The State of the Crisis
What the most recent national surveillance data show about the mental health of American adolescents.
The CDC Youth Risk Behavior Survey
The Youth Risk Behavior Survey (YRBS) is the federal government’s primary instrument for tracking the health-related behaviors of U.S. high school students. It is administered by the Centers for Disease Control and Prevention every two years and draws nationally representative samples in the tens of thousands. The 2023 cycle, released in 2024, surveyed approximately 20,103 students in grades 9 through 12.
The headline findings on mental health were as follows. Forty percent of all high school students reported persistent feelings of sadness or hopelessness in the prior year — defined as feeling so sad or hopeless almost every day for at least two weeks in a row that they stopped doing some usual activities. One in five had seriously considered attempting suicide in the prior year. Nearly one in ten had attempted suicide. These figures represent the second-highest level recorded in the survey’s history.
The distribution of these outcomes is not uniform. Female students reported persistent sadness or hopelessness at a rate of 53%, down slightly from 57% in 2021 but still substantially elevated above pre-2012 levels. Twenty-seven percent of female students seriously considered suicide in 2023, compared to 14% of male students. Students who identified as lesbian, gay, bisexual, or questioning reported persistent sadness or hopelessness at a rate of 65%.
The Long Trend
The 2013–2023 YRBS Data Summary and Trends Report places the current numbers in historical context. From 2013 to 2023, persistent sadness rose from 30% to 40%; serious consideration of suicide rose from 17% to 20%; suicide attempts rose from 8% to 9%. Each of these increases is statistically significant.
Beyond the YRBS, the National Survey on Drug Use and Health tracks past-year major depressive episode prevalence in adolescents 12–17. That measure roughly doubled between 2009 and 2019, with the rise concentrated in girls. The youth suicide rate, which had been roughly stable from the late 1990s through 2007, began rising in the early 2010s and has continued upward.
Hospital and Emergency Data
Self-reported survey data is corroborated by clinical surveillance. Emergency department visits for mental health concerns among U.S. adolescents rose substantially across the 2010s, with girls accounting for the majority of the increase. In Canada, hospital admissions for intentional self-harm among adolescent girls rose by 110% between 2009 and 2014, while admissions for other medical conditions in the same age group declined.
We are in the midst of a youth mental health crisis. Yet we are also seeing promising improvements.Centers for Disease Control and Prevention, 2024
This is the situation the rest of this document attempts to explain.
Saturation
How thoroughly social media now occupies the daily life of American children and adolescents.
Penetration
Ninety-five percent of U.S. teenagers ages 13–17 use at least one social media platform, according to Pew Research Center surveys conducted in 2022, 2023, and 2024. This figure has been remarkably stable for several years. What has changed is the intensity of use. In 2014–2015, roughly one in four teens reported being online “almost constantly.” By 2024, that figure had risen to 46% — nearly half.
Time
Common Sense Media’s biennial census found that teens 13–18 averaged eight hours and 39 minutes of total screen media use per day in 2021, up from seven hours 22 minutes in 2019. Tweens 8–12 averaged five hours 33 minutes. The social media component alone averaged roughly three to three-and-a-half hours daily for teens.
Platforms
As of the 2024 Pew survey, YouTube reached 90% of U.S. teens, followed by TikTok at 63%, Instagram at 59%, and Snapchat at 55%. Facebook usage had collapsed among teens to roughly 33%. The shift toward short-form video — TikTok, Instagram Reels, YouTube Shorts — has been the dominant platform-level trend of the past five years. These products optimize for what their engineering teams call “watch time” and “session length.”
The Frequency Question
The CDC’s 2023 YRBS, for the first time, included a direct question about frequency of social media use. Seventy-seven percent of U.S. high school students — more than three in four — reported using social media at least several times a day. The same survey found that frequent social media use was associated with higher rates of bullying victimization, persistent sadness or hopelessness, and suicide-related risk indicators.
Indicators of poor mental health have continued to rise, particularly among female and LGBQ+ students.CDC MMWR, October 2024
The 2012 Inflection
The most striking feature of the trend data is the year the curves bent.
From the early 1990s through approximately 2010, indicators of adolescent mental health in the United States and most of the developed world were broadly stable. Rates of major depressive episode, persistent sadness, suicidal ideation, and suicide attempts moved within narrow bands. There were no large shifts.
