Unpacking The "Gen Z" Mental Health Crisis
Conservatism and participation in its core institutions - marriage, church, and the military - are associated with better mental health. Gen Z, however, is rejecting these beliefs and behaviors.
The country is struggling with a profound mental health crisis. The crisis is particularly acute among Americans under 25. Consider the articles on mental health among young people published in the last week alone:
Understanding the Barriers – and Solutions – to America’s Youth Mental Health Crisis
Team USA player uses World Cup to address mental health crisis
Baltimore City Schools sues Facebook and others for fueling mental health crisis
How social media is contributing to a mental health crisis in youths
Study Delivers More Evidence of a Mental Health Crisis Among Teens, Particularly Girls
Amid mental health crisis, school teaches students how to help each other
More systematically, a content analysis of mainstream news coverage reveals a dramatic surge in the media’s interest in mental health. As Figure 1 shows, major American newspapers have devoted a far greater share of their coverage to mental health issues in general and mental health issues among young people over the last two decades (with the number of yearly articles per 1,000 increasing by more than 10x between 2000 and 2022).1 As Figure 1 also shows, most of the change occurred after 2017. In the last five years, mental health (particularly among teenagers) has become a central fixation of the country’s public discourse.
Figure 1 - Major Newspaper Coverage of Mental Health Issues
The intensifying concern about mental health should not be surprising. The last few years have seen a seemingly endless stream of shocking new studies about the low and declining quality of young people’s mental health. For example, using the Monitoring the Future (MTF) studies (which are yearly, nationally representative surveys of high school students), Jean Twenge has shown a dramatic increase in depressive attitudes among American teens (Figure 2):
Figure 2 - Depressive Symptoms among American Teenagers
Drawing on the Behavioral Risk Factor Surveillance System (a yearly survey of 100,000+ U.S. adults administered by the CDC), Twenge has also shown that young people are experiencing a rapidly growing number of “poor mental health” days each month (Figure 3).
Figure 3 - Poor Mental Health Days Each Month by Age
Providing further confirmation of these trends, a 2022 report by the American Psychological Association found that young people (particularly young women) are incapacitated by daily stress. Specifically, a majority of those under 35 claimed that “stress is completely overwhelming most days.” By contrast, less than 9% of those 65 or over experience “overwhelming” stress (Figure 4).
Figure 4 - Overwhelming Stress by Age and Gender
Other data from 2022 paints a similar (yet equally disturbing) picture of the steady, intergenerational decline in Americans’ mental health (Figure 5). While more than 70% of the Silent generation (born 1928 to 1945) and 60% of Boomers (born 1946 to 1964) report “excellent” or “very good” mental health, only 29.4% of Gen Z (born after 1996) do. Gen Z’s mental health stands out even in comparison to Millennials, with members of Gen Z nearly 15% more likely than Millennials (born 1981 to 1996) to claim their mental health is “fair” or “poor.” Clearly, there is something unique going on with Gen Z. In other words, the “kids aren’t alright.”
Figure 5 - Self-Reported Mental Health by Generation
So what is wrong with Gen Z? I’m not the first analyst, of course, to attempt to answer this question (see, for example, Jonathan Haidt and Jean Twenge’s work). In this post, however, I’m going to be the first to use the novel data provided by the 2022 Cooperative Election Study (CES). The CES has a number of characteristics that may help shed new light on the dynamics behind young people’s (particularly Gen Z’s) deteriorating well-being. To be more specific, the CES surveys a large enough number of Americans (60,000) that there is a sufficient number of Gen Z respondents to draw meaningful conclusions (N=5,484), asks a question about mental health (“Would you say that in general your mental health is…excellent, very good, good, fair or poor?”), and includes a diverse array of questions about who respondents are and what they believe.
Let’s use the CES, then, to get a better sense of the kinds of attributes associated with better (and worse) mental health among Americans 25 and under.
Gender
Figure 6 - Self-Reported Mental Health by Gender among Members of Gen Z
The data displayed in Figure 6 provide show a massive mental health gap based on gender. Men were 16% more likely than women to report “excellent” or “very good” mental health and 33% more likely to report “excellent” or “very good” mental health than non-binary and “other” gender-identifying young people.
