That’s why, in 2009, I created a nonpartisan, nonprofit organization called the , with a mission to catalyze transformative change in Tennessee education. There’s still more work to do, but since SCORE’s founding we have seen rapid growth and achievement gains statewide. From 2011 to 2017, Tennessee made some of the fastest gains on the , and show that Tennessee’s recovery from pandemic learning loss was among the most robust of any state.

Today, however, Tennessee faces another wakeup call: the youth mental health crisis. Worsened by the pandemic and exacerbated by social media, this demands urgent attention. 

In this, Tennessee is not alone. The from the Centers for Disease Control and Prevention found more than 4 in 10 (42%) high school students reported feeling persistently sad or hopeless and nearly one-third (29%) experienced poor mental health. More than 1 in 5 students (22%) seriously considered suicide in 2021. 

Often overlooked and untreated, poor mental health has a ripple effect that impacts learning and overall development inside and outside the classroom. Physical, mental and emotional health are intrinsically tied to the ability for young people to realize their full potential. As a former physician, I see a need to examine areas where education and health intersect and to facilitate meaningful discussions that seek solutions to related challenges. That’s why I established a collaborative health movement called .

Recently, SCORE and NashvilleHealth held a to begin the hard work of addressing the student mental health crisis. Alongside national, state and local leaders, we held meaningful conversations, backed by data and focused on solutions, to spark collective learning and action. Here are five takeaways that we believe can strengthen student mental health and further the discussion.

Increase Access to Data 

Despite a wealth of research, there are clear gaps that limit the ability of Tennessee leaders to assess the mental well-being of youth in our state. In response, the Belmont Data Collaborative released a in April that included a looking at all 95 counties in the state.

Drawing on publicly available datasets, the index makes clear which areas have the highest mental health vulnerabilities, leading to a more comprehensive understanding of risk factors at the county and local levels.

By analyzing community data alongside broader research and external influences like education and economic indicators, education leaders and policymakers can better assess our strategies and move forward in a positive way. 

Develop Local Solutions for Local Needs

Encouraging localized initiatives is key, as positive adult relationships and supportive environments have a significant impact on student outcomes. For example, during the symposium, Superintendent Selina Sparkman of rural Bledsoe County Schools highlighted the effectiveness of its grant, part of a program that helps state and local education agencies deliver school-based mental health programs and services. She shared the of a student who had not been able to eat with his peers in the school cafeteria since starting elementary school but began to thrive after receiving support through Project AWARE.

With mental health challenges continuing to rise in higher education, Dr. Zainab Okolo from The JED Foundation elaborated on the foundation’s efforts to help colleges address this crisis. Through the foundation’s technical assistance program, JED Campus, schools achieve in student mental health. Colleges completing the program reported that students were 25% less likely to report a suicide attempt, 13% less likely to report suicide planning and 10% less likely to report suicidal ideation.

Streamline and Share Best Practices 

Through the developed by the CDC, have been able to connect physical, emotional and social health with learning. Other states have done the same: Across the country, similarly effective initiatives are extending across college campuses, schools and communities. Examples include Sandy Hook Promise’s prevention programs, a learning community of working to develop policy recommendations through the State Higher Education Executive Officers Association and The Jed Foundation, the and Communities In Schools. A Governor’s Playbook: Strengthening Youth Mental Health, developed by the National Governors’ Association, contains examples of successful policies and programs that states can emulate.

Elevate Student Voices

Importantly, students must be included in discussions impacting their mental health. Among Generation Z (11- to 27-year-olds in 2024), greater school engagement is related to more positive life outlooks. For this, there is not a one-size-fits-all solution. Students come from diverse backgrounds with diverse experiences and needs. Initiatives that seek to implement solutions for their mental health must take a diverse range of perspectives into account. These can be much more powerful and accessible when they come from students and peers.

Collaborate to Create Meaningful Change

There are no easy answers or quick fixes to this crisis. By connecting the dots between education and mental health, leaders in Tennessee and across the nation can build more resilient and supportive systems that empower all children to reach their full potential. While schools can play an important role in supporting student mental well-being, the crisis is too big for one group or policymaker to solve. The challenge should not rest solely on the shoulders of schools, educators or health care providers. It demands collective action from all of us, working together, to better understand data, explore research, share best practices and engage in deep discussions. As a member of the Aspen Health Strategy Group, I will be delving deeper into the topic of youth mental health.

