The COVID-19 pandemic upended world-wide public health, causing many deaths and leaving in its wake numbers of people of all ages with chronic physical and mental health problems. But even before the pandemic, there were already alarming trends that pointed to deteriorating mental health among America's young people.

In 2021, the U.S. Surgeon General, concerned about the possible additional impact of the pandemic on American youth at home, at school and in the community, issued a warning about youth mental health.

A new research report from a team of researchers at Northwestern's Feinberg School of Medicine and Chicago's Ann & Robert H. Lurie Children's Hospital confirms that American youth are, in fact, significantly more anxious and more depressed than before the pandemic, while selected physical conditions, in contrast, have decreased.

Anxiety and depression in young people each steadily increased from 2016 to 2022. They especially accelerated in the two years post-pandemic.

The researchers analyzed publicly available data from the annual National Survey of Children's Health (NSCH) that were collected from 2016 through 2022. This dataset range provides a built-in comparison of pre-, during- , and post-pandemic rates. Approximately 22,000 and 54,000 youths were randomly selected and surveyed each year. The samples were weighted to be representative of the U.S. population.

The researchers tracked mental health conditions such as anxiety, depression, behavioral problems and attention-deficit/hyperactivity disorder (ADHD). And they estimated what percentage of young people had physical health issues such as asthma, heart problems and severe headache or migraine.

Their analysis showed that anxiety and depression each steadily increased from 2016 to 2022. They especially accelerated in the two years post-pandemic. Anxiety and depression in young people each steadily increased from 2016 to 2022. They especially accelerated in the two years post-pandemic. In contrast, asthma rates were steady from 2016-2020, then declined post-pandemic, reaching its lowest point in 2022. The trend pattern for severe headache or migraine was the same. The proportion of youth with heart conditions was unchanged from 2016 to 2022.

Study authors, Marie E. Heffernan, PhD, and Michelle L. Macy, MD, MS, caution that “parent-reported data” may have resulted in lower reporting and that more research is needed to determine if researchers can pinpoint “factors associated with observed trends and mechanisms associated with changes.”

The research letter is published in JAMA Pediatrics.