Mental Health and Substance Use: A Crisis for California’s Youth


Earlier this year, CHCF published two Almanac reports: Mental Health in California: For Too Many, Care Not There and Substance Use in California: A Look at Addiction and Treatment. This report, Mental Health and Substance Use: A Crisis for California’s Youth (PDF), and an accompanying infographic focus on youth-specific data from those two publications to paint a picture of California youth and the behavioral health conditions they face.

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A growing number of youth in California experience mental illnesses and substance use disorders (SUDs). The incidence of major depressive episodes in adolescents has increased over the last five years, as has the national rate of alcohol and drug use. Unfortunately, access to mental health and SUD treatment falls far short: A majority of youth do not receive treatment.

Behavioral health conditions are illnesses of pediatric origin. Half of all mental illnesses appear by the mid-teens and three-quarters by the mid-20s. Many people first use alcohol, marijuana, and other drugs during adolescence, and studies have shown that the earlier people start, the greater the risk of later developing a substance use disorder.

For adolescents, mental illnesses and substance use disorders often occur together. As many as 60% to 75% of adolescents with substance use disorders are estimated to have a co-occurring mental illness. In some cases, substance use may begin as a strategy for self-medicating to manage psychiatric symptoms.

Key Findings:

  • The prevalence of serious emotional disturbance in children and adolescents varied by income, with much higher rates at lower income levels.
  • The rate of depression has been steadily increasing among teens in California and the US. One in eight teens reported a major depressive episode in 2014–2015, up from one in 11 in 2011–2012. Two-thirds of adolescents with major depressive episodes did not get treatment.
  • One in nine high school girls in California attempted suicide in 2015.
  • By 11th grade, about half of California students have used alcohol and almost 40% have used marijuana.
  • Nine percent of adolescents 12 to 17 reported using alcohol in the past month. Five percent reported binge use.

The full report, all of the charts found in the report, and an infographic are available under Related Materials. These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape.