The Real Culprit Behind Plummeting Children’s Mental Health

Before treating kids with therapy and medication, make sure they’re getting enough “psychological nutrients.”

Kids are suffering. In the United States, 13 percent of three- to 17-year-olds had a mental or behavioral health diagnosis. That number climbs to 20.3 percent among teens aged 12 to 17 (as of 2023). Globally, 15 percent of 10- to 19-year-olds have a mental health disorder.

You’re right in thinking it hasn’t always been like this. There’s been a sharp spike in recent years—even before the COVID-19 pandemic’s contribution. Between 2012 and 2018, there was a 34.6 percent increase in child mental illness. ADHD, anxiety, depression, and behavior/conduct problems are the most common conditions afflicting youth. Diagnoses of depression in children aged 3 to 17 grew 27 percent from 2016 to 2020.

Parents and teachers often blame social media for rising teen depression rates. But many studies show only a correlation between the two (and a low one at that), not causation. It’s just as or more likely that kids experiencing poor family dynamics, a lack of autonomy, academic pressures, or other issues find solace and distraction in excessive social media use. Too much tech use is a symptom of a deeper problem, not the sole cause.

As mental health diagnoses surge, so does the reliance on therapy and medication. While these interventions can be helpful, they are reactive rather than preventive. To support children’s mental health, we need to focus on one of the root causes.

But what exactly about modern childhood environments is making kids so unhappy? The answer lies in understanding the stark gap between what children need psychologically and what their daily lives actually provide.

Kids’ Lives Aren’t Easy

What many people don’t know is that many childhood struggles stem from lifestyle factors rather than chemical imbalances. Addressing those factors should be the first step in helping a suffering child.

“If we treat children with mental, emotional, and behavioral problems without individually and collectively addressing social and relational health risks, or even assessing them, which is often the case, we are missing some of the biggest factors driving the mental and emotional suffering of our children,” says Christina Bethell, professor at Johns Hopkins and director of the Child and Adolescent Health Measurement Initiative at the Bloomberg School.

The truth is, kids have a lot bringing them down. For starters, school.

“Schools produce anxiety and depression in children,” according to Boston College research professor Peter Gray. He notes that U.S. school systems have reacted by spending tons of money on mental health professionals and programs (more than $1.7 billion in the 2021–22 school year went to social and emotional learning). But, he wrote, “if schools would stop stressing kids out as they do, and stop preventing them from being kids, our kids wouldn’t need so much therapy!”

A survey of 65,000 third- through 12th-grade students, released in January 2025, showed that kids’ severe lack of agency in school is part of the problem. It found that 26 percent of 10th graders say they love school, compared to 74 percent of third graders, which Jenny Anderson and Rebecca Winthrop—co-conductors of the survey and authors of The Disengaged Teen: Helping Kids Learn Better, Feel Better, and Live Better—attribute to 33 percent of 10th graders saying they don’t develop their own ideas in school. “School feels like prison, many teenagers told us over three years of research,” Anderson and Winthrop wrote in a New York Times op-ed. “The more time they spend in school, the less they feel like the author of their own lives, so why even try?”

The comparison to prison isn’t an exaggeration. Robert Epstein, the researcher who wrote “The Myth of the Teen Brain” in Scientific American, has a similar conclusion: “Surveys I have conducted show that teens in the U.S. are subjected to more than 10 times as many restrictions as are mainstream adults, twice as many restrictions as active-duty U.S. Marines, and even twice as many restrictions as incarcerated felons.”

Most formal schooling in America and similar industrialized countries is the antithesis of a place where kids have the autonomy to make their own choices. And that’s not the only problem.

While some standardized tests like the SAT serve an important role in providing an objective measure of academic achievement, the sheer volume of testing in schools can take a toll on students’ well-being. Kids today take standardized tests in mathematics and English language arts every year from third to eighth grade and once in high school, plus less frequent science tests. In-class tests account for a significant percentage of students’ grades—as high as 40 to 60 percent in some school districts. This constant assessment creates an environment where many students feel perpetually evaluated rather than focused on learning; that potentially undermines their sense of competency and increases stress levels.

The education system has begun recognizing these challenges. The 2015 U.S. Every Student Succeeds Act, which replaced the No Child Left Behind Act, reduced some testing requirements. Poor test scores and grades can make children feel incompetent. Persistent stress in schools is shown to adversely affect children’s physical and mental health into adulthood.

No, traditional Western school isn’t the only factor that contributes to poor mental health in children. However, kids consistently report that school is the primary source of their distress. In one survey, 83 percent of the teens said school pressures were responsible for some of their stress.

