And more than one in ten girls had been forced to have sex in their lifetime, says Ethier.
"That is just an overwhelming finding," she says. "So, not surprisingly, we're also seeing that almost 60% of teen girls had depressive symptoms in the past year, which is the highest level in a decade."
Nearly one in three girls also reported seriously considering suicide in the past year – a 60% rise from a decade ago.
The report also found that 52% of teens identifying as LGBTQ+ experienced poor mental health in the past year, with 1 in 5 saying they had attempted suicide during that period of time. Among racial and ethnic groups Native American teens were the most likely to have attempted suicide in the year before, followed by Black youth, at 14%.
Trauma plays a role
There's often a history of trauma among teens experiencing a mental health crisis, says Dr. Vera Feuer, a child and adolescent psychiatrist at Northwell Health in Long Island, NY, who did not participate in the study.
"Most of the kids presenting to psychiatric emergency rooms and a lot of the kids presenting with suicidal thoughts do have a background that includes trauma," she says, and that trauma often stems from, "some sort of victimization, sexual victimization, as well as bullying, cyber bullying."
However, there are a whole host of social and environmental factors driving the behaviors and mental health problems among teens, especially teen girls, says Dr. Stephanie Eken, a pediatrician and child and adolescent psychiatrist at Rogers Behavioral Health in Wisconsin, which also has a program for adolescent girls.
One of those factors, she says, is early puberty.
Girls "are starting puberty early, and we know that hormones certainly start to differentiate issues for females versus males," says Eken. "When we look at research studies, girls, when they start to hit puberty, start to have increasing rates of depression and anxiety. So there are the hormonal factors that we think could play a role."
Social media also plays a major role, she adds.
"We see that for girls and their social networks, even when they're socializing, they are not socializing in person," she says. "They are socializing through their phone or through some type of device rather than in-person."
But, she adds, adolescents in general, and girls in particular need in-person social contact.
The lack of it, she adds, has created higher levels of loneliness among teens, even before the pandemic. And loneliness is a well known risk factor for suicide.
Social media also exposes girls to all kinds of negative social pressures.
"Body type expectations and the images that they're shown with the flood of information that we have available to us has detrimental effects," says Eken. "And they're being exposed to them earlier and earlier in their lives when their brains are not prepared to deal with this information and know what to do with it."
That's also why there's been a dramatic rise in teen girls with eating disorders in recent years, say Eken and Feuer.
Schools can be part of the solution
Schools are key, the report suggests, to help teens facing these behavioral and mental health challenges.
"Schools are on the front lines of dealing with the mental health crisis that we're experiencing in this country," says the CDC's Ethier.
She points to a number of things that schools can do to prevent these issues and also to support vulnerable students.
"Things like making sure teachers are well trained in dealing with the mental health issues that are arising in their classrooms, making sure that there are programs in place to get young people out into their communities to provide service and bringing important community members into schools to meet, to provide mentorship," Ethier says.
The report also points to the need to have school environments where students feel socially connected, not just to their peers, but also to caring adults.
"The role of other trusted adults at school is a big part of that," says Feuer.
A proven way to protect vulnerable students against despair and suicide is to help them feel like they belong – at school, at home, in their communities.
"We know from suicide research that the sense of belongingness and feeling connected is a really, really important factor to consider," adds Feuer.
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