Youth Needing Help for Emotional or Mental Health Problems, by Receipt of Counseling (California & L.A. County Only)

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Learn More About Children's Emotional Health

Measures of Children's Emotional Health on Kidsdata.org
Kidsdata.org provides the following indicators of children's emotional health:
Data on student depression-related feelings come from the California Healthy Kids Survey (CHKS). State-level CHKS estimates, although derived from the Biennial State CHKS, may differ from data published in Biennial State CHKS reports due to differences in grade-level classification of students in continuation high schools.

*Levels of school connectedness are based on a scale created from responses to five questions about feeling safe, close to people, and a part of school, being happy at school, and about teachers treating students fairly.
Children's Emotional Health
Bullying and Harassment at School
Pupil Support Services
School Climate
Deaths
Hospital Use
Youth Suicide and Self-Inflicted Injury
Injuries
Why This Topic Is Important
Emotional health is an integral part of overall health, as physical and mental well being are intricately linked (1, 2). Mental wellness—which is more than the absence of disorders—includes effective coping skills and the ability to form positive relationships, to adapt in the face of difficulties, and to function well at home, in school, and in life (1). Emotional development is influenced by complex biological and social factors, with early positive and adverse experiences in relationships and environments being particularly profound (1, 2). Sound emotional health prepares young people for the challenges of growing up and living as healthy adults (1).

Most mental health disorders emerge before age 24, and the prevalence of such disorders is on the rise, affecting as many as one in five U.S. children and youth each year (1, 2, 3). Suicide has become the second leading cause of death among youth ages 10-24 (2). Treatment of mental illness is costly and accounts for the largest share of health care spending for children and youth in the U.S. (1, 4). Still, the majority of young people who need mental health treatment do not receive it, placing them at increased risk for negative outcomes throughout their lifetimes (1, 2, 3).

Anxiety disorders are the most commonly diagnosed mental health conditions among youth, affecting an estimated 32% of U.S. adolescents (1). Depression-related feelings also are common, with 37% of high school students nationwide in 2019 estimated to have had persistent feelings of sadness or hopelessness in the previous year, up from 26% in 2009 (5). Youth with anxiety, depression, or other mental health problems are more likely to exhibit suicidal behavior, drop out of school, use alcohol or drugs, and engage in unsafe sexual activity, in addition to having difficulties with school and relationships (1, 5).
For more information, see kidsdata.org’s Research & Links section.

Sources for this narrative:

1.  National Academies of Sciences, Engineering, and Medicine. (2019). Fostering healthy mental, emotional, and behavioral development in children and youth: A national agenda. National Academies Press. Retrieved from: https://nap.nationalacademies.org/catalog/25201/fostering-healthy-mental-emotional-and-behavioral-development-in-children-and-youth

2.  Meschan Foy, J., et al. (2019). Mental health competencies for pediatric practice. Pediatrics, 144(5), e20192757. Retrieved from: https://publications.aap.org/pediatrics/article/144/5/e20192757/38256/Mental-Health-Competencies-for-Pediatric-Practice

3.  Mental Health America. (2021). The state of mental health in America. Retrieved from: https://mhanational.org/issues/state-mental-health-america

4.  Dickson, K. S., et al. (2020). Defining and predicting high cost utilization in children's outpatient mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 47(5), 655-664. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202946

5.  Centers for Disease Control and Prevention. (n.d.). Youth Risk Behavior Survey: Data summary and trends report 2009-2019. Retrieved from: https://www.cdc.gov/healthyyouth/data/yrbs/yrbs_data_summary_and_trends.htm
How Children Are Faring
There were 37,787 hospital discharges for mental health issues among California young people ages 5-19 in 2020: 12,719 for children ages 5-14 and 25,068 for teens ages 15-19. After peaking at 5.8 hospitalizations per 1,000 youth ages 5-19 in 2019—a two-thirds increase compared with 2007—the statewide rate of mental health hospitalization fell to 4.8 per 1,000 in 2020.

In 2017-2019, an estimated 30% of 7th graders, 33% of 9th graders, 37% of 11th graders, and 32% of non-traditional students in California experienced depression-related feelings in the previous year (meaning they felt so sad or hopeless almost every day for two weeks or more that they stopped doing some usual activities). Depression-related feelings were more common among female students and those with low levels of school connectedness. More than 67% of gay, lesbian, and bisexual youth had experienced depression-related feelings in 2017-2019, compared with fewer than 30% of their straight peers.

According to 2017-2018 estimates, 23% of California youth ages 12-17 needed help for emotional or mental health problems (such as feeling sad, anxious, or nervous) in the previous year, up from 13% in 2009. Among those who needed help, fewer than half (45%) received counseling.
When asked whether their school emphasizes helping students with emotional and behavioral problems, 37% of responses by elementary school staff, 33% of responses by middle school staff, 29% of responses by high school staff, and 50% of responses by staff at non-traditional schools reported strong agreement in 2017-2019.
Policy Implications
Youth emotional health problems and hospitalizations have been increasing in recent years, statewide and nationally (1, 2, 3). The vast majority of mental health problems begin before age 24, making childhood and adolescence a critical period for preventing disorders and promoting mental wellness (1). Screening, early identification, and treatment are critical, as untreated mental illness can disrupt children's development, education, and their ability to lead healthy, productive lives (1, 4, 5). Health care and school settings are natural places to identify early warning signs and connect children to services, although barriers exist such as lack of time and training among primary care providers and school staff (1, 4). Even when mental health problems are identified, most children who need treatment do not receive it, often due to factors related to administrative or insurance obstacles, cost, stigma, or shortage of providers (4). Policymakers and other leaders can work to improve systems so that all children with mental health problems are identified early and receive appropriate, timely services.