Sexual Orientation
Figure 7 - Self-Reported Mental Health by Sexual Orientation among Members of Gen Z
Gay, lesbian, and bisexual members of Gen Z claim their mental health is significantly worse than heterosexual members of Gen Z. As Figure 7 shows, heterosexual young people (35.1%) were more than twice as likely to say their mental health was “excellent” than gay, lesbian, or bisexual young people (13.6%).
Church Attendance
Figure 8 - Self-Reported Mental Health by Church Attendance among Members of Gen Z
According to political scientist, Ryan Burge (author of the indispensable Substack site “Graphs About Religion”), not every dimension of religiosity is equally important from a social, political, and individual perspective. Attendance at church services, as opposed to holding intense beliefs or identifying strongly with a particular religious tradition, is likely to offer the most significant and wide-reaching set of benefits. More directly, using Pew data from 2020, Burge has shown that church attendance is correlated with a lower probability of reporting anxiety, depression, and loneliness.
Consistent with Burge’s insights, church attendance is significantly and positively correlated with the quality of one’s mental health. As Figure 8 shows, those who attend church more than once a week are nearly three times as likely as those who never attend church (19.6% to 53.3%) to claim that their mental health is “excellent” or “very good.”
Marital Status
Figure 9 - Self-Reported Mental Health by Marital Status among Members of Gen Z
Very few 18 to 25-year-olds (8%) are currently married. Yet, marital status is strongly correlated with better mental health among Gen Z. As shown in Figure 9, married members of Gen Z are much more likely (43.8%) to report “excellent” mental health than unmarried members of Gen Z (28.1%).
Education
Figure 10 - Self-Reported Mental Health by Education among Members of Gen Z
Educational differences in well-being are slightly smaller than differences connected with gender, sexual orientation, religiosity, and church attendance. Additionally, contrary to these other variables, educational differences appear stronger on the low end of the mental health spectrum than on the high end. As Figure 10 shows, the educational gap is largest in the “fair” or “poor” mental health category, with those who have at least a college degree approximately 15% less likely to describe their mental health as “fair” or “poor” than those who do not.
Social Media
Figure 11 - Self-Reported Mental Health by Social Media Use among Members of Gen Z
The CES does not include the kind of finely-grained measure of social media usage that would allow us to assess whether there are differences in mental health based on the intensity (i.e. time spent, number of engagements, etc.) and location (i.e. Twitter, Facebook, Instagram, TikTok, etc.) of an individual’s social media activities. It does, however, include an item asking respondents whether they have used social media at all in the last 24 hours. Despite its limitations, I used this item as a rough proxy for social media activity.
Even this overly broad measure suggests a significant relationship between social media use and mental health. Paralleling the relationship with education, the primary difference between social media users and non-users is on the low end of the mental health spectrum. As Figure 11 shows, while 47.3% of daily social media users reported “fair” or “poor” mental health, only 29.2% of those who do not use social media each day did.
Political Ideology
Figure 12 - Self-Reported Mental Health by Ideology among Members of Gen Z
Figure 12 displays the widely discussed ideological differences among 18 to 25-year-olds, with a clear “staircase” pattern of improving mental health as young people become more conservative. As Figure 12 shows, very conservative Gen Z’ers (49.3%) are actually more than twice as likely to say that their mental health is “excellent” than very liberal Gen Z’ers (20.8%).
Military Service
Figure 13 - Self-Reported Mental Health among Active Duty and Civilian Members of Gen Z
As Figure 13 shows, there are vast differences in mental health among members of Gen Z based on whether they are currently serving in the armed forces. To be exact, while 54.2% of Gen Z’ers currently on active duty reported “excellent” mental health, only 28.5% of civilian Gen Z’ers did.
Figure 14 - Self-Reported Mental Health among Veteran and Non-Veteran Members of Gen Z
The differences in mental health between Gen Z’ers broadly and those connected to the military are not limited to those who are currently serving. A similar difference exists between those who previously served and those who have not, with veterans nearly 25% more likely to say their mental health is “excellent.”
What’s Different About Gen Z?
The above analyses show that being heterosexual, being married, being college educated, attending church frequently, serving in the military, and avoiding social media are all associated with better mental health among Gen Z’ers. Yet, all of these things are relatively rare and/or declining among the country’s 18 to 25-year-olds:
Figure 15 - Marriage Rates among American Women by Birth Decade
Let’s start with marriage. Marriage is strongly correlated with better mental health (Figure 9). In 2022, however, only 8% of Gen Z’ers were married. In addition to contributing to Gen Z’s current mental health crisis, this rate puts Gen Z on track for historically low levels of marriage. As indicated in Figure 15, the percentage of women married by age 28 has dropped from each cohort to the next, by about 11 percentage points per decade. If the marriage trends in Figure 15 hold and if marriage continues to be associated with better mental health, the country’s aggregate mental health is likely to become worse in the coming years.
Figure 16 - Church Attendance by Year among 18 to 25-Year-Olds
A similar story can be told about church attendance. Currently, 37% of Gen Z never attend church. As Figure 16 shows, young people were not always this way. Indeed, the share of 18 to 25-year-olds who never attend religious services has been steadily increasing over time. Fewer church attendees means less overall well-being among Gen Z (as indicated by the strong relationship between church attendance at mental health). To the extent that church attendance continues to be associated with improved mental health, this trend bodes ominously for the future.
Figure 17 - Sexual Orientation by Generation
One of the most widely discussed features of Gen Z is the comparatively high percentage of people who identify as lesbian, gay, and bisexual. Data from Gallup, for example, shows that nearly one in five members of Gen Z identify as LGBT (more than five times greater than the rest of adults). Given that these groups provide significantly worse assessments of their mental health than heterosexuals (Figure 7), the growing number of people identifying as gay, lesbian, and bisexual may (if nothing changes) lead to a noticeable overall decline in the country’s mental health.
Figure 18 - College Enrollment by Year
To date, only 15% of Gen Z have graduated from college. While this number will undoubtedly increase as Gen Z ages, there are some indicators suggesting this increase will be smaller than expected. Perhaps the most important is college enrollment (a leading indicator for college graduation). In Fall 2020, there was a 4.3% decline year-over-year. Preliminary data indicate that total postsecondary enrollment fell by another 14.7% between Fall 2020 and Spring 2022. Assuming college graduation continues its strong association with mental health (as shown in Figure 10), the decline in college graduates will mean fewer mentally well Americans.
Figure 19 - Likelihood of Serving in the Military among American Teenagers
While Gen Z’ers constitute a relatively larger share of the military than other generations, less than one-half of one percent of Americans serve in the armed forces at any given time. According to the JAMRS surveys, the propensity to serve among 16 to 21-year-olds has steadily decreased over the last few years. The small number of Gen Z’ers with a connection to the military limits the overall significance of military service to the country’s current and future mental health situation. Nevertheless, it is important to point out that, much like church attendance, marriage, and college enrollment, there is declining interest in military service among American youth.
Figure 20 - Social Media Use among Teenagers by Year
According to the Pew Research Center, approximately half of 18 to 29-year-olds are online “almost constantly,” with the bulk of this time being spent on social media apps such as Instagram, Snapchat, and TikTok. As Figure 19 shows, older Americans spend far less time on social media. While we obviously need better, more nuanced measures of social media use to draw firmer conclusions than the ones presented here (Figure 11), it does appear that Gen Z’s social media use has been (and will continue to be) an important part of the story of their mental health struggles.
Figure 21 - Political Ideology by Generation
Last but certainly not least is Gen Z’s rejection of political conservatism. As Figure 20 shows, Gen Z is currently the most liberal and least conservative generation, with Gen Z roughly twice as likely to identify as liberal than Silent Generation members or Boomers. If Gen Z does not get more conservative as they age and political ideology continues to be strongly associated with mental health, we could see a worsening national, mental health picture going forward.