Perhaps the most damning indictment of our educational environment comes from this sobering statistic: teenage suicide attempts drop by 28% during summer months when school is not in session. Let that sink in—the very institution we trust to nurture our children’s minds may be contributing significantly to their psychological distress.

Recognizing the challenges of children’s day-to-day life allows us to understand that raising happy, healthy kids means addressing these challenges. Instead of jumping to therapy, we should first assess whether children’s basic psychological needs are being met.

The Psychological Nutrients Kids Need to Thrive

According to self-determination theory, all humans—kids included—need three psychological nutrients to flourish, a widely accepted theory of human motivation and flourishing developed by renowned human-behavior researchers Richard Ryan and Edward Deci.

• Autonomy: A sense of control over their own lives. Many kids feel anxious because their lives are overly structured and controlled.

• Competency: Feeling capable and effective. Without opportunities to succeed at meaningful tasks, kids may develop low self-esteem.

• Relatedness: Feeling connected to others. Genuine connection and supportive relationships, not just therapy sessions or structured socialization, are essential for emotional well-being.

Even if kids don’t get all these nutrients at school, caregivers can provide them in other ways.

How to Give Your Kid a Rich Life

What does feeding your kid the psychological nutrients they need look like? My wife and I have a teenage daughter, but our approach to raising her isn’t the only way and may not even apply to yours.

Instead of prescribing advice, I offer several studies that point to what kids need to be mentally healthy.

1. Make Their Choices Count

A 2009 study examined children’s attention and learning during an experiment with Guatemalan Mayan and European American five- to 11-year-olds. Two children were brought into a room where an adult taught one of them how to build a toy while the other one waited; researchers observed what the nonparticipating child, the observer, would do while waiting. In the United States, most of the observer children shuffled in their seats, stared at the floor, and generally showed signs of disinterest. But the Mayan children concentrated on what the other child was learning and sat still in their chairs as the adult taught the other child.

Overall, the study found that American children could focus for only half as long as Mayan kids, even though the Mayan children had less exposure to formal education. Less schooling meant more focus. How could that be?

Psychologist Suzanne Gaskins, who has studied Mayan villages for decades, told NPR that Mayan parents give their kids a tremendous amount of freedom. “Rather than having the mom set the goal—and then having to offer enticements and rewards to reach that goal—the child is setting the goal. Then the parents support that goal however they can,” Gaskins said. Mayan parents “feel very strongly that every child knows best what they want and that goals can be achieved only when a child wants it.”

Any parent can offer their child this same freedom. A great way to start is by helping them build an indistractable summer. Kids may not have much autonomy during the school year, but in the summer, they have unlimited free time. Caregivers can support kids in planning a balanced schedule for spending their time how they want.

Other ways to give kids autonomy:

• Let them choose their extracurricular activities instead of pushing them into what we think is best.

• Give them choices in everyday life, such as picking out their clothes and meals.

• Allow them to take (reasonable) risks, like climbing trees, biking to a friend’s house, or picking up an ingredient at a nearby grocery store.

2. Connect with Them

Another multi year study, led by Bethell, concluded that strong family connections and resilience can offset kids’ mental health conditions.

Nearly 70 percent of children with mental health conditions in the study experienced at least one of eight social or relational health risk factors including economic hardship, food insecurity, unsafe neighborhood, racial discrimination, and adverse childhood experiences such as substance abuse or domestic violence.

Relational health risks—namely, poor caregiver mental health, low levels of caregiver coping, or high aggravation with their child—in particular influence children’s mental health: Compared to social health risks, they are not only more prevalent among kids with mental health conditions but also more strongly associated with those conditions, according to Bethell’s study.

Strong relational health can alleviate mental health problems by promoting children’s self-regulation and resilience. For example, children with a strong parent-child connection were 5.73 times more likely to demonstrate good self-regulation and 2.25 times more likely to do so “when their family reported staying hopeful and could identify strengths to draw on during difficult times.”

To build strong family connections, try having regular family dinners without screens, or go on one-on-one outings with your kids. When she was younger, my daughter and I used to have a fun jar of activities we would pull from, and today we have planned spontaneity together.

3. Take Care of Yourself

Did you hear? Poor caregiver mental health can adversely affect kids’ mental health. So if you ever needed an evidence-backed reason to practice self-care, this is it.

