Climate disasters, power-hungry narcissists, fake news, identity theft, rising food prices … Has a sense of overwhelm begun to permeate as you scroll through your feed? Do you feel a certain weariness around caring? If so, you are not alone; compassion fatigue has worsened for many people post-pandemic, leading to sleep difficulty, irritability, and numbing. Many of us are at the point of “Who cares?”

Yet more than ever, faced with existential challenges, we need people who can care deeply and act. What is going on, and what can we do?

It’s vulnerable to care.

When we care, we allow ourselves to feel our desire for something to be a certain way. But as soon as we feel our longing, reality confronts us with our limits. We cannot 100 percent secure any outcome. Forces outside our will and effort always play a role in how things turn out.

The pandemic was a clear example of how our lives, indeed our world, can be upended by something as small as a virus. Certainty is a fantasy and striving for ultimate control is a strategy to deny our limits. We are indeed only human.

Faced with the pain of caring without having control, some people go into worry mode where conscious anxiety spikes and they run scary movies. But many others do not consciously feel anxious. Instead, they escape what they feel. They numb out and avoid the inner experience. And the trigger is unrest.

Is your alarm waking you or are you pressing snooze?

In my book, Embracing Unrest: Harness Vulnerability to Tame Anxiety and Spark Growth I share the key to transforming experience avoidance. Unrest is a valuable alarm inside all of us, meant to get our attention at the optimal moment for growth. When we are vulnerable, unrest speeds our breathing, tightens our muscles, and agitates our nervous system.

Unrest wants to wake us up so we can access the power of adaptive emotion to live our most authentic, resilient, and connected lives.

But there’s a catch: Unrest only works as a wake-up call if we perceive it accurately. If we do not, unrest ejects us from our inner experience. It signals us through the sympathetic nervous system and is physiologically indistinguishable from fear. If we don’t recognize the growth-promoting purpose of unrest, the alarm meant to wake us and bring us into the moment will make us shut down and press snooze on our inner lives.

We have a choice: Approach or avoid.

Unrest is a phone call letting us know we are on the cusp of a growth moment, and we need to learn our unique ringtone. We need to become aware of body sensations letting us know we’re faced with longing and limits. Even though we’re wired to avoid anything that feels like fear, unrest is a call to come home and feel in the body. We have a choice: Approach or avoid.

When we tune into those uncomfortable sensations with precision, we can soothe our nervous system. Through slowing down and really feeling our held breath and tense muscles we send a message to the body that it is not in danger. This nervous system activation is not an immediate threat to life and limb. It’s simply unrest heralding emotion, inviting us to come home and feel.

Doing what we can with what we have.

Feelings are energy meant to motivate and empower us so we can adapt to reality. We are meant to be able to accept our limits without collapsing in despair and going numb. We are meant to be able to move from the anger and grief of not being able to make things as we wish, to the place of doing what we can with what we have.

When we face our human limits, we come out the other side with the energy to care and act. We matter and feel how others matter. We feel more alive and connected. Even though we do not have ultimate control, we can still care. And that matters.

References

Brown, Brene (2015). Daring Greatly: How the Courage to be Vulnerable Transforms the Way We Live, Love, Parent and Lead. New York: Avery.

Santomauro, D.F., Mantilla Herrera, A.M., et al (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 epidemic. The Lancet, 398(10312), 1700-1712

The post Who Cares? appeared first on My Blog.

• A new study reveals 1 in 5 birthing individuals experience maternal mental health (MMH) conditions.
• MMH conditions extend beyond depression to anxiety, OCD, psychosis, substance abuse, and bipolar disorder.
• MMH State Report Cards provide a comprehensive view of maternal mental health in the U.S.
• MMH is the responsibility of policymakers, healthcare providers, hospitals, insurers, and communities.

The journey of motherhood is often romanticized, but beneath the surface lies a complex landscape of challenges that can significantly impact a woman’s mental health.

Up to 20 percent of pregnant individuals and new mothers are affected by maternal mental health (MMH) conditions, including anxiety, depression, and obsessive-compulsive disorder (1).

Approximately 75 percent of MMH conditions experienced by birthing individuals go untreated (2). Recently, the Policy Center for Maternal Mental Health provided the first-ever comprehensive view into the state of maternal mental health in the U.S.

With only one state receiving the highest grade, a B-, and dozens receiving Ds and Fs, the U.S. is facing a crisis in maternal mental health.

