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Youth Risky Behavior and Mental Health in the U.S and New England

Updated: May 26, 2021

By Hailey Jordan, CEI Intern

The Youth Risk Behavior Surveillance System (YRBSS) was developed in 1990 to keep track of health behaviors that contribute to the leading causes of death, disability, and social problems among youth in the United States (YRBSS, 2019). The YRBSS is a useful resource for evaluating trends in health behavior over time and comparing data among subpopulations of youth. The YRBSS includes six main categories of risky health behaviors:

  1. Unintentional injuries and violence

  2. Tobacco use

  3. Alcohol and drug use

  4. Sexual behaviors related to unintended pregnancy and sexually transmitted infections (STIs)

  5. Inadequate physical activity

  6. Unhealthy dietary behaviors

Mental Health and Risky Behavior among U.S Youth

From 1991 to 2019, the YRBSS gathered data from nearly five million U.S high school students through more than 2,100 surveys administered on the national, state, territorial, tribal government, and local school-based level. Biannual survey results show a connection between mental health and risky behavior among U.S youth: poor mental health can increase the likelihood of youth participating in risky behaviors.

The YRBSS measures mental health with five questions related to constant feelings of sadness or hopelessness as well as suicidal thoughts in the past year. There was a significant increase in high school students who experienced persistent bouts of sadness and hopelessness from 2007 (28.5%) to 2017 (31.5%). A similar 10-year trend exists for youth who seriously considered attempting suicide, made a suicide plan, or suffered from injury in a suicide attempt (YRBSS, 2019). These findings highly suggest there is room to improve upon mental health promotion efforts among youth and limit their participation in risky behavior.

Youth Mental Health and Risky Behavior in New England

It is also important to explore the relationship between youth mental health and risky behavior on a regional level. Comparing survey results with that of the entire U.S. reveals differences worthy of discussion. In the New England area, high school students are at less risk of feeling sad and hopeless and experiencing suicidal thoughts (e.g. making a suicide plan, considering a suicide attempt) than those in the rest of the country (YRBSS, 2019). According to Mental Health in America (2020), youth in New England also have lower prevalence of mental health issues and higher rates of access to care.

Despite New England’s outstanding ranking in youth mental health, there are findings on the state level that tell a different story. Here are statistics from the YRBSS (2019) that indicate greater likelihood of specific risky behavior as compared to the rest of the United States:

  1. Youth were more at risk of being bullied on school property in Maine (22.4%) and New Hampshire (23.0%) than those in the rest of the U.S. (19.5%).

  2. Youth were more at risk of being bullied online in Maine (18.0%) and New Hampshire (20.1%) than those in the rest of the U.S. (15.7%),

  3. Youth were more likely to carry a weapon on school property in Vermont (4.9%) and Maine (4.6%) than those in the rest of the U.S. (2.8%).

  4. Youth were more at risk of smoking 10 cigarettes per day in New Hampshire (16.1%) and Vermont (13.1%) than those in the rest of the U.S (8.1%).

Addressing Youth Risky Behavior with School-based Mental Health Care

Greater numbers of youth presenting with behaviors that contribute to the leading causes of death and disability can be seen as a reflection of inaccessible mental health resources in an area. School districts in New England and across the country can play a role in reducing risky behavior among students by providing school-based mental health services that promote social emotional learning, resilience, and positive relationships with others (NASP, 2016).

Employing mental health staff in the school setting is an effective strategy for creating a safe environment for all youth—including those who are at-risk, have chronic problems, or exhibit no mental health issues (NASP, 2016). School districts in the U.S. can also collaborate with school-based mental health professionals and educators on implementing prevention programs that reduce youth risky behavior (i.e. anti-bullying and anti-violence). Better access to mental health care and school wide interventions can make a huge difference in how youth handle emotional, physical, and social distress.

Educators and school-based mental health providers can work together to improve mental health and lessen risky behavior among U.S. youth. Using the YRBSS to determine trends in risky health behaviors is a solid first step in identifying how youth respond to life stressors. Tailoring school-based mental health care and prevention programs to what is seen among subpopulations of youth is an ideal next step in addressing poor mental well-being and youth risky behavior.


Mental Health America. (2020). Mental health in America – youth data. Mental Health America.

National Association of School Psychologists (NASP). (2016). School-based mental health services: Improving student learning and well-being. NASP.

Youth Risk Behavior Surveillance System (YRBSS). (2019). 2019 YRBSS results. Centers for Disease Control and Prevention.

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