In Tennessee and beyond, important conversations connecting mental health and education are gaining momentum. As Tennessee leaders heed the urgent call to support our students, there is a need to better understand the extent of the crisis, continue exploring connections and innovations across health and education systems, and spark collective recognition and action. 

This crisis affects all of us — our children, our families and our communities. By leveraging data, research and a shared commitment to student well-being, education leaders, policymakers and advocates must continue to collaborate and illuminate the path forward to build a brighter, healthier future for generations to come.

“As human beings we need social support, we need reassurance, and algorithms now are taking advantage of those needs and keeping us online and engaged with content even when it doesn’t feel good,” Erickson-Schroth said in an interview with ĂŰĚŇÓ°ĘÓ.

Youth suicide rates have escalated over the last decade, making it the second leading cause of death among teens and young adults. But suicide rates are starkly different among different populations, a reality brought into full view in , a nonprofit focused on youth suicide prevention. And the harms of social media — the subject of a bipartisan push to regulate tech company algorithms and a bevy of lawsuits filed by school districts and states — is just one piece of the crisis.

But Erickson-Schroth, JED’s chief medical officer, has observed one promising trend: Schools are more interested than ever, she said, in addressing students’ mental health needs. 

ĂŰĚŇÓ°ĘÓ caught up with Erickson-Schroth, whose work places a particular emphasis on LGTBQ+ mental health, to gain insight into the factors driving the youth suicide crisis, the conditions that put some groups of students at heightened risk and strategies that educators and policymakers can use to keep kids safe. 

The conversation has been edited for length and clarity. 

Among all youth, what are the primary factors that you see having contributed to the increase in the youth suicide rate over the last decade? 

The COVID pandemic certainly played a role. Globally, rates of childhood depression and anxiety doubled during the pandemic. In my own practice, working with LGBTQ+ young people, I could see how the pandemic was affecting them. Many young people were becoming more anxious because of the social isolation and having trouble reengaging in social situations. Many of them missed important milestones like graduation, many young people lost people in their lives.

But I don’t think it’s the whole story. Youth mental health issues and suicide rates have been increasing for the last decade at least and the COVID pandemic doesn’t explain that.

I think one of the biggest drivers is this increasing digital connection, when the internet met the phone, and we can see kind of around when that happened. If you look at studies of what percentage of Americans had smartphones at different times, in 2011 around 35% of people [had them] and now we’re up to about 85%. So almost everyone in the United States has a computer in their pocket.

That’s really different than the worlds that we grew up in in prior generations. There are a lot of positives and negatives to that. There are positives in building community and connections, especially for young people who have a hard time finding that in person.

But also it’s changed their lives completely in some negative ways. We’re constantly exposed to news, some of it really difficult news: wars around the world, climate change, racial violence, anti-LGBTQ legislation, those kinds of things. There’s cyberbullying, there are all of these chances for social comparisons, there’s this hijacking of reward systems. 

As human beings we need social support, we need reassurance, and algorithms now are taking advantage of those needs and keeping us online and engaged with content even when it doesn’t feel good. 

So all of that is adding up to a really different world that young people are living in where they’re increasingly lonely and disconnected socially.

Let’s turn to the pandemic. The data show that youth suicides reached a high in 2021 and leveled off a bit in 2022. What does this tell us about the pandemic’s effects on the youth suicide rate and how has the situation changed now that we’re no longer in lockdown? 

It’s important to say that youth suicide rates have been increasing for a long time, long before the pandemic. 

So we did see youth suicide rates rise during the pandemic. There was a study that looked at the second half of 2020, and there was a higher than expected rate of suicide for young people. It was particularly (true) among some groups, and that’s including Black youth. That likely had to deal with specific events that were occurring during the pandemic within those communities. 

Black youth disproportionately lost members of their families and communities to COVID. The pandemic also coincided with these highly publicized incidents of racial violence. So, the pandemic really did have an effect on young people, but the pandemic isn’t the whole story. 

If we’re talking about the increase from 2020 to ’21 and then the decrease from 2021 to 2022, yes, based on we do see that there was an 18% drop in suicides for young people 10 to 24 and then a 9% drop for young people 15 to 24. The pandemic might have added to the numbers for 2021 and coming out of the pandemic might have improved those numbers. 