Then, beginning in 2010 to 2012, depending on the indicator, the lines moved. Rates of depression, anxiety, self-harm, and suicide began rising. The rise was sharpest among adolescent girls, but extended to boys. It appeared in U.S. data, in Canadian data, in U.K. data, in Nordic registries, and in international academic achievement and well-being surveys.
In a foundational 2018 paper in Clinical Psychological Science, Jean Twenge, Thomas Joiner, and colleagues documented that between 2010 and 2015, the proportion of U.S. teens reporting classic depressive symptoms rose by approximately one-third. Suicide attempts rose by approximately 23%. Sleep problems rose. Loneliness rose. Time spent with friends in person declined. Time spent on screens rose.
Adolescent mental health issues rose sharply since 2010, especially among females. New media screen time is both associated with mental health issues and increased over this time period.Twenge, Joiner, Rogers & Martin, Clinical Psychological Science, 2018
The timing matters. Smartphones reached approximately 50% of U.S. adults in late 2012. By 2015, more than 90% of U.S. teenagers and young adults owned one. The same window saw the rise of front-facing cameras, the maturation of the Instagram product, the launch of Snapchat (2011), the introduction of algorithmic feeds, and the emergence of TikTok (2018).
The Argument From Timing
Several alternative explanations have been proposed for the post-2012 rise: the 2008 financial crisis, rising academic pressure, the politicization of national life beginning roughly with the 2016 election, the COVID-19 pandemic. Each accounts for some part of the picture, but none accounts for the international uniformity of the timing or the gendered shape of the harm.
The factor that maps most cleanly onto the timing, the geography, and the demographic distribution of the harm is the global rollout of smartphones and algorithmic social media. This does not prove causation; it does, however, explain why so many serious researchers — Twenge, Haidt, the Surgeon General, the World Health Organization — have converged on the conclusion that digital media are at minimum a major contributor.
Mechanisms of Harm
Six mechanisms by which heavy social media use plausibly worsens adolescent mental health.
1. Displacement
Time is finite. Hours spent on social media are not spent doing other things — sleeping, exercising, reading, conversing in person, being unstructured and bored. Adolescent boredom, far from being a problem to be solved, appears to be a developmental necessity: the soil in which self-direction, identity formation, and creative thinking grow. The smartphone has, for the first time in human history, made boredom optional.
2. Variable-Ratio Reward
The operating logic of the social media feed is the variable-ratio reinforcement schedule, the same psychological mechanism that makes slot machines maximally compulsive. Variable-ratio schedules produce the most persistent and resistant-to-extinction behaviors documented in operant psychology. The product is not accidentally engaging. Internal documents and former employees have confirmed that this engagement profile was deliberately engineered.
3. Social Comparison at Scale
The adolescent brain is particularly tuned to peer status comparison. Pre-smartphone, the reference group for an American teenager was perhaps thirty to fifty peers. Post-smartphone, it is the entire filtered, lit, professionally produced, commercially incentivized planet. Internal Meta research found that approximately one in three teenage girls who reported body image issues said Instagram made them worse. Among teens reporting suicidal thoughts, 13.5% of British teen girls in Meta’s research attributed worsening of those thoughts to Instagram specifically.
4. Sleep Disruption
The adolescent brain requires approximately nine hours of sleep per night. Most U.S. adolescents now get fewer than seven. The smartphone in the bedroom is implicated in this on multiple pathways. Roughly 80% of teens admit to using their phones after lights-out. Sleep deprivation is itself a powerful risk factor for depression, anxiety, attention problems, and suicidality.
5. Algorithmic Contagion
Recommendation algorithms surface content predicted to maximize engagement. For some users — particularly users in distress — the most engaging content is content that mirrors and intensifies their distress. The 2022 Center for Countering Digital Hate study documented that TikTok accounts registered as 13-year-olds with usernames suggesting body image concern were served eating-disorder content within minutes and self-harm content within an hour. A 2024 study found users with diagnosed eating disorders received 4,343% more pro-eating-disorder videos than control users — a delivery rate driven by the algorithm rather than by users’ explicit interactions.
6. Attention Erosion
Sustained attention is a developmental skill, built through the practice of attending to one thing for extended periods of time. Practice is precisely what the smartphone replaces. The Adolescent Brain Cognitive Development study, the largest longitudinal study of adolescent brain development ever conducted, has documented small but consistent associations between higher digital media use and lower performance on tests of working memory, executive function, and attention.