To convince you further, this study found that “people who are surrounded by many happy people and those who are central in the network are more likely to become happy in the future.” Your happiness, as the guardian of a child, is important. Devote time to yourself. Taking care of yourself is at the core of the three life domains—you, your work, and your relationships—because the other two depend on your health and wellness. If you’re not taking care of yourself, your relationships, including with your kids, suffer.

4. Let Them Play

Remember playing pickup games at the basketball court, hanging out at the mall on weekends, or simply roaming around the neighborhood until you found a friend? Sadly, spontaneous socializing for kids isn’t as common as it used to be.

“But the world is different now,” some parents argue. “We can’t just let kids roam free like in previous generations.” While safety concerns are valid, the data doesn’t support the level of restriction many children experience today. Crime statistics show that children are safer now than in previous decades, despite parental perceptions to the contrary. The real danger may lie in overprotection itself—depriving children of the very experiences that build confidence, resilience, and social skills.

Peter Gray, who has studied the decline of play in America, reported that since about 1955, “children’s free play has been continually declining, at least partly because adults have exerted ever-increasing control over children’s activities.” Parents restrict outdoor play due to “child predators, road traffic, and bullies,” according to a survey in an Atlantic article—even though kids today are statistically the safest generation in American history.

Kids have no choice but to stay indoors, attend structured programs, or rely on technology to find and connect with others.

Although virtual social interactions can be positive because they allow people to feel relatedness, the loss of in-person play has real costs, including social isolation and loneliness. According to Gray, “Learning to get along and cooperate with others as equals may be the most crucial evolutionary function of human social play.”

Gray argues that schools should integrate more play into the day. Until that happens, caregivers can make sure kids have time for free play outside of structured academic or athletic activities.

Considerations Before Therapy or Medication

The environmental factors discussed throughout this article—school stress, lack of autonomy, limited play, and poor relational health—create the foundation for children’s mental well-being. By addressing these fundamental needs first, we can prevent many mental health challenges before they require clinical intervention.

That said, we must acknowledge an important truth: some children will need professional support even with the most nurturing environments. The key is approaching mental health as a spectrum rather than a binary choice between “environment fixes everything” or “medication is always necessary.”

When environmental changes don’t fully address a child’s struggles, consider these principles:

1. Normalize emotions without pathologizing them

There’s a crucial difference between experiencing anxiety and having an anxiety disorder. Teaching children that uncomfortable emotions are normal parts of life—not symptoms to be eliminated—builds emotional resilience. This perspective helps them develop healthy relationships with their feelings rather than fearing them.

2. Seek support thoughtfully

If professional help becomes necessary, approach it with intentionality. Find practitioners who consider the whole child—their environment, relationships, and unique circumstances—not just their symptoms. The best mental health professionals for children recognize that diagnosis should inform care, not define identity.

3. Maintain agency in treatment

Even within therapeutic contexts, children need autonomy. Involve them in decisions about their care when appropriate, and ensure that any intervention strengthens rather than diminishes their sense of competence and connection.

The path to better mental health for our children isn’t found in either rejecting or embracing therapy and medication wholesale. Instead, it lies in creating environments where children can thrive naturally while recognizing when additional support serves their well-being. By addressing the root causes first—the environmental factors that deprive children of autonomy, competence, and relatedness—we give them the best chance at flourishing, with or without clinical intervention.

Our responsibility isn’t to shield children from all difficult emotions or experiences, but to ensure they have the psychological nutrients and supportive relationships that allow them to navigate life’s challenges with resilience and hope.

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What You Can Do Today:

1. Audit your child’s schedule for balance between structured activities and free time. Does it allow for daily periods of self-directed play?

2. Evaluate your own expectations about achievement, grades, and performance. Are they serving your child’s well-being?

3. Advocate within your school system for more unstructured time, less testing pressure, and greater student agency.

4. Become an “Indistractable” parent by modeling healthy technology use. Children learn more from what we do than what we say. When you set boundaries around your own screen time—putting your phone away during meals, establishing tech-free zones in your home, and being fully present during family time—you teach powerful lessons about attention management. Show your children that technology is a tool to be used intentionally, not something that controls your attention. This modeling is far more effective than rules and restrictions that apply only to them but not to you.

5. Teach the “why” behind technology boundaries, not just the rules. Empower them with strategies to maintain control over their attention. When children understand the psychology behind distraction, they develop critical thinking skills that serve them throughout life.

The mental health crisis among children isn’t inevitable—it’s the product of environments we’ve created, and we have the power to change them. Our children’s well-being depends on our willingness to examine and transform the worlds they inhabit, not just treat the symptoms that result from environments that fail to meet their most basic psychological needs.