Social conditions and practices—such as poverty and systemic inequities—and relationships and environments at home, school, and in the community influence children's emotional health (1). Policymakers can promote emotional wellness by prioritizing policies and cross-sector strategies that strengthen protective factors and provide stable, positive environments for children and families (1, 6).

Policy and practice options that could promote children's emotional health include:
  • Aligning mental health funding with what is known about the age of onset of disorders, groups at high risk (such as children in foster care and LGBTQ youth, among others), and effective strategies integrating mental health, health care, education, child welfare, juvenile justice, and other systems (1)
  • Promoting strategies to expand mental health services at schools, maximizing Medi-Cal and other existing funding streams (1, 2, 3)
  • Training school staff to recognize signs of mental distress and connect students with appropriate services; school practices should be trauma informed, culturally sensitive, and promote a safe and supportive environment for all students (2, 7)
  • Supporting schools in creating positive school climates in which students feel valued and engaged, and can develop problem-solving and self-regulation skills as part of a comprehensive approach to social-emotional learning (1, 2, 8)
  • Investing in community efforts—especially in under-resourced areas—to provide youth with positive experiences, relationships, and opportunities, such as quality after-school and summer programs, and safe places to play and exercise (2)
  • Promoting the use of primary care settings to prevent and address emotional health problems; as part of this, increasing consistency of mental health screenings in pediatric practice, expanding trauma-informed training for medical residents and pediatricians, and improving multidisciplinary coordination of services (1, 4)
  • Expanding and diversifying the workforce of qualified mental health professionals serving youth, e.g., school counselors, social workers, and psychologists (1, 8)
  • Supporting efforts to promote parents’ mental health and positive parenting skills, increasing mental health screenings for caregivers, and expanding family support services, such as home visiting and mental health treatment as needed (1, 9)
  • Improving access to high-quality early childhood education programs, especially for children experiencing poverty or other disadvantage, and ensuring that staff are trained on social-emotional learning (1, 2)
  • Promoting proactive social policies and investments to address structural inequities and strengthen economic support for families (1, 6)
  • Supporting public education to raise awareness of the importance of children’s emotional health, reduce the stigma associated with mental health problems, and increase knowledge of warning signs and how to seek help (1)
For more on this topic, see kidsdata.org’s Research & Links section. Also see Policy Implications under the following kidsdata.org topics: Childhood Adversity and Resilience, School Climate, and Youth Suicide and Self-Inflicted Injury.

Sources for this narrative:

1.  National Academies of Sciences, Engineering, and Medicine. (2019). Fostering healthy mental, emotional, and behavioral development in children and youth: A national agenda. National Academies Press. Retrieved from: https://nap.nationalacademies.org/catalog/25201/fostering-healthy-mental-emotional-and-behavioral-development-in-children-and-youth

2.  Children Now. (2021). 2021 pro-kid policy agenda for California. Retrieved from: https://www.childrennow.org/portfolio-posts/the-2021-pro-kid-policy-agenda

3.  Briscoe, A., et al. (n.d.). Practical guide for financing social, emotional, and mental health in schools. California Children's Trust & Breaking Barriers. Retrieved from: https://cachildrenstrust.org/wp-content/uploads/2020/08/cct-practicalguide-final-v2.pdf

4.  Meschan Foy, J., et al. (2019). Mental health competencies for pediatric practice. Pediatrics, 144(5), e20192757. Retrieved from: https://publications.aap.org/pediatrics/article/144/5/e20192757/38256/Mental-Health-Competencies-for-Pediatric-Practice

5.  World Health Organization. (n.d.). Improving the mental and brain health of children and adolescents. Retrieved from: https://www.who.int/activities/improving-the-mental-and-brain-health-of-children-and-adolescents

6.  Centers for Disease Control and Prevention. (n.d.). Essentials for childhood: Creating safe, stable, nurturing relationships and environments for all children. Retrieved from: https://www.cdc.gov/violenceprevention/childabuseandneglect/essentials

7.  Joshi, S. V., et al. (n.d.). K-12 toolkit for mental health promotion and suicide prevention. HEARD Alliance. Retrieved from: https://www.heardalliance.org/help-toolkit

8.  Whitaker, A., et al. (n.d.). Cops and no counselors: How the lack of school mental health staff is harming students. American Civil Liberties Union. Retrieved from: https://www.aclu.org/issues/juvenile-justice/school-prison-pipeline/cops-and-no-counselors

9.  Centers for Disease Control and Prevention. (2021). Mental health of children and parents—a strong connection. Retrieved from: https://www.cdc.gov/childrensmentalhealth/features/mental-health-children-and-parents.html
Websites with Related Information
Key Reports and Research
County/Regional Reports
More Data Sources For Children's Emotional Health