When she was 11 years old, Maddie felt a crippling despair and loneliness that rendered her daily existence almost unbearable. She was already the target of significant bullying when a fellow student took a picture of her, photoshopping her head onto the body of a dog. Maddie had felt confident in that photo, sporting a dress and a hairstyle that she loved. Now classmates at her school in Houston, Texas, were making their own edits of the picture, changing its color and enlarging her head.
“It was very embarrassing and tragic for me,” Maddie, now 23, recalled. “I was already being bullied at school, and now I’m coming home, and I see this, and so it felt like it didn’t end.”
The tormenting by her peers continued into middle school. In an environment that punishes individuality, Maddie—who asked that only her first name be used to preserve anonymity—was unabashedly quirky, wearing bow ties and suspenders along with her school uniform. As she wryly noted a decade later, this defiant sense of self did not help her avoid bullying. Maddie is Black, and she felt as if she needed to hide her struggles because of stigma toward mental illness that she believes is still pervasive within the Black community.
Plagued by frequent panic attacks and overwhelmed with depression, she turned to Crisis Text Line, a secure service that offers support for people experiencing severe emotional or psychological distress. The volunteer counselors on the other end of the line, who are trained in crisis response, taught her breathing exercises and grounding techniques to help manage these painful experiences.
“Around the time I was, like, 12 [years old], I didn’t think I was going to make it to 16. When I made it to 16, I didn’t think I was going to make it to 18, and so in between 12 and 16 I made myself a promise that if I lived to be 18 years old, I would volunteer at Crisis Text Line,” Maddie recalled. That goal helped sustain her until she arrived at the University of Texas at Austin as a freshman, and she signed up to become a volunteer for the text line.
But Maddie was quickly overwhelmed by the academic demands and financial pressures of college, which only exacerbated the mental health challenges related to her then-undiagnosed bipolar disorder. As she struggled, academic advisers told her that maybe she was not cut out for the rigors of college, without offering sufficient resources for support.
In 2023, when she was a junior, she made a suicide plan, although she ultimately decided not to attempt. On the very night she had planned to take her life, a student who lived in the building across the street from hers died by suicide, and Maddie witnessed the aftermath. She was admitted to the hospital for the first time that night and was hospitalized another two times within a year after the first stay. Thankfully, she had friends who helped coordinate her treatment, but even acknowledging that the situation was serious enough to warrant assistance was difficult.
“I wanted to keep pushing through. I wanted to feel like I had everything together, that I could handle it, that I didn’t need help,” she recalled. “That year of hospitalizations was honestly the hardest thing I’ve ever had to do in my life. Getting that type of help was very, very scary to me … even though I had always told people, like, ‘If you need help, reach out for help.’”
Maddie has continued to process her trauma through writing, and particularly poetry. In one poem, entitled “The Day I Planned To Kill Myself,” she outlines the anguish she felt in the months before and after that experience. She wonders, “How many academic advisors have co-authored a student’s suicide?”
Maddie’s specific experiences are emblematic of the challenges felt by many young Americans contending with the inescapable torment of cyberbullying, a stressful academic environment, cultural stigmatization of mental health issues, and interactions with social media that aggravate a sense of isolation. And recent actions by the current administration and Congress—for example, threatening funding for mental health research and cutting key social safety net benefits—could put young people struggling with their mental health at risk.
In her poem, Maddie recalls two younger college students in the hospital seeking her guidance. She writes:
The second time I am in the hospital,
six months after the day I didn’t kill myself,
I am joined by a freshman and a sophomore, looking up to me, asking if life gets better.
And I feel like the leader of an army band,
preparing young soldiers to die, and I so badly want to shake them.
Want someone to shake me and say:
“Debt is not worth your life.”
“Your parent’s ‘sacrifice’ is not worth your life.”
“The fear of failure is not worth your life.”
“College is not worth your life!”
“Your life is worth it.
You are worth it, and you don’t
have to walk across that damn stage.
But please,
walk out of here
alive!”
