,” she said.
Data from the CDC’s Youth Risk Behavior Survey provide an especially grim view of the mental health of high schoolers. In 2021, 44 percent of Boston public high school students said they felt sad or
hopeless every day for two weeks or more, up from 27 percent in 2015, with higher rates among female, Latinx, and LGBQ+ students. The number of youths who considered or planned a suicide went up, but not the number who attempted suicide. But Black and Latinx youth had higher rates of attempted suicide than white youths.
Separated from their peers while schools were closed, children missed out on important aspects of their social development and suffered learning loss that has hampered their optimism, self-confidence, and sense of purpose, Childs said. Repairing all this, she said, is going to take years of hard work, including the long-term psychotherapy that insurers don’t want to pay for.
The pandemic disproportionately affected communities of color and heightened existing problems with food insecurity, income disparities, and housing, said Mary Skipper, Boston Public Schools superintendent. At the same time, social media increased feelings of isolation and negativity among young people, she said.
Among adults, sadness was not as common, but showed a similar increase. The Boston Behavioral Risk Factor Surveillance System, an every-otheryear phone survey, found that the percentage of adults who felt sad for more than 15 days out of the previous 30 spiked from 12 percent in 2015 to 17 percent in 2021, with higher rates among women, Latinx adults, and LGBTQ+ adults.
Those least likely to report persistent sadness were foreignborn adults who have lived in the United States for 10 years or fewer.
A breakdown by neighborhood suggests that lower income plays a role. People living in Charlestown, Mattapan, Roxbury, and Allston-Brighton had the highest rates of persistent sadness, while the lowest rates were found in Back Bay, Downtown, Beacon Hill, the North End, and the West End.
Anxiety is also on the upswing among Boston’s adults. The percentage who reported feeling anxious, worried, or tense for at least 15 days in the previous 30 days increased from 22 percent in 2015 to 27 percent in 2021. White female adults had higher rates of anxiety than Asian, Black, or Latinx women.
Not surprisingly, more than half of homeless adults experienced persistent anxiety, double the proportion of people with roofs over their heads.
Nearly three-quarters of adults said they would seek therapy during an emotional crisis. Still, nearly 1 in 10 had wanted to consult with a mental health professional but could not because of cost.
Among high school students in 2021, 43 percent said they had received the help they needed when feeling sad, empty, hopeless, or angry.
Danna Mauch, president and CEO of the Massachusetts Association for Mental Health, said in a phone interview that since 2021, demand for mental health services has moderated but remains higher than before the pandemic, and schools are contending with worse behavioral problems.
”This mental health epidemic that arose in the context of the pandemic has a longer tail of resolution than the pandemic itself,” Mauch said. “We’re in that period of resolution now.”
Officials at Wednesday’s press conference described an array of programs intended to bolster mental health resources for youngsters and teens, most of which have started. Among them were a $5.8 million partnership between Boston Public Schools, UMass Boston, Boston University, Brown University, and others to prepare 200 school psychology, school counseling, and social work students to serve Boston youth; $4 million over the next four years to train 37 lay health workers, nurses, and social workers to support Black and Latinx children under 4 years old who are connected to the state child welfare system or in need of early social and emotional development; and $2.5 million to expand a program at Franciscan Children’s that places social workers and psychiatrists in Boston public schools.
Most were funded by ARPA, with additional grants from the US Substance Abuse and Mental Health Services Administration and US Department of Education.
Mayor Wu said the use of ARPA for this initiative is “a little bit unusual.” While many cities used ARPA funds to “plug holes or fill gaps temporarily,” Wu said the mental health initiative shows that “more is possible with those dollars.”
Critical infrastructure, Wu said, doesn’t just mean roads, bridges, and other tangible developments, but also building a workforce that cares for people’s mental health within their own schools and communities. “It is about building those connections, empowering and investing in our community,” she said. “This is going to be a model for the rest of the country and certainly will make a difference for generations to come.”
Leihla Martinez, an eighth grader at the Joseph Lee K-8 School, said she has become a better student and person since working with the social worker at her school. Before, she said, she tended to “bottle up” her emotions.
“What we need is encouragement to share our story. We need adults that can make us feel safe and will listen when we talk about our challenges,” she said. “I didn’t think I needed someone to talk to, but I did.”