Moreover, when we critically examine the disproportionate burden borne by birthing individuals due to systemic factors such as race and disability, we further see the necessity of targeted interventions. Stigma, systemic forces, and uneven progress across states underscore the urgency for collaborative efforts toward comprehensive maternal mental health care, ensuring the well-being of mothers and families across the United States.

A Complex Landscape

The PPD (postpartum depression) questionnaire is a common one for new birthing individuals, who see this survey at the pediatrician’s office and/or the ob-gyn. The Edinburgh Postnatal Depression Scale 1 (EPDS) asks the individual to respond to questions about their experience in the past week with statements including: “I have been able to laugh and see the funny side of things;” “I have been anxious or worried for no good reason;” and “I have been so unhappy that I have been crying.”

According to the Maternal Mental Health Leadership Alliance (MMHLA), however, maternal mental health conditions can range beyond depression, encompassing a range of conditions including postpartum anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, substance use disorders, bipolar disorder, and postpartum psychosis (3).

Research suggests that mothers may be more at risk of experiencing mental health concerns if they lack social support, especially from their partner or family; experienced a traumatic birth or previous trauma in their lives; have a personal existing mental health concern; or have a baby in the neonatal intensive care unit (4).

Postpartum refers to one year from a child’s birth. According to a 2013 study of birthing individuals who experienced postpartum anxiety or depression, 40 percent developed symptoms following childbirth, 33 percent developed symptoms during pregnancy, and 27 percent entered pregnancy with anxiety or depression (5). Research suggests that women with untreated MMH conditions are more likely to:

• not manage their own health
• experience physical, emotional, or sexual abuse
• question their competence as mothers
• experience breastfeeding challenges
• be less responsive to a baby’s cues (6)

Uneven Progress

The inaugural Maternal Mental Health Report Card provides the first-ever comprehensive view into the state of maternal mental health in the U.S. The 2023 State Report Cards serve as an evaluation of each state’s policies and initiatives concerning maternal mental health care, shedding light on the progress made and the challenges that persist.

The main objective of the State Report Cards is to assess the accessibility and quality of maternal mental health care services provided by each state. The report card grades states in three domains:

• Providers and Programs
• Screening and Screening Reimbursement
• Insurance Coverage and Payment

Up to three points are provided for each of the 17 measures within these domains. Readers can find more about the Policy Center’s methodology and assessment here.

The evaluations reveal a diverse landscape across the nation. While some states have made commendable strides in addressing maternal mental health issues by implementing comprehensive policies and frameworks, others continue to lag behind.

California scored, for example, the highest with a B-, broken down more specifically as:

• Providers and Programs, score C
• Screening and Screening Reimbursement, score C
• Insurance Coverage and Treatment Payment, score B

Pennsylvania, from where I write, scored, overall, a C with that further broken down as:

• Providers and Programs, score D
• Screening and Screening Reimbursement, score D
• Insurance Coverage and Treatment Payment, score C

Forty states, along with Washington D.C., scored an overall D or F.

The Center highlights what is at the root of this failure:

• States do not have enough therapists and psychiatrists with specialties in MMH disorders
• States lack MMH treatment programs and community-based MMH resources
• States do not require providers to screen for MMH disorders
• States do not hold health plans to quality standards regarding MMH services

The report cards provide a clear picture of the gaps in maternal mental health care services and the need for a more uniform and equitable approach to maternal mental health care.

The Effects of Stigma, Silence, and Systemic Disadvantage

A pervasive challenge that impedes overall progress in maternal mental health is the stigma attached to mental health issues in general. The Maternal Mental Health Leadership Alliance (MMHLA) emphasizes that the stigma surrounding mental health often prevents women from seeking help, leading to underdiagnosis and untreated conditions. This silence can perpetuate the cycle of suffering and prevent women from accessing the support they desperately need during a vulnerable phase of their lives.

More specifically, one of the striking revelations is the disproportionate impact of maternal mental health issues on Black women and birthing individuals. Research by the MMHLA highlights startling facts:

• almost 50 percent of Black mothers will experience MMH conditions
• Black women are twice as likely as white women to experience MMH conditions but half as likely to get care
• single Black mothers are six times more likely than the general population to experience depressive symptoms (7).

