Teen Mental Health Statistics North Carolina

Teen mental health continues to be a significant concern in North Carolina (NC), particularly in the aftermath of the COVID-19 pandemic. The situation has been exacerbated by long-standing issues such as the inaccessibility of treatment, stemming from decades of underfunding, and persistent stigma surrounding mental health care. This crisis, which predates the pandemic, has markedly impacted young people, highlighting the urgent need for attention and action in North Carolina.


  • Nearly two out of three teenagers (ages 12 to 17) diagnosed with depression in North Carolina don’t receive treatment.
  • From 2019 to 2021, the risk of teenagers experiencing one or more major depressive episodes increased by 46%.
  • In 2021, 22% of NC high school students said they seriously considered attempting suicide during the past year.
  • In 2021, 10.1% of high school students attempted suicide, a 23.2% increase from 2017.
  • From 2018 to 2019, 15.1% of adolescents experienced past-year major depressive episodes.  
  • Only 43.3% percent of adolescents aged 12 to 17 with major depressive episodes received treatment for depression in 2019.              
  • The number of ED visits by North Carolina youth (aged 12 to 17) for mental health dif­ficulties increased five-fold for suicide-related behaviors from 2011 to 2020.  
  • Firearm-related death rates among adolescents in North Carolina rose by 23.1% from 2020 to 2021.

General Insights

Concerns regarding youth mental health have intensified in recent years due to various factors affecting young people’s well-being. These factors include social isolation, disruptions in support services, and stressors related to various life challenges. Consequently, there has been a noticeable increase in mental health and behavioral issues among teenagers, with statistics indicating a growing prevalence of depression, anxiety, and suicidal ideation.

  • In 2022, 11% of North Carolina children aged 3 to 17 received a diagnosis of depression or anxiety from a healthcare provider. This is up from 7.6% in 2016 — a 48.7% increase.  
  • In 2021, only 49% of North Carolina high school students said they felt good about themselves. This figure was 80% in 2011.
North Carolina High School Students Emotions infographic
  • Among high school students, the rate of suicidal ideation rose from 16.2 percent in 2017 to 22.3 percent in 2021, according to the Youth Risk Behavior Survey. This indicates that one in five students seriously considered attempting suicide during the past year.
Suicidal Behaviors in North Carolina Highscoolers chart graph
  • In 2021, one in ten students reported having attempted to end their lives.
  • In 2020, over 10% of children aged three to 17 in North Carolina received a diagnosis of mood disorders like depression or anxiety. That’s a 49% increase from 2016.
  • Around 23% of children in North Carolina experienced at least one mental, emotional, developmental, or behavioral challenge in 2020. That’s a 22% increase from 2017, when this rate was 18.9%.
  • In 2019, suicide was the leading cause of death for chil­dren in North Carolina in the 10–17 age group.
  • In 2020, 67 children in North Carolina died by suicide between ages 0 and 18. A year later, 62 adolescents aged 10 to 17 died as a result of suicide. These are the highest rates in two decades, largely affecting older teens.  
  • The Youth Risk Behavior Survey revealed that 43% of high school students expressed feelings of sadness or hopelessness, with less than half indicating a positive self-perception. Around 33% also reported experiencing a sense of loneliness in their lives.
High SChool Students Who Felt Hopeless or Sad in NC statistics over time
  • From 2018 to 2019, 15.1% of adolescents experienced past-year major depressive episodes. This is up 25.8% from 2017 to 2018.
  • Only 43.3% percent of adolescents aged 12-17 with major depressive episodes received treatment for depression in 2019. This is barely 5% up from 41.4% in 2018.        

Effects of Mental Health Problems

The decline in the mental health of NC teenagers has led to an increase in serious public health problems like homicide. These are devastating families and communities across North Carolina.