Screens have a significant impact on sleep patterns across all age groups.Coleman, in Children and Screens, 2024
Sleep and Cognition
What the developing brain needs, what the screen takes, and what we can measure.
The Sleep Deficit
The American Academy of Sleep Medicine recommends 8 to 10 hours of sleep per night for adolescents 13–18. The CDC YRBS has consistently documented that roughly two-thirds of U.S. high school students fail to meet this minimum. Insufficient sleep is associated with decrements on virtually every measure of adolescent functioning: academic performance, athletic performance, immune function, emotional regulation, depression risk, anxiety risk, and suicide risk.
Phones in Bedrooms
Multiple lines of evidence implicate the bedroom-resident smartphone in the sleep deficit. The Sleep Foundation reports that 57% of teens who keep technology in their bedrooms suffer sleep problems. A randomized controlled crossover study of Dutch adolescents 12–17 found that one week of complete screen abstinence in the evening, or one week of consistent blue-light-blocking glasses, restored sleep onset times in heavy screen users to the level of light-screen users. The effect operated within a single week.
Brain Structure and Function
The Adolescent Brain Cognitive Development study has been tracking approximately 12,000 children since age 9–10. Neuroimaging substudies have associated higher screen use with lower cortical thickness and white matter integrity in regions involved in language, executive function, and visual processing.
A 2025 Translational Psychiatry paper using ABCD data on more than 6,000 children found that screen time was associated with structural differences in the right temporal pole, left superior frontal gyrus, and left rostral middle frontal gyrus.
Academic Performance
U.S. reading and mathematics scores on the National Assessment of Educational Progress have declined since approximately 2012, with the lowest-performing students reaching levels last seen in the 1970s. A 2024 study from the Norwegian Institute for Public Health found that middle schools that banned smartphones saw measurable improvement in girls’ GPA, test scores, and likelihood of attending an academic high school track.
Body Image and the Algorithm
How recommendation systems amplify the harm to teenage girls in particular.
The Baseline
The U.S. Surgeon General’s 2023 advisory documented that 46% of adolescents 13–17 said social media made them feel worse about their bodies. This figure rises sharply when restricted to female adolescents and to high-frequency users. The mechanism is straightforward: image-based platforms train an aspirational reference set that no real adolescent can match, and the algorithm preferentially surfaces the most engaging — which is often the most extreme — instances of that reference set.
Internal Evidence
The Facebook Files, leaked by former Meta product manager Frances Haugen in 2021, included internal Meta presentations on Instagram’s effects on teenage girls. Among the findings the company’s own researchers documented and that the company’s leadership chose not to make public:
- 32% of teen girls said that when they felt bad about their bodies, Instagram made them feel worse.
- 13.5% of British teen girls who reported suicidal thoughts attributed worsening of those thoughts to Instagram.
- 17% of teen girls said Instagram contributed to worsening of eating disorders.
We make body image issues worse for one in three teen girls.Internal Meta research presentation, leaked 2021
Algorithmic Amplification
The Center for Countering Digital Hate’s 2022 Deadly by Design study created experimental TikTok accounts presenting as 13-year-olds in four English-speaking countries. Within minutes of the accounts beginning to engage with body-image content, the algorithm shifted toward serving more extreme content. Within thirty minutes, accounts whose usernames suggested body image concern were receiving content related to self-harm and suicide.
A 2024 study by Griffiths and colleagues at the University of Melbourne, published in Body Image, analyzed 1.03 million TikTok videos delivered to 42 individuals with diagnosed eating disorders versus 49 healthy controls over one month. Algorithms belonging to users with eating disorders delivered 4,343% more toxic eating disorder videos. The recommendation system was driving the exposure, not merely reflecting user choice.
The Eating Disorder Trend
Pediatric admissions for eating disorders rose substantially during the 2010s and accelerated during the COVID period. Hospitals reporting on adolescent eating disorder admissions have variously cited 2x to 3x increases over pre-pandemic baselines, with the trend particularly pronounced in 12–14-year-old girls and especially in anorexia nervosa.
Predation
Sextortion, online grooming, and the exploitation of minors at scale.