But there were a lot of other factors that were contributing. I think one is that we’re paying more attention to mental health than we were in the past. We can see it in the numbers. Large donors gave more money towards mental health in 2022 than in any other year over the past decade.

At JED, we work with schools and we’re seeing more schools interested in making mental health a priority than we’ve ever seen before. 

LGBTQ+ students have long experienced higher suicide rates than their straight and cisgender peers. What do the data show about the current political climate’s effects on their well-being and suicide risk? 

There’s good research coming out of The Trevor Project. They do a survey every year that looks at LGBTQ+ young people’s experiences and one of the questions that they always ask is about how the political climate is affecting them. Based on their data, it looks like it’s affecting them quite a bit. 

Young people who are hearing about anti-LGBTQ+ legislation or movements against their rights are having a more difficult time with their mental health, which makes sense. It’s important that, in our conversations about this, we make sure that people know it’s not about someone’s gender or someone’s sexuality. That’s not the reason that they’re having mental health issues. It’s about the way that our society reacts to young people who are different. 

Black youth have experienced the fastest increase in suicide rates, with that rate nearly doubling in just the last decade. What do the data tell us about what might be at play here within the last decade in particular? 

It’s always been really hard to be a Black young person in America, so what makes the recent decade different? I think what makes it different is, again, this constant digital connection. 

The water that you swim in is this digital world and you have to spend time in this world because it gives you so many positives. It connects youth of color to other youth of color, who may be in other areas, so they can seek out community. It helps them connect with adults who are going to be supportive of them. But it also involves interacting with racist comments online, it involves seeing these really highly publicized incidents of racial violence. Young people are watching those videos and seeing what’s happening. They’re seeing movements for change, but they’re also seeing pushes back against those.

I’m curious about the rural-urban divide. Young people in rural areas are far more likely than their urban counterparts to die by suicide. What particular risk factors do rural teens face and what prevention methods might work best for them in particular?

I think young people in rural areas are in a unique position right now. There are a lot of positive benefits to living in rural areas. Young people getting out in nature and having close social ties. But at the same time, rural communities can be places where young people have less access to some of the things that they need. If they are in a particular group, there might not be as many people like them in that area.

It’s hard to connect to providers if you’re looking for mental health support because rural communities have lower rates of insurance and they have provider shortages. There’s also a lot of stigma around mental health in rural areas and it depends on the area, of course, from one place to another. 

A really important one to talk about is access to firearms. It’s really common for young people in rural areas to have access to firearms. In rural areas, young people are twice as likely to die by suicide as those in larger metro areas. And they have easier access to firearms. 

We have a lot of work to do in terms of expanding access to mental health care and making sure that young people can access mental health care in school. I was on a panel with a middle school and a high school principal and both of them were in rural areas. 

And one of the things that they talked about was that young people in rural areas may not want to seek out mental health help from a clinic or a hospital because that may put them at risk of being identified as someone who’s getting mental health care. If you park your car outside of a clinic in a rural area, everyone else in your community knows what you’re doing. If you get mental health help in school from a school counselor, that’s just a regular part of the day that lots of young people engage with.

What immediate, actionable steps can parents and educators take to help prevent this problem from getting worse?

We can talk about immediately actionable things that we know are going to make a difference in the short term and then we can talk about longer-term solutions. In the short term, one of those things is, you know, how are we going to approach firearms? 

More than half of young people who die by suicide use firearms and we know that firearms are readily accessible to many young people in their homes: 4.6 million children live in homes with at least one loaded, unlocked firearm.

How do we approach that? That’s through community work, that’s through making sure that gun owner groups, gun retailers and families are aware of the risks, that young people are turning to firearms when they’re thinking about suicide. Suicidal crises are often shortlived. Many people who attempt suicide, there’s very little time between when they first think about that suicide attempt and when they act upon it, so if we can reduce their access to lethal means in that moment, we can get them through the crisis and make sure that they have the support that they need, that they’re safe, that they have someone that they can talk to. 

So that’s one of the clearest actions we can take. 

How about policymakers? What key policy changes would you like to see, that you believe would have the largest impact on reducing young people’s’ risk for suicide? There are a lot of ongoing legislative efforts to limit children’s access to social media as a way to improve their mental health. 

It’s really, really important that legislators and the government are involved in this issue. Number one, we have to establish a minimum set of safety standards for young people online. We have to have a regulatory commission that oversees that, we have to make sure that we have regulations for companies so that they don’t have to govern themselves.