Overall, then, the beliefs and behaviors of Gen Z: (1) are distinct from those of previous generations; (2) strongly associated with poor mental health; and (3) appear to be trending away from previous generations and away from those most strongly associated with better mental health.
What This Analysis Can (and Can’t) Tell Us About Gen Z’s Mental Health
There are five important things to point out about the analyses presented above. First, these bivariate relationships illustrated in each of the above figures hold up in a multivariate analysis that controls for other important causal variables. To be more precise, I ran a multivariate OLS regression model predicting self-reported mental health on the basis of race, gender, sexual orientation, political ideology, family income, education, religiosity, marital status, parenthood, social media use, and military service (active duty and veteran). As the coefficient plot in Figure 22 shows, every one of the relationships documented above remains significant even after the addition of statistical controls.
Figure 22 - Multivariate OLS Regression Analysis Predicting Self-Reported Mental Health among Members of Gen Z
Second, the findings presented here provide additional confirmation for the congealing conventional wisdom about the determinants of mental health among young people. Most recent accounts of Gen Z’s mental health have focused on the role that gender and political ideology play in shaping well-being. A recent paper by Gimbrone et al., for example, identified a large and accelerating gap in well-being between liberal and conservative teens. As their analysis also showed, liberal girls have consistently expressed more depressive attitudes than liberal boys (Figure 23).
Figure 23 - Depressive Affect Scores by Gender and Ideology among American Teenagers
Extending Gimbrone et al.’s analysis of the MTF data through 2021, Zach Goldberg finds widening gender and ideological disparities in measures of depression, self-esteem, life satisfaction, self-derogation, loneliness, and general well-being. Goldberg shows, for example, recent growth in the “female-to-male” and “liberal-to-conservative” gaps with respect to seeing a “doctor or other health professional at least once for some emotional or psychological problem of symptom in the past 12 months” (Figure 24).
Figure 24 - Treatment for Emotional or Psychological Problems by Gender and Ideology among American Teenagers
Similar to studies of American teenagers, these studies also reveal that women and liberals are more likely to experience mental health issues (with the largest differences existing among younger adults). Jonathan Haidt, for instance, used a 2020 Pew survey on formal mental health diagnoses to show that a majority of 18 to 29-year-old liberal women have been told by a “doctor or healthcare provider” that they “have a mental health condition.”
Figure 25 - Mental Health Diagnoses by Age, Gender, and Ideology
There are also gender and ideological differences in “life satisfaction.” As Brad Wilcox writes, “Liberals, especially liberal women, are significantly less likely to be happy with their lives and satisfied with their “mental health”, compared to their conservative peers aged from 18-55.”
Figure 26 - Life Satisfaction by Gender and Ideology
Summarizing this work in an incredibly thoughtful and thorough review of the literature that should be read by everyone with an interest in these topics, Musa al-Gharbi writes:
“the well-being gap between liberals and conservatives is one of the most robust patterns in social science research. It is not a product of things that happened over the last decade or so – it goes back as far as the available data reach. The differences manifest across age, gender, race, religion, and other dimensions. They are not merely present in the United States, but in most other studied countries as well.”
The data in Figures 6 and 12 are, of course, entirely consistent with each of these accounts. To further illustrate this consistency, Figure 27 shows the interaction between gender and ideology among members of Gen Z in the CES data.
Figure 27 - Self-Reported Mental Health by Gender and Ideology
Figure 27 again shows that conservatives report higher levels of mental health than liberals and that the relationship between ideology and well-being is conditioned by gender.
The coefficient plot in Figure 22 also helps us expand on these previous studies. For example, some have suggested that the well-being gap is simply a product of conservatives being more religious, more likely to be married, and more likely to be male. While all of these things are true (e.g. 17% of Gen Z’ers that attend church more than once a week are married but only 6% of Gen Z’ers that never attend church are), being more conservative exerts an influence independent of these factors. The benefit of more conservative views manifests even when controlling for all other influences on mental health.