The FBI Data
Between October 2021 and March 2023, the U.S. Federal Bureau of Investigation and the Department of Homeland Security received more than 13,000 reports of online financial sextortion of minors. The reports involved at least 12,600 victims — primarily teenage boys — and were linked to at least 20 documented suicides. The crime is typically perpetrated by offenders located outside the United States, with West African countries (notably Nigeria and Ivory Coast) and Southeast Asian countries (notably the Philippines) most commonly implicated.
The Mechanism
Financial sextortion typically begins with an offender posing as an attractive peer, often through a fake account on Instagram, Snapchat, or a gaming platform. The offender persuades the victim to share an intimate image, then immediately demands payment — often in gift cards or cryptocurrency — under threat of distributing the image to the victim’s family, friends, or followers. The offender has typically already screenshotted the victim’s follower list to make the threat credible. Payment rarely ends the harassment.
The 764 Network and Violent Online Targeting
Beyond financial and sexual exploitation, the FBI has identified a category of violent online networks — including but not limited to the network designated 764 — that target vulnerable minors specifically to coerce them into producing extreme content. These networks operate across mainstream social media platforms and represent the most severe end of the online predation spectrum.
The Decline of In-Person Life
Loneliness is rising and in-person socializing is collapsing. The two trends are linked.
The Numbers
The Monitoring the Future study, conducted at the University of Michigan, has tracked the daily activities of U.S. high school seniors since 1976. In 2010, 44% of seniors gathered with friends in person almost every day. By 2022, that figure had fallen to 32%. For eighth graders, average weekly social outings declined from approximately 2.5 in 2000 to 1.5 in 2021. Teen loneliness, measured in the Monitoring the Future and PISA international datasets, nearly doubled between 2012 and 2018, with the increase appearing in nearly every country the surveys cover.
The steepest decline commenced around 2010, just as smartphones and social media were taking hold.Twenge, on Monitoring the Future data, 2023
Displacement Effects
Twenge, Spitzberg, and Campbell, in a 2019 paper in the Journal of Social and Personal Relationships, analyzed 8.2 million U.S. adolescents and entering college students between 1976 and 2017. They found that the iGen cohort (born 1995–2012) spent significantly less time on in-person social interaction than previous generations had at the same ages, with the decline beginning around 2010. College-bound seniors in 2016 spent approximately one hour less per day in person with peers than seniors in the late 1980s.
Adolescents low in in-person social interaction and high in social media use reported the highest levels of loneliness in the dataset. The relationship is not symmetric: high social media use does not appear to compensate for low in-person interaction, but high in-person interaction appears to buffer against the negative effects of moderate social media use.
The WHO Verdict
In 2025, the World Health Organization Commission on Social Connection issued a report identifying loneliness as a major global health challenge. The report estimated that loneliness contributes to roughly 100 deaths globally per hour — more than 871,000 annually. Adolescents and young adults were identified as among the most affected age groups.
The Industry Knew
The Facebook Files, the Haugen disclosures, and what internal company research had been documenting for years.
The Whistleblower
In September 2021, the Wall Street Journal began publishing a series of investigative articles based on a trove of internal Meta documents leaked by former Meta product manager Frances Haugen. The series, which the Journal titled the Facebook Files, exposed the contents of internal company research that the company had not made public. Among the most damaging findings were a set of internal studies on Instagram’s effects on teen girls.
In October 2021, Haugen testified before the U.S. Senate Subcommittee on Consumer Protection. She had separately filed disclosures with the U.S. Securities and Exchange Commission alleging that the company had misled investors and the public about the harms of its products.
What the Documents Showed
- Approximately one in three teen girls who reported body image concerns said Instagram made those concerns worse.
- 13.5% of British teen girls who reported suicidal thoughts attributed worsening of those thoughts specifically to Instagram.
- 17% of teen girls said Instagram contributed to the worsening of an eating disorder.
- Internal slides described social comparison on Instagram as more harmful to teen girls than other forms of social media.
- Researchers wrote that teens “blame Instagram” for increases in their anxiety and depression — a finding the report described as unprompted and consistent across focus groups.
- Despite this, the company’s public posture continued to dispute the framing that it harmed teen mental health.
The Pattern Across Platforms
Subsequent disclosures and litigation have produced similar evidence at TikTok, Snap, and elsewhere. Internal documents and former-employee testimony have established that engagement metrics — time on platform, sessions per day, scroll depth — were prioritized in product decisions even when researchers within the company had documented harm to specific user populations. The architecture of the products, including infinite scroll, autoplay, push notifications, social-pressure features, and algorithmic recommendation, was repeatedly evaluated by internal research as harmful to vulnerable teens — and was repeatedly retained or expanded for engagement reasons.
