Kidsdata.org provides the following indicators of children's emotional health:

• The number and rate of hospital discharges for mental health issues among children and youth ages 5-19, by age group
• The percentage of California and U.S. children ages 3-17 with behavioral or mental health conditions (attention deficit disorder (ADD) or attention-deficit/hyperactivity disorder (ADHD), anxiety problems, behavioral or conduct problems, or depression), along with the share of those who have received mental health treatment or counseling in the previous year
• The percentage of students with depression-related feelings (i.e., being so sad or hopeless every day for two weeks or more that they stop doing some usual activities) in the previous year, by grade level (7, 9, 11, and non-traditional), gender, level of school connectedness,* parent education level, race/ethnicity, and sexual orientation
• The percentage of youth ages 12-17 needing help in the previous year for emotional or mental health problems, and, in California and Los Angeles County, the share of those receiving counseling
• The percentage of reports by school staff on their level of agreement that students are well behaved, the extent to which student depression or other mental health issues are a problem, and their level of agreement that helping students with emotional and behavioral problems is emphasized at their school, by type of school (elementary, middle, high, and non-traditional)

Emotional health is an integral part of overall health, as physical and mental well being are intricately linked (1, 2). Mental wellness—which is more than the absence of disorders—includes effective coping skills and the ability to form positive relationships, to adapt in the face of difficulties, and to function well at home, in school, and in life (1). Emotional development is influenced by complex biological and social factors, with early positive and adverse experiences in relationships and environments being particularly profound (1, 2). Sound emotional health prepares young people for the challenges of growing up and living as healthy adults (1).

Most mental health disorders emerge before age 24, and the prevalence of such disorders is on the rise, affecting as many as one in five U.S. children and youth each year (1, 2). Suicide has become the second leading cause of death among youth ages 10-24 nationwide (2). Treatment of mental illness is costly and accounts for the largest share of health care spending for children and youth in the U.S. (1, 3). Still, the majority of young people who need mental health treatment do not receive it, placing them at increased risk for negative outcomes throughout their lifetimes (1, 2).

Anxiety disorders are the most commonly diagnosed mental health conditions among youth, affecting an estimated 32% of U.S. adolescents (1). Depression-related feelings also are common, with 42% of high school students nationwide in 2021 estimated to have had persistent feelings of sadness or hopelessness in the previous year, up from 28% in 2011 (4). Youth with anxiety, depression, or other mental health problems are more likely to exhibit suicidal behavior, drop out of school, use alcohol or drugs, and engage in unsafe sexual activity, in addition to having difficulties with school and relationships (1, 4).

There were 37,787 hospital discharges for mental health issues among California young people ages 5-19 in 2020: 12,719 for children ages 5-14 and 25,068 for teens ages 15-19. After peaking at 5.8 hospitalizations per 1,000 youth ages 5-19 in 2019—a two-thirds increase compared with 2007—the statewide rate of mental health hospitalization fell to 4.8 per 1,000 in 2020.

According to 2017-2021 data collected from parents and caregivers, an estimated 12% of California children ages 3-17 had one or more provider-diagnosed mental health conditions—attention deficit disorder (ADD) or attention-deficit/hyperactivity disorder (ADHD), anxiety problems, behavioral or conduct problems, or depression—at the time of survey. Just over half of these children (52%) had received mental health treatment or counseling in the previous year, while the remainder were reported as either not needing services or not receiving the services they needed. By comparison, nationwide, 17% of children had diagnosed conditions, with a similar share (53%) receiving treatment or counseling in the previous year.

In 2017-2019, an estimated 30% of 7th graders, 33% of 9th graders, 37% of 11th graders, and 32% of non-traditional students in California experienced depression-related feelings in the previous year (meaning they felt so sad or hopeless almost every day for two weeks or more that they stopped doing some usual activities). Depression-related feelings were more common among female students and those with low levels of school connectedness. More than 67% of gay, lesbian, and bisexual youth had experienced depression-related feelings in 2017-2019, compared with fewer than 30% of their straight peers.

Youth emotional health problems and hospitalizations have been increasing in recent years, statewide and nationally (1, 2, 3). The vast majority of mental health problems begin before age 24, making childhood and adolescence a critical period for preventing disorders and promoting mental wellness (1). Screening, early identification, and treatment are critical, as untreated mental illness can disrupt children's development, education, and their ability to lead healthy, productive lives (1, 4, 5). Health care and school settings are natural places to identify early warning signs and connect children to services, although barriers exist such as lack of time and training among primary care providers and school staff (1, 4). Even when mental health problems are identified, most children who need treatment do not receive it, often due to factors related to administrative or insurance obstacles, cost, stigma, or shortage of providers (4). Policymakers and other leaders can work to improve systems so that all children with mental health problems are identified early and receive appropriate, timely services.

Social conditions and practices—such as poverty and systemic racism—and relationships and environments at home, school, and in the community influence children's emotional health (1). Policymakers can promote emotional wellness by prioritizing policies and cross-sector strategies that strengthen protective factors and provide stable, positive environments for children and families (1, 6).

Policy and practice options that could promote children's emotional health include:

• Aligning mental health funding with what is known about the age of onset of disorders, groups at higher risk of mental illness (such as children in foster care and LGBTQ youth, among others), and effective strategies integrating mental health, health care, education, child welfare, juvenile justice, and other systems (1)
• Promoting strategies to expand mental health services at schools, maximizing Medi-Cal and other existing funding streams (1, 2, 3)
• Training school staff to recognize signs of mental distress and connect students with appropriate services; school practices should be trauma informed, culturally sensitive, and promote a safe and supportive environment for all students (2, 7)
• Supporting schools in creating positive school climates in which students feel valued and engaged, and can develop problem-solving and self-regulation skills as part of a comprehensive approach to social-emotional learning (1, 2, 8)
• Investing in community efforts—especially in under-resourced areas—to provide youth with positive experiences, relationships, and opportunities, such as quality after-school and summer programs (2)
• Promoting the use of primary care settings to prevent and address emotional health problems; as part of this, increasing consistency of mental health screenings in pediatric practice, expanding trauma-informed training for medical residents and pediatricians, and improving multidisciplinary coordination of services (1, 4)
• Expanding and diversifying the workforce of qualified mental health professionals serving youth, e.g., school counselors, social workers, and psychologists (1, 8)
• Supporting efforts to promote parents’ mental health and positive parenting skills, increasing mental health screenings for caregivers, and expanding family support services, such as home visiting and mental health treatment as needed (1, 9)
• Improving access to high-quality early childhood education programs, especially for children experiencing poverty or other disadvantage, and ensuring that staff are trained on social-emotional learning (1, 2)
• Promoting proactive social policies and investments to address structural inequities and strengthen economic support for families (1, 6)
• Supporting public education to raise awareness of the importance of children’s emotional health, reduce the stigma associated with mental health problems, and increase knowledge of warning signs and how to seek help (1)