A National Crisis
Since the height of the coronavirus pandemic, during which many schools and colleges closed their doors to in-person learning for months at a time, there has been a general consensus among medical experts that the kids are not all right.
“What a lot of young people are telling us is that there’s just high levels of anxiety and depression and stress, more so than we’ve seen with other generations,” said Courtney Gallo Hunter, the then vice president of public policy and advocacy at Crisis Text Line. Where adults might feel stress about weighty topics such as economic instability, political division, climate change, and systemic discrimination, teenagers—who already feel the impact of life events so deeply, from the stress of homework to first crushes—are experiencing those same concerns with higher intensity.
Although the trend of declining youth mental health predated the pandemic, the loss of social opportunities in 2020 and 2021 highlighted the ways in which members of Generations Z and Alpha face different challenges than their predecessors. Young people became more reliant on social media for connection, as they were prevented from interacting with friends and attending school in person; this was associated with a commensurate uptick in depressive episodes and thoughts of suicide. In December 2021, the U.S. Surgeon General issued an advisory warning of the “devastating” effects of declining youth mental health.
After lockdowns concluded, there was some improvement, evidenced by a decrease in suicidal ideation among adolescents and young adults since 2021. But the situation remains grim, as millions of young Americans struggle with their mental health and a pervasive sense of isolation.
“Social connectedness is not like what it used to be. People will spend time together, but they’re on their phones. They’re not making eye contact. They’re not sharing that social connection that is so important in every human being,” said Ana Tueme Lezama, a 24-year-old clinician living in Boston who volunteers with Crisis Text Line.
In 2023, suicide was the second-leading cause of death among individuals between the ages of 10 and 34. A recent survey by the Substance Abuse and Mental Health Services Administration found that in 2025 around 15 percent of youth between ages 12 and 17 reported having a major depressive episode in the previous year, and roughly 10 percent had serious thoughts of suicide. Around 11 percent of adults aged 18 to 25—among whom Maddie can be counted—had serious thoughts of suicide during the previous year.
The root causes of mental health issues among young people are varied and intertwined, making it difficult to tease out any particular problem that, once fixed, would lead to an immediate and universal cessation in internal psychological hostilities. But if one were to braid the fine strands of these roots into a single prescription—say, for the purposes of an explanatory magazine article—it may be this: Adolescents and young adults exist in a world where they lack sufficient external support and a sense of community.
The “lack of external support” condition could be met by any number of metrics, most obviously a difficulty in accessing care. There is a nationwide dearth of behavioral health providers, with 40 percent of Americans living in an area with a shortage of mental health professionals. And those existing professionals are less likely to take health insurance, due to lower reimbursement rates from insurers. Federal law mandates that insurers covering mental health and substance abuse services treat them in the same way they would medical and surgical benefits; however, it doesn’t require insurers to cover those services in the first place. Meanwhile, more generalized clinicians often lack the training to spot the warning signs of mental distress.
Then there are the other, more structural predictors of poor mental health. Among Americans younger than 18, mood disorders, substance use, and suicidal behaviors are more common among low-income individuals; youth who have been involved in the criminal justice system; American Indian and Alaska Native young people; those who identify as LGBTQ+; and rural youth.
Dr. Maria Rahmandar, an attending physician for adolescent and young adult medicine at the Children’s Hospital of Chicago, noted that there was nothing “inherent” about these identities that made young people particularly susceptible to suicidal ideation. “It’s about the systems that people live within that persecute them, that discriminate against them, that make them feel unsafe and disconnected—that is likely a big contributor to why we see youth die in these populations,” said Rahmandar.
Asheton Medlin, a recent graduate of the University of North Carolina at Chapel Hill, grew up in an area where mental health care was a literally and metaphorically distant prospect. In her hometown of Roxboro in rural northern North Carolina, visiting a therapist would require a 45-minute trek to a larger city. This is a significant challenge for someone in a town where one-third of residents live in poverty, and getting time off from work or affording gas for such a drive can be an insurmountable hurdle.
