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Results from the 2023 B.C. Adolescent Health Survey paint a worrying picture of the mental health of the province’s teens.

Compared with results from previous years, youth were more likely to have self-harmed, suffered from eating disorders and experienced abuse. They were also less likely to report positive mental health or feel hopeful for the future.

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“I’ve done this four times and the results have been considerably more positive the last three times,” said Annie Smith, executive director of the McCreary Centre Society, a non-profit group focused on youth health and development that created the survey.

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The survey, which has been conducted every five years for the past 30 years, offers a broad view of the health of B.C. youth aged 12 to 19 and poses questions on sleeping and eating habits, relationships, exercise, home life, sex, drug use, mental health and more.

In this most recent study, conducted in 2023, the percentage of youth reporting good or excellent mental health dropped 21 points in the past decade — from 81 per cent in 2013 to 60 per cent last year.

There was also a significant increase in the number of students who self-harmed or seriously thought about suicide.

Eighteen per cent of students reported they considered suicide in the past year, the highest point since at least 1992. The number of students who attempted suicide, at five per cent, was the lowest in 30 years, however.

Twenty-four per cent of youth reported cutting or injuring themselves on purpose at some point in the year before completing the survey, up from 15 per cent 10 years ago.

“To see that 24 per cent of young people self-harmed in the past year is shocking,” Smith said.

Youth also reported engaging in deliberate self-harm other than cutting, including starving themselves, over-exercising or exercising with an injury and using substances.

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Smith said the reasons behind the decline in mental health are complex and interrelated.

“It’s so hard to pull one thing out,” she said. “They’re all linked.”

The survey found youth were less likely to feel connected to their school and community, as well as having fewer friends. One-quarter of youth reported that they always or often felt lonely.

“We know the huge value that sleep has, and youth are sleeping less well. We know the huge value of connection to community, to schools and of having friends,” Smith said.

Youth who reported feeling more connected to school, community and friends generally reported better mental health and well-being and had more positive feelings about the future.

The number of youth reporting they slept eight or more hours fell compared with five years ago as did the number of youth rating their health as good or excellent.

Those who slept well and exercised regularly were more likely to experience positive mental health, life satisfaction and well-being. For example, youth who slept for at least eight hours were more likely to report good or excellent mental health (76 per cent versus 48 per cent for those who slept less).

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Despite the need, nearly one-in-five students reported not getting the mental-health services they needed in the past year. There was a significant gender disparity, though. Seventeen per cent of females didn’t get mental-health support. For males it was only five per cent.

Over half of teens that didn’t get support said it was because they didn’t want their parents to find out. Others said they hoped the problem would go away or didn’t know where to go.

Postmedia News recently reported that an in-patient hospital program that provided Vancouver-area teens with addictions and mental-illness treatment, as well as schooling and other support, is quietly being closed.

Results from the survey varied considerably by gender.

“Overall, we see males are reporting the best outcomes, females not doing as well as males and for nonbinary the outcomes are not as positive,” Smith said.

“We definitely see high rates of discrimination coming into play,” she added.

While it seems likely that COVID-19 played a role, particularly in relation to reporting lower levels of connection and in-person friendships, Smith said it was “hard to tease those pieces out.”

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She said early drafts of the survey had many questions about youth experiences during COVID.

“The feedback we got was that it was not that relevant, that they’re not putting things in that context,” she said.

While many of the results were worrying, Smith was hopeful for the future as the pandemic fades farther into the past and additional youth services come online.

“We are coming out of a huge pandemic and all the impacts that has had and I hope that the 2028 data is much more positive,” she said. “We’re getting all these fantastic Foundries (program services). We’re getting the child and youth mental-health services, which we really need and will be a huge asset to communities across the province. But it’s going to take awhile for those to roll out.”

Foundry’s integrated care model brings together health and social-service providers working to empower young people on their path to wellness, says the Foundry B.C website.

Smith acknowledged the changes from previous surveys were significant.

“For us the job now is going and having those conversations about what’s driving that,” she said.

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Roughly 38,500 students from 59 of B.C.’s 60 school districts took part in the survey, the highest number of respondents ever recorded by the survey. It’s considered representative of nearly 98 per cent of B.C. youth aged 12-19.

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