BEHAVIOUR PROBLEMS IN YOUTH

Every generation of adults seems to worry that the next generation of youth is in trouble. The
perception of kids today is no different, with theories abounding as to why the mental health of
the newest generation is slipping, compared with previous standards. From mobile phones to
helicopter parents, it might seem like a foregone conclusion that our current crop of young
people is destined to be insecure, inattentive, and unable to cope with challenges and stress.
Many news headlines on the latest mass shooting or standardized test results often seem to
confirm these widespread concerns.

Pediatricians often hear parents lamenting the “good old days” when such things as corporal
punishment were more easily accepted to help keep kids in line. But taking a step back, it may be
worth a more objective look to examine the assumption that child behavioral problems are worse
than ever. Measuring overall mental health is not an easy task, but looking at several important
metrics indicate that things may not be nearly as bad as many people think.

- SUBSTANCE IN USE

From the latest data from the Monitoring the Future Study, one of the nation’s most reliable
sources on teen substance use, the use of both alcohol and tobacco among youth is at the lowest
level since the study began in 1975. Use of drugs like heroin and ecstasy also are declining. The
only major exception to this trend seems to be cannabis use, which has generally shown stable
rates during this climate of marijuana decriminalization and, for some states, legalization.

- TEEN PREGNANCY RATES

One area where there continues to be sustained progress is in teen pregnancy. According to the
government’s Centers for Disease Control and Prevention, the overall pregnancy rate among
adolescent females has been cut in half from 1991 to 2011, across many different ethnic groups.
The rate fell from 61.8/1,000 teenagers aged 15-19 years to 31.3/1,000 teenagers.

- DELINQUENCY

Far fewer adolescents are being held against their will in juvenile detention centers. The number
of youth who are incarcerated have dropped from a high of 381/100,000 in 1995 to 225/100,000
in 2010, according to a report by the Annie E. Casey Foundation.

- BULLYING

Bullying has been increasingly recognized as the public health problem that it is. The use of
online technology also has created many new settings in which bullying can take place.
Nevertheless, there is reason to be optimistic. From the National Center for Education Statistics
and the National Crime Victimization Survey, the number of students who report being bullied at
school has dropped from 32% in 2007 to an all-time low of 22% in 2013. Another recent study
reached similar conclusions for bullying and many other forms of child victimization between
2003 and 2011.
 - SUICIDE

According to the CDC, the rate of completed suicide in youth peaked in the early1990s and then
dropped and stabilized before starting to creep up again over the past 5 or so years. The trends
are somewhat different, based on gender and the specific age group that is examined. The
majority of completed youth suicides occur in males, with current rates still well below those
historical highs.

- PSYCHIATRIC DISORDERS

This one is particularly tricky. While the rates of many specific psychiatric disorders such as
ADHD and bipolar disorder have been rising in youth, as well as the use of psychiatric
medications, it is much less clear whether this represents a true rise in these disorders versus
other factors such as improved detection and a lower diagnostic threshold. One study by
Achenbach et al. that measured quantitative levels of child behavior problems from the same
rating scale over a 23-year time span found some increases in overall levels from the 1970s to
the early 1990s, but then levels began to fall by the end of the millennium.

Of course, these hopeful trends in many significant areas do not mean that these problems have
been overcome. While much work remains to be done on many fronts, it is still worth keeping in
mind that the overall condition of youth mental health may not be as dire as we might be led to
believe and that there is evidence that our efforts, perhaps, are leading to some progress.