State of Girls Mental Health

By Vanessa Beltran, Mental Health Policy Fellow

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What is Mental Health?

Mental health is a state of well-being in which a girl can cope with the normal stresses of life, participate effectively in activities like school, and contribute to her community.[1,2] Self-efficacy, a girl’s belief in her ability to succeed, enhances a girl’s sense of well-being and promotes good mental health.[3,4] Our Six Cs – Critical thinking, Creativity, Communication, Coping Skills, Collaboration and Confidence – give girls essential tools for emotional, psychological and social well-being.[2,5]

What is Mental Illness?

Many girls have mental health concerns from time to time. Mental health can change over time depending on biological factors, life experiences, and family history of mental health conditions.[5,6] A mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect a girl’s ability to function.”[7] Mental illness refers to diagnosable mental disorders that affect a girl’s thinking, emotion, and/or behavior and can involve problems functioning in social, work or family activities.[2,6] These conditions may be occasional or long-lasting, with over half of all chronic mental illness beginning by age 14.[6]

The National Survey of Children’s Health (NSCH) and Youth Risk Behavior Surveillance System (YRBSS) are used to measure the prevalence of mental illness in youth.[8,9] The prevalence is the proportion of a population who have a specific condition in a given time period. Currently, 1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year.[10,11] Effective prevention and early treatment of mental illness can help prevent more severe, lasting problems as girls grow up.[12]

Mental health experts are concerned that heavy social media use[13,14] and the novel COVID-19 pandemic[15] place this generation of girls at increased risk of mental illness. Research on the impact of technology and heavy social media use on mental health has found that Snapchat, Facebook, Twitter and Instagram all led to increased feelings of depression, anxiety, poor body image, and loneliness in teenage girls.[14,16] High levels of smart phone and social media use are associated with increase in mental distress, self-injury, and suicidal behavior among adolescents.[13]

Experts theorize that the COVID-19 pandemic, which prompted the sudden closure of schools around the nation, will make existing mental health disorders worse due to the isolation, anxiety, and lack of peer contact. These measures to limit community spread of the virus may also contribute to the onset of new stress-related disorders in children and adolescents.[17]

Impact on Girls

While mental illness can affect all children and youth, research shows girls are at greater risk for certain mental health conditions.  

Depression and Anxiety

Depression is an internalizing mood disorder, meaning that it disturbs a girl’s emotional life. Symptoms of depression include persistent feelings of sadness or hopelessness for at least two weeks and withdrawal. A girl may stop doing things she usually likes to do and there may be changes in her energy level, sleep patterns, or academic performance.[18,19] In Texas, 49% of high school girls report signs symptoms of depression. For gay, lesbian, or bisexual (LGB) youth, the number climbed to 71%.[9]

Anxiety is an occasional, natural response to stress. For a girl with an anxiety disorder, the worry and fear do not go away. Anxiety that is disproportionate to the situation and interferes with a girl’s ability to function can interfere with daily activities, academic performance, and relationships.[18,20] Girls are more than twice as likely than boys to be diagnosed with a mood disorder in their teen years.[18]

Suicidal Thinking/Behavior and Self-Injury

Suicide is defined as death caused by direct violence at oneself with intent to die as a result of the behavior.[21] Depression and other mental health disorders are risk factors for suicide, as well as self-injury. Self-injury, such as “cutting”, is the deliberate, direct destruction or alteration of body tissue.[22] Suicide is the second leading cause of death in the country among individuals between the ages of 10 and 19.[23]

One in five high school girls in Texas has seriously considered suicide, and one in five has made a plan for attempting suicide.[9] The suicide attempt rate for high school students in Texas is higher than the national average, with high school girls in Texas twice as likely as boys to seriously consider attempting suicide.[9]

Racial disparities in suicide attempt rates among high school girls show that Black girls are at increased risk, which reflects an alarming emerging trend across Black youth in the country. Black girls were 25% more likely to attempt suicide, and nearly twice as likely to be seriously injured in the attempt.[9,24]

Striking differences could be observed when looking at LGB youth, especially girls. One in two LGB girls had seriously considered attempting suicide, and nearly one in four actually attempted suicide.[9,25]

Texas High School Students: Attempted Suicide in the Last 12 Months, 2019

Eating Disorders

Eating disorders are characterized by severe disturbances to a person’s eating behaviors. They can be life-threatening and often develop during childhood and the teen years. Signs of an eating disorder may include a preoccupation or obsession with food, body weight, and shape.

Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder. Each of these eating disorders will present differently, and have its distinct health risks.[26] Girls make up over 90% of children admitted to hospitals for eating disorders.[27]

COVID-19 Pandemic and Youth Mental Health

The pandemic created a perfect storm of stressors for youth. In the recent National Survey of Youth Well-Being During COVID-19 conducted by the Jed Foundation, nearly two-thirds of U.S. parents report that their child has recently experienced a mental or emotional challenge. These challenges ranged from social isolation to suicidal thoughts, with 1 in 3 parents indicating their child's mental and emotional health was worse than before the pandemic.[28]

A meta-analysis on the global prevalence of depression and anxiety symptoms during COVID-19 has doubled, particularly in older adolescents and girls.[29] Hospitalizations for eating disorders has spiked among adolescents in the pandemic, with reports of admissions being nearly doubled during the first 12 months.[30] Youth who are admitted have been assessed to be sicker, less medically stable, when the eating disorder was triggered by the pandemic.[31]

Barriers to care, particularly with school closures and the loss of screening and school-based services, have exacerbated many mental health challenges. Research suggests that 70-80% of children rely on school-based services to address their mental health needs.[32] School closures were associated with more mental health difficulties, most notably for students of color from families with lower incomes that engaged in remote learning.[33]

New data released by the CDC indicates that suspected suicide attempts are on the rise among adolescents aged 12–17 years, especially girls. The report shows that adolescent mental health-related ER visits have gone up 31% during COVID-19. Girls accounted for almost all of that, a 50% increase for suspected suicide attempts; boys experienced a 4% increase.[34] The toll the pandemic has taken on girls is significant, with effects that will continue to ripple across their lives in myriad ways as we transition to endemic COVID-19.

Youth recognize the difficulties that the pandemic has presented, and findings show that 42% of teens overall say that the pandemic has increased the number of conversations they have around mental health.[35] Providing needed mental health support is vital to prevent an even steeper decline in mental health outcomes, and is something the youth themselves are asking for.

Why is it important to act?

Mental illnesses can be treated – the earlier treatment is started, the more effective it can be. Research has shown that early treatment of mental illnesses can help prevent more severe, lasting problems as girls grows up.[12] Currently, Texas is among the states with the highest number of children not receiving needed mental health treatment.[11] Most adolescents never begin treatment, either. Sixty percent of youth with depression and 80% of youth with anxiety disorder go untreated.[36]

In addition to the symptoms directly related to the condition, untreated mental health disorders are associated with poor academic performance, misconduct, and school drop-out due to their impact on social and academic progress.[18,37]

At Girls Empowerment Network, our in-school Girl Connect and other programs grow girls’ self-efficacy across the domains of our Six Cs: Critical thinking, Creativity, Communication, Coping Skills, Collaboration and Confidence. The Connectline provides additional emotional support, creating a safe space to connect and cope in these times of uncertainty. Building self-efficacy, with the support of our girl experts, leads to increased resilience in the face of challenges girls confront in their daily lives.[38]  Girls Empowerment Network steps into girls’ lives to enhance their sense of well-being, promote good mental health, and help girls believe in their ability to be unstoppable.

Learn more about building self-efficacy in girls including articles, activities, and resources and sign up to receive our newsletter to stay informed about ways to empower Texas girls.

Vanessa Beltran, MPH, RDN, LD, is the mental health policy fellow for Girls Empowerment Network where she sets the agency’s policy priorities and equips girls with essential advocacy skills to improve girls’ mental health and wellbeing. She also serves on the leadership team and as a mentor to high school girls participating in the Spark Change Project.

Note: This article was originally published October 19, 2020, and revised March 24, 2022.

Five Stats on the Mental Health of Girls

References

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