A recent report from the Centers for Disease Control and Prevention found that rural adults between the ages of 20 and 39 were significantly more likely to die by suicide than their urban counterparts. There is also a dearth of mental health care in less populated areas: 47 percent of nonmetropolitan counties do not have a psychologist, 65 percent do not have a psychiatrist, and 81 percent do not have a psychiatric nurse practitioner.
“There’s no resources to talk about it there. And so if there’s no fix, [and] there’s no reason to talk about it, then people just didn’t bring it up,” said Asheton, who is 23 years old. “People just kind of learned, like, ‘Oh, just toughen up, we don’t talk about that.’”
Along with this keep-it-to-yourself mentality, rural communities have been affected by overuse of alcohol and other substances, especially opioids. Young people in a small town may turn to alcohol or drugs out of boredom, said Asheton. But as adolescents approach adulthood, she continued, their anxieties become more existential and tied to stress about their future.
“How are you going to move on with your life when there’s not so many opportunities in the small town? I think that’s when that mental health struggle kind of shifts from, ‘Oh, we’re doing this for fun,’ to, ‘Oh, I’m doing this as a way to cope because I’m not quite sure what’s next,’” Asheton said.
It’s a problem that Charlie Moser witnessed when he was growing up in rural Montvale in southwestern Virginia. The recent Cornell University graduate recalled the struggles of his friend, Brady, who died in 2021. Brady had issues with mental health, and he may have benefited from resources and support to help him with difficulties at home. Brady became involved with “the wrong group of people,” Charlie said, and his subsequent use of drugs and alcohol ultimately resulted in his death.
“The drug and alcohol scene is sort of a negative outlet for a lot of students where I grew up,” said Charlie, who is now 23. “If you don’t have a job, if you don’t go to college, if you don’t go to community college, if you don’t have any kind of [plans after] high school, it’s a very easy and appealing scene to get into.”
The “Danger Switch”
Despite significant differences in circumstances, poor urban youth face challenges similar to those of young people living in rural communities. Research has found such factors as food insecurity and lack of stable housing contribute to poor mental health among adolescents and young adults. In inner-city Baltimore, for example—an early adopter of the discriminatory redlining housing policies in twentieth century—primarily Black neighborhoods that experienced this kind of institutionalized racism firsthand see lower health outcomes.
“There are a lot of young people who are exposed to chronic stress and trauma that have to do with growing up in sort of historically and currently disenfranchised communities,” said Dr. Tamar Mendelson, director for the Center for Adolescent Health at Johns Hopkins University Bloomberg School of Public Health. Young people living under these kinds of conditions are often “responsible for things that kids shouldn’t necessarily need to be dealing with.”
Mendelson continued: “Not having enough food is a deeply stressful experience, or not having a place to feel safe, not feeling safe in your neighborhood, not feeling like your home is safe. These are things that affect the developing nervous system…. That danger switch is sort of permanently switched on, and that can help in the short term for young people to respond to acute stress and danger—but over time we know that that has a lot of negative health and mental health implications.”
It’s a feeling that Keontè Lewis, a native of Washington, D.C., knew too well as a child. Keontè’s parents had an antagonistic relationship when he was growing up, and he felt unsafe to communicate his feelings with either of them. They were also each raising multiple children—Keontè’s father has nine children, and his mother three—and struggled financially. School didn’t offer any respite from his troubled home life, as he was bullied for not having cooler shoes or nicer clothes.
“I would come home and like, you know, try to find comfort in my parents, or my brothers, and then that was not really accessible either, and it was really hard for me,” recalled Keontè, who is now 23 years old and lives in Maryland. His family was in line with the cliché of strict Black parents, he remembered, scolding him for crying.
“Toxic masculinity was just something that was literally ingrained in us,” said Keontè. “It was never taught to us. That’s just what it was to be a boy, to be a man.”