Those kinds of things would include mandating that they collaborate with technology companies and independent research teams coming together to make sure that people outside of the companies are looking at the data ensuring that the algorithms are not negatively affecting young people’s mental health.

I think we have to take on advertising to young people. You know, what type of advertising is permitted at what ages, what the delivery looks like. We have to require that social media companies build in experts like psychologists to advocate for young people’s well-being and know what’s going on in the algorithms.

We have to make sure that we can accurately detect age, when young people are using these platforms. Those are all things that the government should be regulating. 

There are things social media companies can do, too. They should be aggressively moderating harmful content. They should be making their data available to researchers and being transparent about their algorithms, they should be building in ways for young people to control their experiences online to be able to choose the kinds of things that they’re going to see.

It dramatized what has become increasingly apparent over the past few years: Students are in the midst of a mental health crisis. The U.S. surgeon general, Dr. Vivek Murthy, has warned of this repeatedly. “Mental health challenges in children, adolescents and young adults are real and widespread,” he said in this . “Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression and thoughts of suicide — and rates have increased over the past decade.” 

He is not being overly dramatic. In February, the Centers for Disease Control and Prevention released its , highlighting trends and experiences of U.S. high school students. The findings are sobering. Twenty-two percent, including 30% of girls, seriously considered suicide during the past year, and 10% actually made an attempt. 

Depression and anxiety are also on the rise among young people: according to recent CDC data, reported feeling so sad or hopeless almost every day for at least two weeks in a row that they stopped their usual activities. Sadly, many young people turn to drugs and alcohol to cope.  

Now is the time to change this pattern.

The Cook Center partnered with the American Association of School Administrators (AASA), the and the to host the mental health summit because school leaders bear much of the weight of mental health concerns among young people. In fact, some 80% of families rely on schools for their child’s mental health.

During the summit — the first time AASA had sponsored a conference specifically to address student mental health — educators explored the crisis in depth and collaborated with superintendents from rural, urban, low-income and affluent schools to map out possible solutions. They learned how to discuss mental health in a productive way with teachers, students and parents, using data and language supplied by experts from the foundation and the institute. Since the summit, superintendents have returned to their communities with the knowledge and tools to approach problems more analytically.

Importantly, the AASA Mental Health Cohort was established to help implement real solutions for all students. There are more than 40 members who regularly connect with one another to develop strategic plans, increase support options for all members of their school communities and work toward solutions that can be built into schools’ routines and their existing state, local or Title I funding.

In one member’s district, school staff meet with students and their families following a mental health hospitalization under a new school reintegration initiative. The team partners with local behavioral health providers, such as hospitals or inpatient treatment centers, to make sure the school understands the struggling student’s medical needs and can support the behavioral health treatment. The goal is to ease the transition back into a typical school routine without sacrificing the positive effects of the treatment. The program is new, but the district leader is collecting data to improve and expand it. The Jed Foundation has a available that aims to eliminate suicide among young adults, and Mental Health America’s for schools offers tips to students, teachers and even businesses to support the mental health of young people. 

The Cook Center has developed two resources that are available at no cost. is an animated series that models how the human connection can protect against suicide. The series tells stories of characters who face some of the most difficult issues that young people deal with and shows how they come to the key decision that life is worth living. 

is a free online resource where families can access courses and find answers from therapists. Districts can partner with the site to get additional resources for families, including mental health seminars tailored to local needs.

There has never been a better time to invest in children’s mental health. Unprecedented funding is available: The Department of Health and Human Services has allocated $35 million for mental health services and suicide prevention programs for youth. Congress increased appropriations for the Mental Health Block Grant by $100 million to help state and local governments fill gaps in services. And the Department of Education now has $144 million each year for the next five years to award to state education agencies and districts for mental health support.

Whether that funding is made available long term depends on how well schools implement programs and get feedback quickly. Districts have tremendous leeway in how they gather data and measure their effectiveness of their mental health support programs. Legislators will likely reward initiative and initially fund new programs. But they will also demand accountability, that school leaders gather data and develop improvement cycles. The good news is that fathering data and developing improvement cycles are already institutional skills that education systems do really well.

New coalitions like the AASA Mental Health Cohort and nonprofit groups like the Cook Center for Human Connection and JED are ready to help schools and districts take action to alleviate the mental health crisis among the youth they serve. Time is of the essence. The well-being of millions of young people is on the line.