by Jordan Roberts
Former Director of Government Affairs, John Locke Foundation
The national conversation around mental health has been elevated in recent years. Especially relevant to this conversation is the troubling trend of rising mental health issues among America’s youth. Not only is this trend concerning for the health of our youngest generations, but there are also implications for health-care spending in the United States, which is the highest in the world.
America’s youngest generations seem to be suffering disproportionately from behavioral and mental health conditions such as anxiety and depression. FAIR Health, a health care data firm, evaluated more than 28 billion health care claims filed from 2007-17 from private insurers. Their findings were troubling. Behavioral health diagnoses, including both mental health and substance abuse disorders, increased 108 percent — from 1.3 percent of all medical claims to 2.7 percent. Within the same period, claims for generalized anxiety disorder rose from 12 percent to 22 percent of all mental health claims. The pediatric population, those ages 0-22, was heavily represented in the increased number of behavioral health claims. Generalized anxiety disorder claims from individual’s college and high school age (14-18) rose faster than any other age group in the study. The percent of claims for college-aged students rose 441 percent, while claims for high-school-aged students rose 389 percent.
While this data has its limitations, namely only examining private insurance claims and having been collected during the time following a federal mandate for mental health coverage, the increasing prevalence of behavioral health conditions among the younger generations is concerning.
What’s the reason behind such a trend? My theory is an increase in screen time among young people, which has led to decreased social capital. Described by Robert Putnam is his seminal book, “Bowling Alone,” social capital is defined as “features of social organization, such as trust, norms, and networks, that can improve efficacy of society by facilitating coordinated actions.” Putnam’s book examines data to show American’s have become less engaged with each other over time, thus decreasing social capital. I believe the decline in social capital among younger generations due to increased screen time may be contributing to the rising number of individuals with behavioral health problems.
A 2019 study conducted by researchers at the San Diego State University Department of Psychology found a strong link between screen time and lower psychological well-being. More hours of screen time were associated with lower self-control, more difficulty making friends, and less emotional stability. High users of screens were even more likely to be diagnosed with anxiety, depression, and be treated by a mental-health professional.
U.S. Surgeon General Vivek Murthy once said that health dangers could arise from “isolation, lack of meaning, and a loss of self-worth.” When young people trade off time spent with friends and interacting with real-life individuals, isolation and loneliness may follow. Decreasing accumulation of social capital from human interaction may be contributing to the increasing feeling of loneliness, unhappiness, and isolation. Younger individuals are indeed reporting higher levels of isolation and unhappiness. A survey of 8.2 million U.S. adolescents found those individuals who reported the least in-person social interaction and the highest amount of screen time were the loneliest.
Additionally, data from the General Social Survey shows America’s youth happiness has been declining. In 2012, 34 percent of those aged 18-34 reported being “very happy.” This number has since dropped to only 25 percent of respondents in 2018. For the same age group, those reporting being “not too happy” increased from 10 percent in 2014 to 16 percent in 2018.
A decrease in societal social capital could be a factor driving health care spending in the U.S., as well. A 2019 study from published by the American Academy of Pediatrics found a 28 percent increase in psychiatric emergency department visits between 2011-15 per 1,000 youth in the U.S. Among all age groups the study measured, the largest increase was among adolescents. Sadly, there’s also an increase in the number of emergency department visits in which the individual harmed themselves. Another 2019 study published in the Journal of the American Medical Association found that between 2007-15, the number of visits to the emergency department for suicide attempts or suicide ideation increased from 580,000 to 1.12 million.
The link between social capital and overall health is acknowledged through research. While the documented link between excessive screen time and decreased social capital may not be as strong, I believe it’s a significant factor. As technology grows more ingrained in our daily lives, parents and caregivers should consider its impact on the long-term well-being of younger generations. More emphasis on traditional human contact could help decrease the trends of rising behavioral health problems among younger individuals and could help reduce the troubling trend of mental health-related emergency room visits. We should not undervalue the importance of human contact and its impact on one’s health.
This article originally appeared in the July 2019 issue of Carolina Journal.