The most recent Youth Risk Behavior Survey by the Centers for Disease Control and Prevention (CDC) paints a grim picture of the state of mental health among U.S. students. According to the survey, nearly all indicators of poor mental health, including suicidal thoughts and behaviors, worsened between 2013 and 2023. In fact, in 2023 alone, 20% of students seriously considered suicide, and almost 10% actually attempted suicide. These numbers are deeply concerning, particularly as mental health issues continue to affect younger and younger children.

The onset of many mental health issues occurs much earlier than many people realize. Christine Concesion, Director of Mental Health for Burlington Public Schools in Massachusetts, explains that students today are facing challenges at younger ages than previous generations. “We are seeing more externalizing behaviors in younger grades, and an increase in concerning behaviors in middle and high school, such as self-harming, suicidal ideation, and even hospitalization,” she says. As students grow older, they often face heightened pressure academically, socially, and emotionally, which compounds their struggles that we know to already exist for our young people. 

At Cartwheel, a trusted mental health partner for schools, we are seeing firsthand the growing need for school-based mental health support. Of the 4,492 students that were referred during the 2023-2024 school year, students were referred to Cartwheel for various mental health services, including individual therapy, parent guidance, psychiatric evaluation, and medication management.

School-aged children today face a unique set of challenges. Younger students, especially those in grades K-5, often struggle with coping, anxiety, and family issues. Middle school aged students start to struggle with self-esteem and relationship issues as they begin comparing themselves to their peers. Older students, particularly those in high school, feel the weight of academic pressure, social dynamics, and family expectations. Across the board, students are grappling with the emotional fallout of a world that feels increasingly uncertain and disconnected.

The Top 9 Reasons Students Are Referred to Cartwheel

According to data from Cartwheel, the top reasons students are referred for mental health services include:

Top 5 Reasons: Breakdown by Grade 

While the core challenges often overlap, the specific struggles vary by age group. Here are the most common referral reasons by grade level:

The growing mental health crisis among young people is a call to action for parents and caregivers, educators, mental health professionals, and policymakers. By intervening earlier, providing school-based support, and having open conversations about mental health, children and adolescents can develop the skills they need to cope with their emotions, build resilience, and navigate life’s challenges.

At Cartwheel, we are committed to being part of the solution by providing accessible mental health services and resources to schools and families. Addressing youth mental health on a broader scale requires a community effort. We must prioritize mental health as a critical aspect of youth development and create environments where young people feel supported, heard, and equipped to face their challenges.