Similarly, Keontè did not realize the impact racism had on his life until he was an adult. He believes that the legacy of slavery and segregation had a “subconscious” effect on Black communities, such that he naturally saw himself “in a different light.” The idea that he had to “work harder than others to break even” was a fact of his daily existence. “I just kind of thought of myself and my peers as the underdog, so to speak,” said Keontè. “That’s just something that we always kind of were ingrained with, without anyone [having] told us that.”
When his high school began remote learning during the coronavirus pandemic, Keontè was unable to successfully use the software to log into class—a relatively common experience during the pandemic among low-income young adults without regular internet access, and particularly Black and Latino youth. But when he was expelled for his truancy, Keontè wasn’t overly bothered. He was never the best student, and he didn’t want to attend anyway; he was already “in the streets,” as he put it. He was incarcerated for the first time as an adult at age 19 in 2022—he had been in juvenile detention more than once as a teenager—serving 17 months in D.C. jail before being transferred to a federal prison in Pennsylvania for three months. He came home to the D.C. area in 2024.
Like Maddie, Keontè found an outlet in poetry. While he was in jail, he became involved with Free Minds Book Club & Writing Workshop, a D.C.-based organization that serves incarcerated and formerly incarcerated youth and adults. He has remained involved with Free Minds as a volunteer since returning home. In a recent poem entitled “Redemption,” Keontè outlines some of the challenges he faced as an adolescent—both due to his circumstances and his own actions—including “poverty, struggle, addiction, conviction, then prison.”
“I can write a book or let people write for me,” Keontè writes. “I seen more than a man at 40.”
Beyond his own experiences, Keontè has keenly felt how life in the streets can result in tragedy. Last year, Keontè’s close friend, Malik, died by suicide. Malik was in the streets at the time—meaning that he was selling drugs to make money—in large part because he felt pressure to financially provide for his partner and his parents. Although Keontè offered support for his friend and encouraged him to leave that kind of life behind, he was unable to provide the assistance a trained professional could offer.
“I told him all that I could. I’m not a specialist, so I can’t tell him anything a clinician would tell him,” Keontè said. Life as the underdog, as a man beholden to a very specific version of masculinity in a context rife with violence, took its toll.
Meanwhile, in Washington
By the time I met Saanvi Arora in a conference room in the Rayburn House Office Building in late June, she had been engaged with legislative advocacy work for years. When she founded the Youth Power Project as a freshman at the University of California at Berkeley in 2022, she had been motivated by a desire to connect young people with the lawmakers who write policy on youth mental health but rarely hear from the population whom they are purportedly trying to help.
Now, barely a month after graduating from Berkeley, Saanvi was among the leaders of a day of advocacy organized by the Youth Power Project and Crisis Text Line. Fifty young adults from more than 30 states fanned out across the Capitol Hill complex that week, visiting congressional offices to discuss their own experiences and voice support for certain legislation, including a bill to put information about mental health resources on student IDs.
“We’re here because we believe that young people with lived experiences are most qualified to advise and craft solutions for mental health care in their communities,” Saanvi told the group of assembled volunteer advocates at a June breakfast briefing before they embarked on their visits to individual congressional offices. “Many young people are already doing that work in their communities, and they have really powerful ideas for change. Oftentimes, however, they’re not really met with the resources or opportunities to bring that change to life at a more systemic level.”
Saanvi, who is 22 years old, knew this struggle firsthand. When she was about 15, she lost a friend to suicide and had been motivated by that tragedy to volunteer with a peer-led crisis service focused on youth mental health. She and her peers began advocating for local California state lawmakers to pass a bill allowing school-excused absences for mental health reasons, and they were cold-calling legislative offices to push the measure before they had even taken their PSAT. The bill was introduced and signed into law by Governor Gavin Newsom in 2021.
“I felt like, in that moment, I just wanted to continue to get involved and figure out how I could get more young people to understand the legislative process and help them understand how they could use their voice and their story to effectuate change,” Saanvi recalled. The Youth Power Project has continued to advocate for state and federal legislation, including support for a Senate resolution approved in 2024 that recognized a “pressing need” for youth mental health awareness with recommendations for state governments.
Addressing mental health is, in theory, the rare unifying issue in Washington. Perhaps the most significant bipartisan victory for mental health legislation occurred in 2020, during Donald Trump’s first term, when Congress approved the use of the three-digit 988 number for the federal toll-free suicide and mental health crisis hotline. Between the implementation of the lifeline in 2022 and December 2024, suicide deaths among people between ages 15 and 34 decreased by 11 percent, with the greatest reduction occurring in states with the highest call volumes.
Saanvi and her peers were on the Hill to promote legislation including the Campus Lifeline Act, which would encourage college campus mental health efforts and clarify that information about the 988 Lifeline can be included on driver’s licenses and student IDs. The measure was introduced by a bipartisan group of lawmakers earlier this year. (Mental health experts have encouraged states to maintain regular funding for 988 by implementing a monthly telecommunications fee for phone bills, similar to how 911 is funded, a practice that has been enacted in 12 states.)
Nevertheless, certain actions by the Trump administration and the Republican-led Congress could have a long-term negative impact on mental health care accessibility. Shortly after Trump took office, the CDC pulled the Youth Risk Behavior Survey from its website because it addressed the mental health of transgender youth; a judge ordered it restored in February 2025. The Trump administration also ended the 988 hotline’s specialized services for LGBTQ+ youth in 2025; despite Congress authorizing funding to reinstate “Option 3” (so named for its specific place in the menu), the Department of Health and Human Services has yet to reinstate the line. Freezes in certain federal grants have been disruptive for mental health research, even as some of that funding was reinstated.
The GOP congressional majority last year approved dramatic cuts to Medicaid, which is the largest payer for mental health services in the country. Millions of people are expected to lose health coverage, with significant knock-on effects for access to behavioral health care. Many public schools use Medicaid funding to subsidize in-school mental health services; if states are forced to slash their Medicaid spending, it could result in schools losing funding for these programs.
“We’re really concerned about how that resource limitation is going to impact the availability of these early intervention services,” said Hannah Wesolowski, the chief advocacy officer at the National Alliance on Mental Illness. “There has been quite a long effort—bipartisan effort—to make it clearer what states can use Medicaid for in schools, and unfortunately, with limited resources … we might start to backtrack a bit there.”
Access to lethal means is a major factor in youth suicide as well. Between 2014 and 2023, rates of suicide by firearm increased by over 40 percent among young people ages 10 to 24, according to the organization Everytown for Gun Safety. But given the political controversy over gun safety legislation—a result of persistent lobbying by organizations such as the National Rifle Association—action on this front is unlikely to be taken on a federal level. (One of the authors of 2022 gun safety legislation, GOP Senator John Cornyn, was defeated in his primary this year; his opponent had hammered him on his role in crafting the measure.)
Action is still possible on a state level. Research has shown that stricter gun storage requirements are associated with a decrease in youth suicide by firearms, and 26 states have enacted such policies, known as child access prevention laws.
“The thought of suicide remains a thought if there’s nothing to use to take action. The thought of suicide becomes an action when there’s something available in that moment when a child feels most despondent,” said Dr. Shairi Turner, the chief health officer at Crisis Text Line.
The Social Media Beast
Although gun control may be off the table, members of Congress have lately turned their attention to another area of concern: access to social media. In July, the House approved the Kids Internet and Digital Safety Act, which includes provisions incentivizing certain platforms to verify the age of their users and establish policies to reduce access to harmful content. Critics say this measure threatens the privacy of young people and could result in over-censorship that removes resources for youth on issues such as addiction and sexual exploitation. In early August, the bill cleared the Senate Committee on Commerce, Science, and Transportation with bipartisan support.
Saanvi worries that measures to implement “age gating”—that is, age verification for minors—could result in sites learning more information about young people. “We already have such a severe issue with how targeted our recommendation systems are,” she said.