Meta has profited from children’s pain by intentionally designing its platforms with manipulative features.New York Attorney General Letitia James, October 2023
The Legal Response
Lawsuits, statutes, and regulatory action — what is happening in courts and capitols.
The Meta Multistate Suit
On October 24, 2023, a bipartisan coalition of 42 U.S. state attorneys general filed coordinated lawsuits against Meta Platforms, Inc. The federal complaint alleges that Meta knowingly designed and deployed addictive features on Instagram and Facebook to maximize the time and attention of underage users; that Meta routinely collected data on children under 13 without parental consent in violation of COPPA; and that the company’s public statements about the safety of its products were deceptive in violation of state consumer protection laws.
Product Liability Litigation
Beyond the AG actions, more than 1,200 individual product liability lawsuits have been filed against Meta, TikTok, Snap, and other social media companies on behalf of families whose children suffered serious harm — including death by suicide. The cases have been consolidated for discovery purposes in a multidistrict litigation in the Northern District of California. The legal theory — that the platforms can be sued for negligent product design even where they cannot be sued for the content their users post (which is shielded by Section 230) — represents an active and developing frontier in the law of platform liability.
School District Actions
Hundreds of U.S. school districts, beginning with Seattle Public Schools in January 2023, have filed lawsuits against the major social media companies, alleging that the platforms have created a public nuisance — specifically, the youth mental health crisis — that has imposed substantial costs on schools.
KOSA
The federal Kids Online Safety Act would impose a duty of care on covered platforms with respect to enumerated harms to minors, require strongest-privacy default settings, mandate parental tools, and require platforms to disable autoplay and personalized algorithmic recommendations for minors. The bill passed the U.S. Senate by a vote of 91–3 on July 30, 2024, but did not advance through the House of Representatives. It was reintroduced in the 119th Congress in 2025.
Australia’s Under-16 Ban
On November 29, 2024, the Parliament of Australia passed the Online Safety Amendment (Social Media Minimum Age) Act 2024, prohibiting persons under the age of 16 from holding accounts on designated social media platforms. The provisions took effect December 10, 2025. Penalties for non-compliance reach AUD 49.5 million per violation. Public opinion in Australia at the time of passage strongly supported the measure (77% in a November 2024 YouGov poll).
Phone-Free Schools
The closest thing to a controlled experiment in the policy literature.
The Norway Study
A 2024 study by Sara Abrahamsson, published by the Norwegian Institute for Public Health, compared middle schools that had implemented smartphone bans to those that had not. The findings were striking. Banning smartphones reduced bullying among both boys and girls. Banning smartphones improved girls’ GPA by approximately 0.22 standard deviations on externally graded mathematics exams — for context, reducing class size by one student typically improves test scores by 0.00–0.05 standard deviations, meaning the phone-ban effect was four to twenty times larger. Among girls in schools with the strictest bans, visits to specialists for psychological symptoms declined by 60%.
U.K., Spain, and the United States
A 2015 U.K. study examined standardized test scores before and after secondary school phone bans. Compliance was reported as moderately high, and post-ban test scores showed small but statistically significant improvement. A 2022 Spanish study covering two regions that banned phones in 2015 documented a 15–18% reduction in bullying among 12–14-year-olds and 10–18% reduction among 15–17-year-olds. In the United States, an October 2025 NBER working paper studied a Florida school district that implemented a bell-to-bell phone ban. By the second year, suspensions had returned to pre-ban levels, and student test scores rose by 2–3 percentile points.
The Mixed Picture
Not every study has found clear benefit. A February 2025 study published in the Lancet Journal for European Health Policy, involving 1,227 youth across 30 schools, found that schools with restrictive phone policies saw 50 fewer minutes of in-school phone use compared to permissive schools, but found no statistically significant improvements in mental health, academic performance, or classroom behavior. The authors concluded that school-day-only restrictions may be insufficient when phone exposure outside school hours remains high.
Educator Sentiment
U.S. National Center for Education Statistics data from February 2025 found that 53% of public school leaders believed cell phones had negatively impacted student academic performance; 72% believed they had negatively impacted student mental health; and 73% believed they had negatively impacted student attention.
