Emotional Well-Being of Children Studied

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CDC’s National Syndromic Surveillance Program’s (NSSP) monitoring of ED data showed a seasonal increase among children and adolescents ages 10–17 years for mental and behavioral conditions during the school year. These data showed that visits for eight mental and behavioral health conditions began increasing during the typical back-to-school period and remained elevated throughout the school year when compared to the summer.

Increases begin at the start of the school year, which raises questions about the challenges children face at school. Findings in previous reports about child and adolescent mental health also show a striking seasonality in ED visit trends.

Collaborative effort

NSSP surveillance experts examined changes in the number and proportion of weekly ED visit data for mental and behavioral health conditions in January 2018 through June 2023 among U.S. children and adolescents aged 5–17 years, stratified by age group (5–9 years, 10–14 years, 15–17 years). To get further insight into the emotional health and well-being of U.S. children and adolescents in relation to the academic year, subject experts from multiple centers at CDC collaborated with the Children's Hospital at Vanderbilt, District of Columbia Office of the State Superintendent of Education, federal partners from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Department of Education, and frontline public health experts from eight health departments—Arizona, Colorado, District of Columbia, Kansas, Kentucky, New Mexico, North Carolina, and Tennessee.

Findings from this collaborative study show the value of systemic changes that prioritize protective factors (e.g., physical activity, social support, and inclusive school and community environments) and incorporate preparedness for increases in mental and behavioral health conditions during back-to-school planning.

Things we can do

Awareness of these data is the first step toward improving connections across children, parents, clinicians, and schools to protect children's mental and behavioral health.

• Parents: You know your child best. Talk to your child's health care professional if you have concerns about your child's mental health or the way your child behaves at home, in school, or with friends. There are things you can do to work with your child's school to reinforce behaviors that contribute to a healthy and supportive school environment.
• Health care professionals: Early diagnosis and appropriate treatment of mental health concerns, using evidence-based guidelines, are very important. Screening and referral during health care visits can support early identification.
• Teachers/school administrators: Early identification is important so that children can get the help they need before mental health concerns reach a crisis point. Schools, families, and health care professionals can work together if there are concerns about the mental health of a child in your school. This CDC toolkit for schools can help your school promote parent awareness about school connectedness and emotional well-being.

Why studies like this matter

ED data give insight into who seeks care and why—symptoms, demographics, and trends—to help practitioners decide whether a larger public health response is needed.

Eight conditions that may increase during the school year

• Depressive disorders
• Suicidal ideation or self-harm
• Trauma- and stressor-related disorders
• Cannabis-related disorders
• Lifestyle or life management factors
• Mood disorders
• Poisoning by drugs
• Symptoms of mental and substance use conditions