While the analysis here helps us start to identify the aspects of conservatism that produce better mental health by ruling out the confounding effects of gender, marriage, and religiosity, there are a wide range of other possible explanations that our data cannot speak to. As al-Gharbi summarizes:
some have argued that the apparent psychological benefit of conservativism actually comes from feeling deeper connections with one’s country, one’s family and the Divine….In a similar vein, studies have repeatedly found that conservatives – both politicians and laymen – tend to be more conventionally attractive than liberals (and have better sex lives). Moreover, people who are healthier in childhood have been shown to be more likely to become conservative as adults. Meanwhile, people with high measured cognitive ability are also more likely to support economic conservativism (and cultural liberalism)…. conservativism and ideological fellow travelers (religiosity, patriotism) may help people make sense of, remain resilient in the face of, and respond constructively to, inequality and misfortune – irrespective of where they fall on the social strata. Liberal ideology, by contrast, may not provide the same benefits to adherents.
As suggested above, the CES does not allow us to test all of these possibilities. What’s most important for our purposes here, however, is that these findings once again show that even among Gen Z, conservatism is correlated with better mental health (independent of gender, religiosity, and marital status).
Third, the findings here also allow us to highlight some previously under-discussed correlates of mental health among young people. Most notably, the results presented here allow us to make some initial observations about military service’s relationship to mental health. There is extensive and much-needed reporting on mental health issues among active duty members of the military and veterans. Most of this reporting focuses on the prevalence of serious mental health issues, such as PTSD and suicide. A consistent theme of this research is that those connected to the military (now or in the recent past) have a higher (though time-varying) risk of experiencing major mental health problems. For example, 7% of veterans will experience PTSD at some point in their life (compared to 6% of Americans in the general population). Similarly, after adjusting for the demographic differences between the military and the rest of the American population (e.g. accounting for the fact that the military is disproportionately young, white, and male), the suicide rate among members of the military has fluctuated from slightly lower than the public more generally (e.g. 17 per 100,000 compared to 20 per 100,000 in 2010) to much higher (e.g. according to Defense Department data, suicides among active-duty service members increased by more than 40% between 2015 and 2020).
Regardless of the actual numbers, however, the perception among many Americans is that military service is bad for mental health. In fact, the perceived negative mental health consequences of military service have become a major problem for military recruitment among young people. According to the JAMRS surveys (conducted by the Department of Defense on a tri-annual basis to measure young people’s propensity to serve in the military), the “possibility of PTSD or other emotional/psychological issues” are a primary reason many young Americans say they would not consider joining the military. In fact, concerns about these mental health issues have been the second most frequently cited reason to avoid military service since at least 2017 (consistently mentioned by more than half of those who do not want to serve).
Yet, the relationship between military service and other, less formal measures of well-being receives far less attention. Part of the reason why is that it is difficult, if not impossible, to use nationally-representative surveys to compare those with military backgrounds to those without. Even if a survey asks both a question about mental health and questions about military service, it typically includes only 20 to 30 members of the military and only 40 to 50 veterans. The samples will be even smaller (often a dozen or so) if attempting to look at the role that military service plays among young people. With sample sizes this small, it is impossible to draw conclusions about the mental health impact of military service. We are left, instead, with data about only the most extreme (and, often, formally diagnosed) mental health problems.
As shown above, members of Gen Z that are currently serving or that have previously served report significantly better mental health than members of Gen Z that have not. This relationship is large and exists net of statistical controls. As I discuss below, we should be cautious in interpreting these results. It is possible that this is a selection effect (i.e. more mentally healthy people choose to join the military in the first place) rather than a causal effect resulting from military service itself. It also should not be taken to minimize the serious and negative consequences that military service has had on a large number of young Americans. It should, however, be part of a broadening conversation about how both military and civilian young people are coping with mental health struggles.
Fourth, the role that gender, sexual orientation, religiosity, marriage, education, active duty military service, and social media use play in mental health is not unique to Gen Z. In fact, these variables appear to connect with mental health perceptions in the same way among all Americans. Indeed, running the same multivariate, OLS regression model for Americans over 25 years old that I ran for Americans between the ages of 18 and 25, produces strikingly similar results:
Figure 28 - Multivariate OLS Regression Analysis Predicting Self-Reported Mental Health among All Americans
As Figure 28 shows, being a man, being a heterosexual, being married, being college educated, attending church frequently, currently serving in the military, and avoiding social media are all associated with better mental health among members of the Silent, Boomer, Gen X, Millennial, and Gen Z generations.2 In other words, what has worked before from a mental health perspective appears to be working again.