  • The rates of firearm-related deaths, predominantly attributed to homicide and suicide, increased by 23.1% among adolescents in North Carolina from 2020 to 2021.
  • In a 2021 survey, 30% of North Carolina high schoolers reported that it would take them less than an hour to get a loaded gun without an adult’s permission. (2021 North Carolina Youth Risk Behavior Survey)
Firearm related Deaths North Carolina
  • Between 2011 and 2020, the volume of emergency department visits for mental health challenges doubled, and incidents related to suicidal behaviors saw a five-fold increase. Barely 20% of these ED visits were supervised by a behavioral health expert.
  • In 2020, suicide was the primary cause of death for NC teenagers aged 15 to 17 at 67.7% and those aged 10 to 14 at 32.2%. Homicide was the second-leading cause of death among adolescents at 10.4% to 62.4% for those aged 10-14 and 15-17.
Cause Of Death, Suicide/Homicide in teens
  • From 2012 to 2021, the rates of suicide in children aged 10 to 17 increased from 1.5 % to 2.7%, while the rates of homicide increased from 2.1% to 4.1%.  
Leading Causes of Youth Death in North Carolina
  • In 2021, there were 783 hospitalizations and 3,362 emergency department visits related to self-injury among individuals aged 10 to 17. Females aged 10 to 14 experienced a 46% increase in self-inflicted injury emergency department visits among those reporting to the hospital. (NC DETECT Emergency Department Visit Data, 2016-2021)
  • There were 54,770 suicidal ideation-related emergency department visits in 2022, and out of these, 54% of visits were by males and 46% were by women.
  • In 2022, there were 14,154 self-inflicted injury-related emergency department visits. About 63% were by females and 37% were by males. Moreover, 40% of self-inflicted injury-related hospital visits also contained a code for suicidal ideation.
Suicidal ideation teens north carolina
  • Rural areas accounted for six out of the ten counties with the highest burden of emergency department visits related to suicidal ideation in 2022. These counties included Swain, McDowell, Robeson, Transylvania, Scotland, and Vance, with rates ranging from 82.2 to 67.2.
  • In 2022, youths aged 10 to 17 made the third-highest proportion of hospital visits related to suicidal ideation at 23% and the highest for self-inflicted injury at 37% of all total visits, according to the North Carolina Department of Health and Human Services. This indicates that younger populations are predominantly affected by suicidal ideation and self-inflicted injury.

LGBTQ Youth Mental Health Statistics

The increased risk of suicide among young LGBTQ individuals is not inherent to their sexual orientation or gender identity. Instead, it stems from the mistreatment and societal stigmatization they experience in North Carolina.

  • In 2022, 74% of North Carolina LGBTQ youth reported symptoms of anxiety, with the percentage rising to 81% among transgender and nonbinary youth.
  • Additionally, 60% of LGBTQ youth and 70% of North Carolina transgender and nonbinary teenagers (aged 13 to 17) experienced symptoms of depression.
  • In 2022, 58% of LGBTQ youth in North Carolina who sought mental health care in the past year were unable to access it. This was because they were afraid to talk about their mental health concerns, they didn’t want to get their parent’s permission, they could not afford it, they were afraid they wouldn’t be taken seriously, and or thought it wouldn’t work.
Access to LGBTQ Mental Health Treatment For Teens In North Carolina
  • According to the Youth Risk Behavior Survey, the rate of suicidal ideation for gay, lesbian, or bisexual students was 48% in 2021.
  • In 2022, 46% of LGBTQ youth aged 13 to 17 in North Carolina seriously considered suicide, with this percentage rising to 53% among nonbinary and transgender youth. This stemmed from discrimination based on sexual orientation or gender identity that negatively impacted their well-being.
  • About 12% of LGBTQ teenagers and 15% of transgender/nonbinary teenagers in North Carolina attempted suicide from January to December 2022.

County Statistics

Youth mental health has been declining for years in North Carolina, especially in counties like Durham, Forsyth, and Harnett with an increase in at-risk behaviors, self-harm, and teen suicide.