The argument over young adults on social media isn’t new. Adults have been worried about adolescent use of social media for as long as there has been social media to use. From the perspective of teenagers and young adults, the benefits are more apparent, but the collateral damage is significant.
Recent polling by the Pew Research Center found that the majority of teenagers between the ages of 13 and 17 believe social media has encouraged their creativity and the formation of connections; however, 27 percent believed social media made them feel a lot or a little worse about their own lives. Teen girls were more likely than boys to say they had negative experiences on social media.
The harmful aspects of social media may be particularly acute among youth struggling with their mental health. According to a poll conducted in 2023 by researchers at the University of Chicago, the majority of youth aged 14 to 22 with depressive symptoms reported that social media made them feel stressed and anxious due to the prevalence of bad news. They were also more likely to say that using social media made them feel as if others’ lives were better than theirs, and to feel bad about the way they look.
Dr. Christine Yu Moutier, the chief medical officer at the American Foundation for Suicide Prevention, said that young adults already combating depression, anxiety, or trauma may be more likely to spend several hours at a time on social media, with interactions that only intensify those preexisting stressors. “It can go very, very badly for a certain subset of people, whereas for some of those folks who are farther along or very intentional about their social media use, they actually may find connectedness and community in a way that’s lifesaving,” said Moutier.
Ana Tueme Lezama could be counted among those teenagers who used social media as a tool for negative comparison. After she received her first iPhone upon graduating from elementary school, she created a profile on Instagram, because everyone else she knew was using Instagram. She believes the use of that app and Snapchat had a significant detrimental effect on her mental health. Ana would scroll Instagram for hours, comparing her own life to photographs of her peers.
“That would oftentimes make me think about myself and, like, ‘I don’t have happy moments,’ or, ‘I don’t feel this connection with my friends,’” she remembered. It was easy for Ana to find others who battled suicidal ideation, and she “trauma-bonded” with them in a way that encouraged her darkest thoughts. As a Latina child growing up in Pound Ridge, New York, where nearly 90 percent of the population is white, Ana also regularly experienced racist interactions and microaggressions that only served to further isolate her and exacerbate her sense of being disconnected from her peers.
Other triggers included “pro-ana”—short for “pro-anorexia”—accounts on Instagram that glorify eating disorders and discourage followers from seeking treatment. Ana had anorexia, her weight eventually dropping to such a dangerous level that her organs began to fail. That led to her first hospitalization; she was involuntarily committed three more times afterward because of her severe depression. Looking back on those difficult times, Ana can easily come to a definitive conclusion: In her words, “social media made my mental health struggles significantly worse.”
Where accounts promoting eating disorders and encouraging suicidal ideation proved triggering for Ana, Keontè had an analogous experience with videos and songs that glamorized life “in the streets.” Given his sense of isolation at home and in school, he sought fulfillment from external sources, including “drill” music. Drill, so named because its percussion beats are akin to the firing of a gun, is a genre of hip-hop that originated in Chicago in the early 2010s, and that critics—including, now, Keontè—argue glorifies gang violence.
“A lot of young adults aspire to be someone recognized as someone who—you know, call it what it is—like, as a murderer, as a killer,” he said. Because of social media, Keontè recalled, drill culture was so big in D.C. when he was a teenager that the music was easily findable on sites such as YouTube and Instagram. Being in that culture was like “drinking water,” he said; in a sense, it provided an avenue for connection because it reflected his life experiences.
But experiencing that lifestyle was not nearly as romantic as the music made it seem. “When you’re in it, it’s not that fun. It may sound good on beats, but it’s not fun for real. Like seeing homeys die, it’s not fun. Going to funerals, it’s not fun. Being locked up is not fun,” Keontè said.
Like all teenagers, Keontè wished to belong. Now, he believes his desire to fit in with that specific culture placed him on the “downward spiral” that began with him stealing from neighbors and culminated with his entering federal prison while still a young adult. Without drill music and social media, he added: “I don’t think that I ever would have been in the spot where I was at when I was 19.”
