Youth Mental Health: Trends from 1990-2021 & Pandemic Surge

The mental wellbeing of adolescents and young adults has been a growing public health concern for decades, but recent research underscores a particularly stark trend: a significant surge in mental health disorders following the COVID-19 pandemic. A new study published in Molecular Psychiatry details patterns in mental health experienced by young people globally between 1990 and 2021, revealing a marked increase in conditions like anxiety and depression during the pandemic years, even as substance use disorders saw a decline.

Understanding the Scope of Youth Mental Health

Adolescence is a period of profound change, both physically and emotionally and a time when many mental health conditions first emerge. Anxiety disorders, depression, and substance use disorders are among the most common challenges faced by young people. Researchers at Ohio State University, Beijing Tiantan Hospital, and other institutions sought to quantify these trends over a 31-year period, examining data from individuals aged 10 to 24 across the globe. Their work aimed to provide a clearer picture of the evolving landscape of youth mental health and to identify potential areas for targeted intervention.

The study, led by Xiangyu Zhao and Ligang Liu, utilized a disease-modeling tool called DisMod-MR 2.1 to compare mental health trends across different countries and years. They too employed Joinpoint regression, a statistical technique used to identify significant changes in trends over time. Joinpoint regression helps researchers pinpoint when and where shifts in prevalence occur, offering valuable insights into the factors driving these changes.

Prevalence of Mental Disorders: A Look at the Data

Prior to the pandemic, anxiety disorders were already the most prevalent mental health concern among both adolescents (aged 10-19) and young adults (aged 20-24). This was followed by conduct disorders, depressive disorders, and autism spectrum disorder in the younger age group. The study found that in 2021, 15.2% of adolescents and 16.1% of young adults globally experienced a mental disorder. Notably, high-income regions exhibited the highest rates of these conditions. Sex differences were also observed, with attention-deficit hyperactivity disorder and autism spectrum disorders being more common in males, while anorexia nervosa was more prevalent in females.

These findings align with broader trends observed in global mental health, where socioeconomic factors and access to care often play a significant role in determining prevalence rates. The study highlights the importance of considering these contextual factors when developing and implementing mental health interventions.

The Pandemic’s Impact: A Surge in Mental Health Concerns

Perhaps the most striking finding of the study was the significant increase in mental health disorders following the onset of the COVID-19 pandemic. While substance use disorders (SUDs) saw a decrease during this period – researchers noted SUDs were the 15th cause of years lived with disability (YLDs) and 22nd cause of disability-adjusted life years (DALYs) among adolescents, and 8th and 11th respectively for young adults – anxiety and depression experienced a marked rise. The researchers observed a substantial increase in disability-adjusted life years (DALYs) associated with mental disorders, particularly among females.

This surge is likely attributable to a complex interplay of factors, including social isolation, economic uncertainty, disruptions to education and healthcare, and the general stress and fear surrounding the pandemic. The increased burden of depression and anxiety underscores the urgent necessitate for age-specific, sex-responsive, and regionally tailored mental health strategies. The study emphasizes that the pandemic did not create these issues, but rather exacerbated existing vulnerabilities and brought them to the forefront.

Understanding DALYs and YLDs

The study utilizes two key metrics to measure the burden of disease: disability-adjusted life years (DALYs) and years lived with disability (YLDs). YLDs represent the number of years lived with a health condition that causes disability, while DALYs combine YLDs with years of life lost due to premature mortality. These metrics provide a comprehensive measure of the impact of a disease or condition on both individual health and population wellbeing. By tracking changes in DALYs and YLDs, researchers can assess the effectiveness of interventions and identify areas where further investment is needed.

Implications for Public Health and Future Research

The findings from Zhao, Liu, and their colleagues have significant implications for public health policy and practice. The study underscores the need for increased investment in mental health services, particularly those targeted towards adolescents and young adults. It also highlights the importance of addressing the social determinants of mental health, such as poverty, inequality, and discrimination.

Looking ahead, further research is needed to understand the long-term effects of the pandemic on youth mental health. It is also crucial to identify effective strategies for preventing mental health disorders and promoting wellbeing among young people. This includes exploring innovative approaches to mental health care, such as telehealth and digital mental health interventions, and ensuring that these services are accessible to all who need them. Global health data consistently shows that early intervention is key to improving outcomes for individuals with mental health conditions.

The insights gathered by this research team emphasize the critical role of proactive and responsive mental health support for young people, especially during times of global crisis. By prioritizing the mental wellbeing of future generations, You can build a healthier and more resilient society.

Written for you by our author Ingrid Fadelli, edited by Gaby Clark, and fact-checked and reviewed by Robert Egan—this article is the result of careful human work. We rely on readers like you to keep independent science journalism alive. If this reporting matters to you, please consider a donation (especially monthly). You’ll get an ad-free account as a thank-you.

Publication details: Xiangyu Zhao et al, The global burden of mental and substance use disorders among adolescents and young adults, Molecular Psychiatry (2026). DOI: 10.1038/s41380-026-03503-9.

Journal information: Molecular Psychiatry