Durham County

  • One in three middle school (34%) and two in five high school students (41%) reported feeling sad or helpless for more than two weeks in the past year, according to the 2021 Youth Risk Behavior Survey (YRBS) Report for Mental Health in the Durham Area.
  • The same report showed that high schoolers were 21% more likely to report not feeling good about themselves compared to adolescents. This was because COVID-19 restrictions led to the cancellation of events like birthday parties, prom, sleepovers, and graduation, which meant the social support these teens needed was gone.
  • In 2021, while most high school students reported never harming themselves, around 6.2% harmed themselves at least once and 6.8% harmed themselves twice or thrice. Females were twice or thrice as likely to harm themselves at least two times and five times as likely to do it four or more times compared to male high schoolers.
Self Harm Amongst HS Students North Carolina
  • Hispanic/Latino and African Americans were at a higher risk of self-harm compared to their white peers in 2021.
  • Around 9% of high schoolers reported attempting suicide, while 12% of middle school students tried to attempt suicide in 2021.  
  • Teen emergency room visits for attempted suicide rose 51% from 2019 to 2020.
  • Female high school students were at a 43% higher risk of having depression, while male students were at a 27% risk in 2019. Middle school students had similar rates of depression at 41% for females and 25% for males.
Middle School Depression Durham County NC
  • In 2019, 19% of high school students considered committing suicide in the past year, which is 25% higher than the 2017 average. Female, Latino, and African American students were more likely to plan and attempt suicide.
  • Around 27% of middle school students thought about committing suicide during their lifetime in 2019, an increase of 19% since 2017. Students with African American or Hispanic backgrounds were more likely to consider suicide compared to white students because of differences in access to mental health services.
Middle School Depression Durham County NC

Forsyth County

  • In 2021, 22.5% of middle school students seriously considered attempting suicide, 14.1% made a suicide plan, and 11.5% attempted suicide.
  • The number of youth depression-related emergencies was above 5,000 every year from 2017 to 2019 in Forsyth County. It fell to 2,950 visits in 2020 and 4,243 in 2021, which were most likely lower because of COVID-19-related policies.
  • According to the 2019 Youth Risk Behavior (YRBS) Middle School Results, 28.7% of Forsyth County middle school students felt hopeless or sad for at least two weeks or more in the previous 12 months. About 27.3% were willing to talk to their parents about their issues, 22.5% seriously considered suicide, 14.1% made a suicide plan, and 12.4% attempted suicide.
  • The same survey also showed that 35.2% of Forsyth County high school students felt hopeless or sad for at least two weeks or more in the previous 12 months, 21.6% considered talking to their parents, 19.7% seriously considered suicide, 15% made a suicide plan, 11.5% attempted suicide, and 4.1% sustained an injury from a suicide attempt that had to be treated by a doctor or nurse.
Youth Risk Indicators For Forsyth County, NC
  • In 2019, Forsyth County high school students who reported feeling hopeless or sad for two weeks or more in the past year were likely to have poor grades. However, middle schoolers who reported the same behaviors weren’t associated with poor grades.
  • In 2018, 7,335 (14%) youths were diagnosed with mental health disorders like depression, anxiety, or disruptive behavior disorders. These numbers are on par with the state average.  

Harnett County

  • In 2022, mental health was reported as the highest community concern in Harnett County.
  • In 2018, 543 teens had depression, 700 had anxiety, 1,781 had ADHD, and 464 had disruptive behavior disorders, with an average of 16% of them having a mental health disorder.  
  • High depression rates most likely contributed to the extremely high drug overdose fatality rate of 52.2 (per 100,000 residents). This is 36% higher than the state average (38.5%).

What Is the Prevalence of Mental Health Disorders in North Carolina?

In North Carolina, 1,469,000 adults have serious mental health disorders, while 128,000 youths aged 12 to 17 have depression, according to National Alliance on Mental Illness data.

Moreover, every two in five adults in prison have a history of mental illness, while seven in ten youths in the juvenile justice system have a mental health condition.

Where Does North Carolina Rank in Mental Health?

North Carolina ranks 39 in mental health and access to care, just behind Virginia, according to Mental Health America. It has fallen one position since 2022. This indicates that it is one of the worst states for adult mental healthcare.

The state is also on the brink of a crisis in overall youth mental health, where it ranks 42 out of 50, according to Hopeful Futures. This is because of a shortage of mental health workers, high treatment price tags, and a lack of adequate insurance.