Although Ana and Keontè’s negative experiences with social media are severe cases, they are indicative of some of the issues that extremely online young people face across the country. Several of the young people with whom I spoke discussed social media as a vehicle for comparison that damages self-esteem, especially for young women who despair of their own appearance when looking at others, and lower-income youth who spend their scrolling time contrasting their own lives to peers with greater opportunities.
Maddie has felt the effects of that kind of comparison. Along with the cyberbullying that she underwent during her childhood, Maddie’s struggles with mental health meant that her life took a different path than many of her college friends did. After her hospitalizations, she left UT-Austin and later attended Houston City College to get her associate degree.
“This year was extremely rough, to see so many people I know graduate or start their master’s programs, and then just feeling like I no longer relate because I’m off the timeline that I thought I was going to be on. So in that sense, social media has been distressing,” Maddie said.
For those who do not experience rigorous academic pressures, social media can still be a lifeline that ultimately entangles its users and is unable to provide the same connection as in-person interactions. “I think it’s incredibly dangerous to young people in rural communities, especially when the internet, in some ways, is all they have to be connected to anything,” Charlie Moser said. “For some people, that’s their escape.”
Persistent use of social media also affects amounts and quality of sleep, which can have a significant impact on youth physical and mental health. According to the recent Pew poll, 40 percent of teenagers said social media platforms hurt their productivity, and 45 percent said it hurt the amount of sleep they received.
“The last thing they see before they go to bed is a screen, and the first thing they see when they wake up is the screen, and then it wakes them up overnight when friends are chatting, or they get a notification on some platform,” said Rahmandar. “Not getting enough sleep is a huge concern for suicidality and generates worsened mental health in general.”
The integration of generative AI into teenagers’ daily lives has raised red flags for mental health experts. The company OpenAI has faced multiple lawsuits by parents alleging that its generative AI tool, ChatGPT, encouraged their children to follow through with suicide plans, resulting in their deaths. In the first known lawsuit, filed in August of last year, Matthew and Maria Raine alleged that ChatGPT had encouraged their son Adam’s suicidal thoughts, urged him against communicating with his parents, and given him step-by-step instructions for methods of suicide. Adam died in 2025. Researchers at Northeastern University recently found that OpenAI had implemented stronger safeguards around questions related to suicide and self-harm, but concluded that chatbot companies in general have failed to extend specific protections regarding other mental health conditions, including substance abuse and eating disorders. And Meta, the parent company of Facebook and Instagram, recently agreed to pay up to $17.1 billion to settle a lawsuit with 47 states for the alleged harm it has caused teenagers.
Another Pew Research Center survey, conducted in late 2025, found that a majority of teens use AI chatbots, including three in 10 who use them daily. Sixteen percent say they have used them for casual conversation, and 12 percent to get emotional support or advice. The appeal of AI as a tool for mental health assistance may lie in its anonymity, or the sense that the advice a chatbot is providing is judgment-free, said Saanvi.
“We could do a better job of educating young people that this is an algorithm. It’s not actually answering you, it’s kind of putting together [outputs] based off of your input that sound correct,” argued Saanvi.
Moutier said that in consulting with the large language model companies on the forefront of developing generative AI, she has learned that how a chatbot responds is based on an initial assessment. “If the assessment is off, then you’re more likely to see these negative outcomes,” Moutier said.
Of Struggle—and Hope
When Asheton Medlin arrived at UNC Chapel Hill, she was quickly overwhelmed. In Roxboro, she had been valedictorian, and she entered college with “full confidence that I would do amazing.” She had always done amazing.
But at Chapel Hill, she wasn’t the smartest student in the room; she was one of thousands of smart students, many of whom had attended high schools with greater resources and college preparation. Everyone else seemed to be fitting in, acing their classes, finding friends. Asheton felt like she was drowning.
