Is youth mental health declining – or are we simply paying more attention?

Girls and low-performing students receive the least support

Girls, low-performing students, and students with parents who have low levels of education show the greatest decline in well-being—a deterioration that coincides with increasingly uneven distribution of resources and support.

– Low-performing girls and students with difficulties receive the poorest type of simplified and positive support, while boys generally receive better quality support, regardless of performance level.

Alli exemplifies high-quality support as when a teacher creates clear structures and promotes student learning—while all students work on the same tasks. Low-quality support, on the other hand, means the teacher gives certain students simpler or different tasks compared to the rest of the class.

One thing Alli has particularly noted is how important “cognitive well-being” is—that is, how much students believe in their own abilities. This seems to predict grades more than their actual capacity. She sees this as a strong incentive to strengthen students’ sense of success early on and through the right support.

– If we constantly raise the bar and think it’s okay for some to fail, we create exclusion. The purpose of school and teaching is for students to develop academic knowledge, but also social and emotional competence. Right now, we’re very focused on knowledge, but knowledge doesn’t develop in isolation—it depends on also feeling well.

Increased mental health issues – a possible consequence of school reforms

Björn Högberg’s research also clearly shows that school is a central arena for young people’s well-being. As Associate Professor at Umeå University, he has studied the link between school performance and mental health.

The extensive school reforms of the 1990s, with high demands on performance, have according to him contributed to the negative health trend — with goal-related grading, extended vocational programs, and tougher requirements for completing upper secondary school.

There’s also evidence that the school reforms of 2010–2012—with earlier grading, a new grading system where the weakest performance determines the final grade, and stricter requirements for upper secondary eligibility—have contributed to certain groups of students experiencing greater mental health issues. Teachers’ work also changed after the latter reform package, requiring more time spent on assessment and documentation.

– The assessment aspect is the most stressful and anxiety-inducing for students. That teachers have had to spend more time on it reinforces this, he explains.

According to Björn, the new structure has affected the sense of belonging in school — some students are left out of the community.

– We have a school system that penalizes students who struggle with theoretical subjects. On top of that, we have a labor market that is tougher on people with low qualifications because there are fewer simple jobs and competition for them is higher.

The changes in school seem to have hit low-performing girls harder, who are more likely to have been treated for depression and anxiety.

– There’s a perception that boys are hit harder, become more aggressive, school refusers, or end up in crime. But things seem to go quite badly for low-performing girls too, though they fly under the radar, he says.

For foreign-born students, the pattern looks different. The link between performance and mental health is weaker and more stable over time. Björn believes the difference may partly be due to their school results being influenced by other factors than those of Swedish-born students—such as a stronger belief in the future.

– Young immigrants in Sweden are significantly more optimistic. They don’t become less motivated when things go poorly in school—they have a much stronger belief that they’ll have a better life.

Mental health doesn’t always align with overall well-being

A more complex picture than what school alone can provide emerges regarding mental health—both in Sweden and neighboring countries. Charli Eriksson, senior research specialist and professor at Karolinska Institutet, leads a Nordic research project analyzing youth mental health from 1986 to 2026 based on eight different complaints.

The study shows that young people’s mental health has worsened, but their self-rated health and life satisfaction have not. This suggests that complaints and well-being don’t always go hand in hand.

He emphasizes the importance of recognizing that things look different for different groups of youth and that simply counting the number of complaints isn’t enough.

– We’ve studied this in the five Nordic countries and found that those with complaints such as stomach aches, headaches, and sleep problems but who otherwise feel fairly well have increased significantly—especially in recent years and among girls. The group of young people with many psychosomatic symptoms and poor well-being has increased somewhat. The latter experience more stress, loneliness, poorer communication with parents, worse health habits, and like school less than the former.

The project also examines everyday habits, such as eating habits, sleep, and family interactions. Eating breakfast and having shared family meals are linked to higher life satisfaction and fewer health complaints.

Sleep also proves—unsurprisingly—to be important for mental health. In the Nordic countries, more and more children aged 10 to 17 report difficulty falling asleep. Reduced life satisfaction, decreased physical activity, feeling down and nervous often correlate with sleep difficulties.

Charli warns that the problems have increased throughout the Nordic region—even though the trend in Sweden has been somewhat more stable compared to other countries.

Family relationships, and especially communication with parents, also proved to be linked to young people's well-being. The problems tend to be greater when communication with the father is lacking than when it doesn’t work with the mother.

– The biggest problems arise when communication with both parents is weak, Charli explains.

More young people turning to civil society and healthcare for help

More young people than ever are seeking support from Bris. More are also seeking help for self-harming behavior and eating disorders within civil society and healthcare, according to statistics from both Bris and the National Board of Health and Welfare.

Nicole Wolpher, a social worker and policy representative at the National Collaboration for Mental Health (NSPH), sees increasing pressure on young people.

– Many describe a sense of stress related to school and performance. This can lead to exhaustion, and some may not even be able to attend school, she says.

Social media is another factor that young people must navigate, with the pressure of constant connectivity and the risk of exposure to unhealthy ideals. But according to Nicole, it can be a double-edged sword.

– It can negatively affect young people's self-image, but at the same time, social media can also offer support and a sense of community.

Nicole calls for more resources in and around schools, as well as better competence regarding mental health and neuropsychiatric disabilities. Support for many students often comes too late and is insufficient.

– For school to work for students with neuropsychiatric disabilities, functioning support is often needed outside of school as well, through the region or municipality. If the demands are too high and the right support isn’t provided, it can often manifest as mental or psychosomatic illness.

Waiting times in youth psychiatry and primary care are, according to her, a major obstacle. What many young people are asking for is access to safe, present adults. Civil society can also contribute, Nicole believes.

– One important task we have is to identify what needs to be addressed and take it further. Is society missing something important? What do different target groups say? Our organizations aren’t meant to replace healthcare, but to provide support on a human level. For many young people, the first experience of telling someone what they’re going through is crucial for how they approach seeking further help.

She concludes by emphasizing the importance of hope for the future.

– Society needs to work harder to instill hope for a sustainable future—in everything from the labor market to the climate. If young people can see opportunities and believe the future can be good, it affects how they feel about the rest of their lives.