Black women face a higher risk of maternal mental health disorders due to systemic factors like racial discrimination, socioeconomic disparities, medical insurance gaps, and inadequate access to quality healthcare. Their experiences of depression may differ from stereotypical symptoms of depression—often involving irritability and somatic symptoms, instead of hopelessness or depressed mood–—and a lack of attention to this difference of manifestation can cause the depression to go overlooked or mistreated. The Superwoman Schema, which involves cultural expectations of strength, compounds stress.

Removing barriers requires culturally competent care, diverse care teams, improved screening, and dismantling systemic racism.

Women with disabilities also face heightened risks of MMH conditions, being twice as likely as women without disabilities. Inadequate healthcare access during pregnancy increases pregnancy complications and exacerbates MMH concerns.

Socioeconomic disparities, coupled with misconceptions and limited awareness among healthcare professionals, contribute to these challenges. Negative stereotypes, misconceptions, and lack of disability-specific knowledge affect care quality.

Non-medically necessary C-sections, inaccessible screening tools, and fear of child protective services further strain their experiences. Tailored strategies, including cultural humility training for clinicians, accessible spaces, and specialized screening tools, are essential for improving perinatal care and addressing MMH conditions among women with disabilities (8).

While the Policy Center for MMH evaluated states based on their support for birthing individuals’ MMH conditions, 2021 research conducted by the MMHLA encourages us to not leave out fathers and non-birthing spouses.

The MMHLA states that approximately 10 percent of fathers will experience postpartum depression, with a peak most commonly observed between 3 to 6 months after childbirth. For fathers, this may manifest as elevated levels of irritability and anger, reduced affection, and increased criticism, both towards and from their partner.

Risk factors can include a lack of social support and networks, a lack of good role models, feeling excluded from infant bonding, the stress of having a new baby in the household, and the presence of a partner’s MMH (9). Recognizing and addressing the mental health challenges faced by fathers and non-birthing partners during the postpartum period is essential for fostering healthy family dynamics and ensuring the well-being of both parents as they embark on the journey of parenthood.

Conclusion

Maternal mental health remains urgent in the U.S., shaped by intertwined factors of race, socioeconomic status, disability, and stigma. To achieve comprehensive care, a collective push from federal and state policymakers, healthcare providers, hospitals, insurers, and communities is vital. Tackling systemic disparities, offering accessible aid, and promoting mental health discourse will propel the nation toward safeguarding mothers and families.

If you are U.S.-based, check out how your current state is doing here: 2023 U.S. Maternal Mental Health State Report Cards.

The post How the U.S. Is Failing Moms on Maternal Mental Health Care appeared first on My Blog.

When your emotions are rocky, this single word can right the ship.

• Forbearance has been shown to reduce depression and improve relationships.
• Forbearance is not submission but shows a willingness to move on.
• Forbearance helps you see the bigger picture and wisely act in accordance with a greater understanding.

Have you ever been the target of unwanted, unwelcome, and unkind words? Or maybe you find yourself in a distressing situation or relationship at home or work that seems untenable at times. If this leaves you feeling stuck, depressed, or hopeless, it’s understandable.

But, believe it or not, there’s a mindfulness practice for that—and to our special word for today: forbearance.

The ancient principle of patience and forbearance, khanti paramita, is one of Buddhism’s “perfections.” Perfections as it is used here, however, doesn’t mean perfectionism or being perfect. Rather, it’s about cultivating a more enlightened and helpful means of living.

Forbearance is a cornerstone practice found in many wisdom traditions. It’s ideal just for those times when you’d be better off “letting it go” and refraining instead of reacting and escalating conflict.

A recent research article explored how practicing forbearance helps to moderate difficult emotions, especially those depressive emotions that arise when you face adversity of various kinds.

The Truth About Forbearance

Forbearance might just be one of the least cultivated and misunderstood practices in our comparison-oriented, quick-serve culture.

Forbearance is about reducing harm by making an enlightened choice to take a step back and offer grace to others. It’s kind of the opposite of reacting or forcing your opinions on others.

If you believe that forbearing or “letting it go” means that you are being weak and submissive, think again. In truth, forbearance is about understanding when it is wiser to surrender, let it be, and accept. The practice of forbearance is definitely not giving up or submitting, which means you have no choice or free will!

Forbearing is a powerful act of grace and compassion offered willingly and intentionally.

This is not to say you need to always forbear. There are times you might decide to stand up and times you might forbear. For example, let’s say that your partner has a strong preference about something. Yes, you can fight to make a point or get your way. Or, you could make the enlightened decision to forbear for the benefit of the relationship.