Around October of her freshman year, a fellow student living in her dorm died by suicide. Asheton hadn’t known him personally, but she was struck by the similarities of their circumstances: He was from a small town, too, and had dealt with a heavy workload in college. In the wake of his death, other students began to speak more openly about their own challenges.
“People started talking, like, ‘Yeah, I also am struggling with this. I also, you know, feel overwhelmed and feel like I’m not enough.’ And I think when they started talking about it, I realized I wasn’t alone in that, and it really shifted my whole perspective,” Asheton recalled.
She started doing better in her classes and using the mental health resources at Chapel Hill. She became involved in advocacy, and has worked closely with Rural Minds, an organization focused on rural mental health. Asheton and Charlie are both on the steering committee of the Youth Rural Mental Wellness Program at Rural Minds, a pilot program in New York and Pennsylvania that aims to provide resources and assistance for young people with mental health challenges in rural areas.
Asheton’s experiences are likely recognizable to young people across the country, not only because of the universal struggle of trying to find one’s place in a new environment, but because of her closeness to tragedy. Of the six young adults with whom I spoke for this story—individuals of different races, ethnicities, income level, gender, sexuality, and home states—every single one had known someone who had died at a young age in connection with their mental health issues, or whose challenges had nearly resulted in their own death.
Connection with others has provided purpose: Ana as a clinician working with families in Boston and a volunteer at Crisis Text Line; Keontè and Maddie with their poetry and their own volunteer work; Saanvi, Asheton, and Charlie with their advocacy. But they each believe that addressing the mental health of young people will require significant action. This means commitment from schools that need proper funding in order to provide helpful resources, from state and federal governments that must bolster the investment, and from a society that can work harder to destigmatize seeking help.
Although the “Make America Healthy Again” movement has ostensibly made youth mental health a priority, the Trump administration has taken several actions that undermine the federal government’s ability to respond to the crisis, including significant layoffs at the Substance Abuse and Mental Health Services Administration and the pause on full enforcement of a 2024 rule aimed at more strictly applying the law requiring insurers to implement mental health parity. While a future president could reverse some of the changes made by the Trump administration, they may be hindered by a hollowed-out federal infrastructure, the impermanence of executive actions, and congressional inertia.
There are some efforts in the House and Senate to expand behavioral care services in schools, and both chambers of Congress have bipartisan caucuses focused on mental health that essentially function as working groups. A few rare policies are backed by members of both parties, including further support and establishment of Certified Community Behavioral Health Clinics, which provide round-the-clock care for mental health crises and substance abuse disorders while meeting federal certification criteria. Pilot programs to cover CCBHC care through Medicaid have been expanded to 31 states, although this could be threatened by cuts to the program implemented by Congress.
Reducing funding for mental health programs is politically unpopular—according to a 2025 National Alliance on Mental Illness/Ipsos survey, 73 percent of Americans “oppose cutting federal jobs and programs focused on mental health services, opioid treatment, suicide prevention programs, and the 988 Suicide & Crisis Lifeline.” The poll also found that 64 percent of Americans believe Congress is doing too little to address the current state of mental health care, along with 58 percent who say the same of the president. Given its importance, political candidates who prioritize mental health in their campaigns could benefit from focusing on it, particularly at a time when health care remains a major motivating factor for voters.
In the meantime, young adults have taken on the responsibility of destigmatizing the seeking of help at an individual level. Keontè plans to apply for college in the D.C. area so that he can remain involved with Free Minds and his community. In his poem “Redemption,” Keontè ends on a note of hope, recalling how he was able to move forward with his life despite the challenges of his upbringing and incarceration.
I found life in my death and I keep growing
Patience is a virtue I keep showing
My hope is my love for the people so potent
you gotta get with it
He sees the universality of mental health challenges—and that chance for redemption—as a point of connection between young people, regardless of circumstances.
“No matter where you come from, you know, like no matter who you are—you can even be someone who doesn’t have any experience being in the streets, or don’t know anyone who are in the streets. We all have experienced being in the struggle,” said Keontè. “If that’s you, that’s something we can relate on.”
