The COVID-19 pandemic has sparked widespread concern about the need for mental health services. But depression was already becoming increasingly prevalent in the U.S. in the years leading up to the pandemic, particularly among young people between the ages of 12 and 25, according to a study published Monday in the American Journal of Preventive Medicine.

By 2020, depression affected nearly one in 10 Americans over the age of 12 — but the number was nearly one in five among those between the ages of 12 and 25, the study found. This new research arrives at a time when advocates in New York are already urging city and state officials to invest more in behavioral health services for young people and address a shortage of children’s mental health professionals.

“I think we’ve always conceptualized mental health as a clinically treated problem where the prevalence is low,” said the study's lead author Dr. Renee Goodwin, a clinical psychologist and epidemiologist who teaches at Columbia University and CUNY. “But more is needed in terms of a public health approach at this point,” because it’s become so common.

The study was based on the National Survey on Drug Use and Health, an annual survey run by the Substance Abuse and Mental Health Services Administration. The data involved comes from more than 55,000 respondents per year between 2015 and 2020. The survey asked participants about whether they had experienced symptoms of a depressive episode over the past year, such as feeling sad consistently over a two-week period, or not being interested in activities that typically brought joy, Goodwin explained.

From 2015 to 2020, there was a significant gap between the number of participants experiencing depression and those accessing treatment.

In 2020, 9.2% of Americans over 12 had experienced symptoms of depression over the past year, Goodwin’s study found. That was up from 8.6% in 2019 and 7.3% in 2015.

But the jump primarily took place among young people, with no increase observed among those over 35. In 2019, about 16% of adolescents reported symptoms of depression, up from about 13% in 2015. By 2020 the figure was about 17% for that age group.

An even sharper increase was observed among those aged 18 to 25: The share with depression grew from a little over 10% in 2015 to about 17% in 2020. That year, only about half of the respondents with depression in that age group said they had spoken to a professional about it, a modest improvement from 2015.

The likelihood of getting help was lower for adolescents — in that age group only about 40% said they had spoken with a professional.

Addressing young people’s needs in NY

Local advocates for children’s mental health said there needs to be a focus both on the factors that exacerbate mental health issues and on increasing access to services. Just last month, an audit of mental health professionals in New York City schools by the state comptroller found that many were understaffed.

“What we saw for a long time leading up to the pandemic and subsequently since is an increase in kids ending up in emergency rooms for mental health concerns because they don't have anywhere else to go,” said Dr. Ruth Gerson, senior vice president for mental health services at the New York Foundling, a nonprofit that provides behavioral health care and other services to children and families. Gerson also previously served as director of the Children’s Comprehensive Psychiatry Emergency Program at Bellevue Hospital.

Gov. Kathy Hochul has recently taken steps to bolster the mental health workforce, such as funding a salary boost for human services professionals in the most recent state budget. Last month, she also announced that the state would put $4 million toward supporting underrepresented students in mental health programs in the SUNY system as a means of producing mental health workers who could better relate to those they serve.

Gerson said it would likely take time to build up the behavioral health workforce. In the meantime, she said, there also need to be more efforts around preventing mental health problems among adolescents before they arise — such as educating families about healthy sleep habits, limiting screen time, and managing social media use.

Age is not the only factor affecting the prevalence of mental health issues. Goodwin’s study also found that those with the lowest household incomes experienced the highest levels of depression.

“This is a crisis and we need to coordinate all of our resources,” said Alice Bufkin, associate executive director for policy and advocacy at the Citizens’ Committee for Children of New York.

She said in addition to addressing workforce needs, policymakers should also focus on factors that exacerbate mental health issues such as unstable housing and economic insecurity.

“We really view COVID-19 as something that took a crisis that was already there and amplified it — and really created a perfect storm,” Bufkin said.