Besides, have we not all been faced with the kind of criticism or events that prod us to react—either with anger or otherwise? A historical example of this was when the Buddha and his monks were the target of unkind rumors while staying in a particular village. They could barely get enough food from community offerings. The Buddha’s trusted aid Ananda exhorted the Buddha to leave and seek a town more to their liking. The Buddha refused the request, saying,

No, Ananda, there will be no end in that way. We had better remain here and bear the abuse patiently until it ceases and then move on to another place. There are profit and loss, slander and honor, praise and blame, pain and pleasure in this world; the Enlightened One is not controlled by these external things; they will cease as quickly as they come.

To sum up, forbearance helps you see the bigger picture and wisely act in accordance with a greater understanding of the situation. Forbearance is a kind of grace that is given to others. It’s a sign of patience and wisdom to know when your message will be heard and appreciated. You might refrain, for instance, from telling someone who just lost her or his job about the incredible promotion you received. By being in the present moment, you can learn to trust the feeling in your body to help you decide when the time is right for speaking.

3-Part Forbearance Practice

Keep in mind that forbearance does not mean ignoring your feelings. If anything, it’s a mindfulness practice that helps you notice your feelings, but without having to pay a price that ends up hurting yourself or others.

1. Notice those times when you feel impatient with your situation or with others. Tune in to what you are feeling and give it a name, such as “I’m feeling anger”; “I’m feeling sadness”; “I’m feeling frustration”; and so on.
2. Take a deep belly breath and exhale slowly. As you exhale, feel yourself letting go of any expectations of others or the situation. Take a second calming breath.
3. Now, reflect on the way things really are—not the way you want them to be. Ask your wise self if this is the best time to speak or whether it’s better to refrain and give grace to another and the situation.

If you frequently experience impatience and have high expectations for yourself and others that are causing problems, then practicing forbearance will help. If you want to know more, my book Clearing Emotional Clutter explores forbearance as a means of enlightened living. Above all, be compassionate and kind with yourself as you bring forbearance into your day.

The post One Special Word That Lessens Depressive Emotions appeared first on My Blog.

Brittney Chesworth Ph.D., LCSW

With health anxiety, we tend to overestimate the likelihood of severe disease. Learning how to challenge thinking errors is critical to see the probability of a threat more accurately. Examining the evidence is a cognitive behavioral therapy technique to help reframe thoughts.

It is well-known among health anxiety researchers and clinicians that people with health anxiety tend to overestimate the probability or likelihood of getting a serious disease. This threat bias, as it is often called, can make one miserable because the threat of serious disease seems to be everywhere. This leads them to interpret bodily sensations and symptoms as threatening when they are often not. Many bodily sensations and symptoms are due to other causes besides serious disease:

• body noise or normal, regulatory physiological processes that maintain the body’s homeostasis
• the anxiety or stress response
• benign and non-serious medical conditions

However, to the health-anxious person, every bodily sensation or symptom is seen as a potential catastrophe, and the cycle proceeds like this:

• They experience a symptom
• Overestimate the threat of this symptom (rather than assume the more likely causes of body noise, anxiety, or benign issues)
• They experience significant distress
• They consult with loved ones, go to the doctor, and Google symptoms

This continuous cycle takes them (and their loved ones) on an emotional roller coaster every week, making life quite challenging.

How do we learn to see threats more accurately?

One of the goals of treating health anxiety with cognitive behavioral therapy (CBT) is to see the threat of serious disease more accurately. When one learns to stop inflating the statistics (that is, the likelihood of getting a serious disease), one will not be as threatened by every bodily sensation or symptom. Here is a technique that can help you reshape how you see this threat, called examine the evidence.

The examine the evidence activity

Examining the evidence is a great exercise for analyzing automatic thoughts that may be distorted. Recall that we tend to assume all of our thoughts are valid when many are not. We move through our day just accepting our thoughts as facts and, thus, react to them as though they are facts.

For example, you notice a funny taste in your mouth and you recall a Facebook post about a family member who was diagnosed with a brain tumor after experiencing strange tastes and smells. You conclude that you have brain cancer and begin to experience the sadness and anger that accompanies this new reality. The problem is that a lot of unnecessary suffering is taking place. If you do not learn to examine the validity of your thoughts, you will spend a lot of time and energy reacting to fiction.