This insight helps us assess why so many in Gen Z describe their mental health as “fair” or “poor” rather than “excellent” or “very good.” Before analyzing the data, we could not rule out the possibility that the variables shown to positively influence mental health among previous generations (e.g. a college degree, church attendance, etc.) do not exert the same impact on Gen Z. It was possible, for example, that marriage (which has historically been associated with better mental health) is no longer correlated with better mental health among Gen Z because it is no longer seen as a necessary condition for maintaining a meaningful relationship and raising children. If this were true, mental health outcomes could become worse even with an increase in marriage rates among Gen Z.
The evidence presented here deals a serious blow to this kind of argument. Indeed, given that the correlation between well-being and gender, sexual orientation, religiosity, marriage, education, active duty military service, and social media use is roughly the same for Gen Z as it is for other generations, we can be more confident in the argument that the worsening mental health of Gen Z is simply a function of having fewer people doing the things that are associated with well-being (which I documented in the previous section).
Finally, cross-sectional analyses like the one presented here have a number of problems when it comes to making compelling causal arguments. Two of these problems are particularly important for this analysis: selection effects (e.g. married people might have better mental health not because marriage produces better mental health but, instead, because people with better mental health choose to get married) and omitted variable bias (e.g. because the analysis does not control for the presence of permanent disability, serious illness, physical attractiveness, etc.) it is producing biased conclusions about the impact of the other variables on mental health). As a result of these two problems, I have avoided using causal language here and the findings should not be used to argue that marriage, a college degree, military service, adopting conservative political ideology, or social media use will lead to better mental health. As always, more work (and better) data is needed.
I searched the Pro-Quest Newspaper Archives for articles mentioning “mental health” AND at least one of the other following terms: “anxiety,” “depression,” “bipolar,” “bi-polar,” “Post-Traumatic Stress Disorder,” “PTSD,” “obsessive-compulsive,” “OCD.” Keywords to identify articles about young people also included one of the following terms: “Gen Z,” “Generation Z,” “teenagers,” “teens,” “adolescent,” “adolescents,” “high school students,” “high schoolers,” “children,” “kids,” “Millennials,” “young people,” “youth.”
Two caveats are in order here. First, some of the regression coefficients are significantly larger among Gen Z than among older Americans (e.g. being a woman relative to a man and receiving a college degree relative to not). This suggests that these variables are more important for Gen Z than they were for Silent, Boomer, Gen X, and Millennial generation Americans. More work is needed to unpack these differences. Second, the impact of being a veteran is not only different in magnitude for Gen Z compared to older generations, it is also working in the opposite direction. As Figure 26 shows, being a veteran relative to not being a veteran is actually associated with worse mental health among Silent, Boomer, Gen X, and Millennial generation members. I will have more to say about this in another post but, for now, it is enough to point out that these differences are largely a function of the military conflicts members of different generations were asked to fight in. Put differently, there is nothing intrinsically beneficial from a mental health standpoint about military service.
It’s possible that the rigors of boot camp weed out the mentally shaky. My stepson, who recently went through boot camp, witnessed quite a few people get tossed out purely because they couldn’t hack it, mentally.
Also, is it possible to compare the data to the same age spreads in previous eras? What I mean is, back in the 1990s, when Gen Xers were 18-25, how was their mental health compared to all older generations? Just want to make sure this isn’t just the self-reported drama and ennui of youth, a sort of Hamlet complex, if you will.
As a parent of three in Gen Z, your cogent analysis rings true. Even within my family, I see mental health differences based on several of the characteristics mentioned.
In the data you examined, is there anything about the feeling of the larger culture? Every decade has felt quite different to me - but it feels right now that the culture at large is uncertain of the future, and pessimistic. Where is the ‘morning in America’ to give optimism of the future?
Thank you for writing about this important topic.