What Is Causing the Youth Mental Health Crisis in North Carolina?

A combination of factors caused the youth mental health crisis in North Carolina. The crisis took root when the government pulled funding for hospitals. However, it truly began during COVID-19 when teens were isolated, lonely, and experienced increased distress, which led to an increase in depressive and anxiety symptoms, substance abuse issues, attempted suicides, and homicides.

How Much Does North Carolina Spend on Mental Health?

While North Carolina has had mental health funding shortages for the past few decades, the state will spend $1 billion to improve healthcare facilities from 2024 onwards.

The government plans to focus on spending:

  • $225 million on raising Medicaid reimbursement rates for behavioral health services. They haven’t been updated since 2013.
  • To improve access to routine mental health care, $175 million on primary care hospitals, clinics, and schools.
  • $150 million to help people returning from jails adjust and fund prison-based programs that help prisoners with mental issues get treatment.
  • $200 million to build mobile crisis teams, housing support, and other services for people with mental health issues.
  • $100 million to create stable foster homes for children with complex behavioral needs.
  • $100 million to ensure sustainable step-down options and hospitalizations for all patients.
  • $50 million on telehealth and other technology that will provide North Carolina residents access to mental health treatments.

What Demographic Has the Highest Mental Distress Rate in North Carolina?

  • Women are at a higher risk of experiencing mental distress at 19.2% compared to men at 11.2%, according to the 2022 BRFSS Survey for North Carolina.  
  • Moreover, American Indian people had the highest likelihood of experiencing mental distress in North Carolina at 19.5%, followed by African Americans at 15.3%, white people at 14.4%, and Hispanics at 11.9%.
  • Furthermore, those aged 18 to 34 had the highest likelihood of experiencing mental distress at 21.4%, while those above 75 experienced the least amount of mental distress.

What percentage of North Carolina teenagers with depression do not receive treatment?

Nearly two out of three teenagers (ages 12 to 17) diagnosed with depression in North Carolina do not receive the treatment they need. This alarming statistic underscores a critical gap in mental health services accessibility and highlights the urgent need for improved mental health care infrastructure and resources.

How has the risk of major depressive episodes changed for teenagers in North Carolina?

From 2019 to 2021, the risk of teenagers experiencing one or more major depressive episodes in North Carolina increased by an astonishing 46%. This significant rise indicates a growing crisis in teen mental health, exacerbated by factors such as the COVID-19 pandemic, social isolation, and the stigma surrounding mental health care.

What percentage of North Carolina high school students considered suicide?

In 2021, 22% of high school students in North Carolina reported that they seriously considered attempting suicide during the past year. This statistic highlights the severe emotional distress many teenagers are experiencing and the critical importance of suicide prevention and mental health support programs in schools.

How has the rate of suicide attempts among high school students in North Carolina changed since 2017?

In 2021, 10.1% of high school students in North Carolina attempted suicide, marking a 23.2% increase from 2017. This rise in suicide attempts among teenagers points to the escalating mental health crisis and the need for comprehensive strategies to address and prevent suicidal behaviors.

What has been the trend in emergency department visits by North Carolina youth for mental health difficulties?

The number of emergency department (ED) visits by North Carolina youth (aged 12 to 17) for mental health difficulties, including suicide-related behaviors, increased five-fold from 2011 to 2020. This dramatic increase emphasizes the growing demand for mental health care services and the importance of early intervention and support for at-risk youth.


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Author: Shantel Sullivan Ed.D., LCSW
Dr. Shantel Sullivan, Ed.D., LCSW, serves as the CEO of Bright Path with a rich background in residential adolescent treatment, adult outpatient services, and academia, leveraging over a decade of licensed social work experience in New York and North Carolina. Her academic credentials include a BA in Sociology, an MSW and a graduate certificate in addictions counseling from the University of New England, culminating in a doctoral degree in Educational Leadership focused on transformational leadership. Beyond her clinical expertise, Dr. Sullivan contributes to the field as a national speaker, educator, and editor of the Bright Path Teen Mental Health Blog, committed to enhancing access to evidence-based mental health care for adolescents and their families.
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