An example from my own life

I smoked on and off from the age of 21 to 26. My smoking escapades would haunt me for many years after I quit. For about a decade, I was vigilantly on the lookout for any signs of lung disease. Once, I was walking up the staircase in my house and I had to catch my breath at the top of the stairs. Huh, that is weird, I thought. Why would I be out of breath from—uh oh. It hit me. This is it. Lung cancer. My time has come.

I unwisely pulled my phone out and began the Google search: shortness of breath and lung cancer. I am instantly flooded with information from the American Cancer Society to every university website that ever existed, all talking about shortness of breath being one of the key symptoms of lung cancer. Engaging in this safety behavior, of course, only further inflated my estimation of this health threat.

Fortunately, having been in therapy for health anxiety, I had a few helpful techniques to pull out of my CBT toolbox. First, I was able to recognize my thinking errors in this case, which were jumping to conclusions and catastrophizing. Next, I completed examining the evidence to help me reassess the likelihood that I had lung cancer.

Examining the evidence for the thought: I have lung cancer

The technique is simple. You divide the page into two columns:

• Divide the page into two columns (evidence for the thought and evidence against the thought)
• After you list out all of the evidence, reframe or challenge the evidence for the thought, as some of these points might be based on faulty or biased assumptions (given that the anxious brain tends to overestimate threat and underestimate coping)
• When completed, take a look at everything. Ask yourself, if you had 100 amazing argument points to divide between the two columns, how would you divide them? Is it 50/50, 80/20, or 60/40? Which side is the big winner?

In the table, you will see a detailed example of how I completed this activity to address my anxious thoughts about having lung cancer.

Don’t be shy about writing down every piece of evidence in the evidence-for section, even when you know it is unrealistic or even silly. You need to acknowledge all the reasons you feel convinced that this thought is true. By acknowledging it, you bring the discussion out into the open and allow yourself to challenge any distorted thoughts. If you pretend they aren’t there, you miss out on the opportunity to reframe them. They will, most definitely, return at some point later, such as when you are in another vulnerable anxious state.

In conclusion

This exercise helped me to see the alleged threat a bit more realistically. Yes, it is possible that my shortness of breath was, indeed, the first symptom of lung cancer. It is also possible that tonight I slip, hit my head, and drown in the bath, or that tomorrow I get shot while shopping in the toy aisle at Target. Many threats are possible but how many of them are probable?

And seeing all of the evidence for and against my having lung cancer allows me to better grasp this low probability. In CBT sessions with my clients, we regularly whip out Google documents to examine the evidence of their anxious thoughts about their health. On almost every occasion, we find that the evidence-against column looks robust and meaty, while the evidence-for column looks empty and hollow.

Anxiety leads us to inflate the numbers. Use this exercise to help you see the probability of serious disease more accurately.

The post Health Anxiety: Inflating the Likelihood of Serious Disease appeared first on My Blog.

Schools can offer a critical lifeline for students facing trauma

New trend data from CDC’s Youth Risk Behavior Survey (YRBS) reveal that teen girls and teens who identify as lesbian, gay, bisexual, and questioning (LGBQ+) are experiencing extremely high levels of mental distress, violence, and substance use. With the right programs and services in place, schools have the unique ability to help students thrive.

Collected in the fall of 2021, these data represent the first YRBS data collected since the start of the COVID-19 pandemic. CDC’s Youth Risk Behavior Surveillance System is the largest public health surveillance system in the United States. It has monitored multiple health-related behaviors among high school students since 1991. YRBS data are a critical first step to revealing, understanding, and addressing emerging threats to the health and well-being of the nation’s youth.

Teen Girls

According to the data, teen girls are confronting the highest levels of sexual violence, sadness, and hopelessness they have ever reported to YRBS.

Almost 1 in 5 teen girls experienced sexual violence in the past year—a 20% increase since 2017.[1]

Sexual Violence Among U.S. High School Students, By Sex, 2017-2021

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More than 1 in 10 teen girls reported they had ever been forced to have sex—up 27% since 2019 and the first increase since CDC began monitoring this measure.

Forced Sex Among U.S. High School Students, By Sex, 2011-2021

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Persistent Feelings of Sadness or Hopelessness Among U.S. High School Students, By Sex, 2011-2021

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3 in 5 girls felt persistently sad and hopeless, a marker for depressive symptoms, in 2021, up nearly 60% from 2011.

A combination of complex factors can place young people at high risk for suicide, depression, substance use disorder, poor academic performance, and other severe consequences.

More than 1 in 4 girls reported they seriously considered attempting suicide in 2021, up nearly 60% from 2011. More than 1 in 10 girls reported they attempted suicide in 2021, up 30% from a decade ago. Alcohol use is also higher among girls than boys.

Attempted Suicide Among U.S. High School Students, By Sex, 2011-2021

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Seriously Considered Attempting Suicide Among U.S. High School Students, By Sex, 2011-2021

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LGBQ+ Teens

A combination of complex factors can place LGBTQ+ youth at high risk for violence victimization, suicide risk, and other severe outcomes. In 2021^[1], lesbian, gay, bisexual, and questioning (LGBQ+) youth were substantially more likely to have experienced all forms of violence and had worse mental health outcomes than their heterosexual peers. The 2021 YRBS survey did not ask about gender identity, so data for transgender students are not available. Previous research has shown that transgender young people experience greater levels of violence, more stigma, and are more likely to have mental health problems and suicidal thoughts and behaviors than the rest of their peers.

In 2021, more than 1 in 10 LGBQ+ students did not go to school because of safety concerns; nearly 1 in 4 experienced sexual violence, and nearly 1 in 4 were bullied at school.

Experiences of Violence Among U.S. High School Students, By Sexual Identity, 2021

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In 2021, almost half of LGBQ+ students seriously considered attempting suicide, nearly 1 in 4 attempted suicide, and nearly 3 in 4 reported persistent feelings of sadness or hopelessness.

Mental Health Among U.S. High School Students, By Sexual Identity, 2021

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In 2021, 1 in 5 LGBQ+ students reported having ever used illicit drugs.

Substance Use Among U.S. High School Students, By Sexual Identity, 2021

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Three key strategies to improve youth health and well-being

Young people in the U.S. are collectively experiencing a level of distress that calls for action. This report focused on a select set of YRBS questions that represent leading indicators of health and well-being for young people—and that share a common set of factors that can be enabled through schools to protect young people from these threats.

While the primary goal of schools is academic learning, they also play a critical role in shaping mental, physical, and social growth. More than 95% of children and adolescents in the U.S. spend much of their daily lives in school, providing a considerable opportunity to foster the knowledge, skills and support needed to help prevent and reduce the negative impact of violence and other trauma and improve mental health. CDC has identified and supports a range of evidence-based activities that can make a profound difference in the lives of teens with a relatively small infusion of support to our schools.

Supporting schools in efforts to reverse these negative trends and ensure that youth have the support they need to be healthy and thrive will take time, partnership, and resources. Supporting schools in efforts to reverse these negative trends and ensure that youth have the support they need to be healthy and thrive will require partnership. The following actions can help ensure success. 

• Increasing the sense among all students that they are cared for, supported, and belong at school. The proven health benefits of this approach, called “school connectedness,” are well demonstrated and can last well beyond their teenage years. However, youth who are racial and ethnic minorities, experience racism, and who identify as LGBTQ+ often feel less connected at school. Effective programs include approaches like providing safe and trusted adults such as mentors or trained teachers and connecting teens to their peers and communities through clubs and community outreach. These programs help kids know they matter and are not alone.
• Increasing access to needed health services, including mental health and substance use prevention services, whether provided on-site or through connecting youth and families to community-based sources of care.
• Implementing quality health education that is medically accurate, developmentally appropriate, culturally and LGBTQ+ inclusive, and grounded in science can help prevent violence and reduce mental health challenges by equipping teens with essential knowledge and skills such as negotiating sexual consent, managing emotions, and recognizing and asking for the help they need.

CDC’s evidence-based What Works in Schools program has demonstrated impact on key health behaviors and experiences that affect the nation’s youth. The program supports school districts across the country in making school environments safer and more supportive—with a strong focus on improving school connectedness; connecting young people and their families to needed services; and implementing quality health education. Participating schools have seen improvements in a wide range of health behaviors, including sexual behaviors, substance use, and sexual violence.

Additional Resources

For the full report, visit CDC Youth Risk Behavior Survey, Data Summary & Trends Report, 2011-2021

For more information on suicide prevention, visit: www.cdc.gov/suicide.

988 Suicide Prevention
Contact the 988 Suicide & Crisis Lifeline if you are experiencing mental health-related distress or are worried about a loved one who may need crisis support. Call or text 988. Chat at 988lifeline.org. Connect with a trained crisis counselor. 988 is confidential, free, and available 24/7/365. Visit the 988 Suicide and Crisis Lifeline for more information at 988lifeline.org.

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