When COVID-19 closed schools in spring 2020, the number of American children and teens getting mental health treatment dropped by more than half. Two years later, that number had not just bounced back — it surpassed what it was before the pandemic even started. That finding comes from a major new study by researchers at Penn State College of Medicine, who analyzed 13 million health records to understand how children's mental health care changed during and after the pandemic.
The researchers used a database of pooled, anonymous patient records from 72 health systems across all four regions of the United States. They tracked children and teens from October 2018 through December 2022, breaking the time period into three phases: before the pandemic, during school closures, and after life started returning to normal.
One of the most striking findings was that the rise in treatment was driven mostly by brand-new patients — kids who had never received mental health care before. First-time prescriptions for psychiatric medication jumped 35%, while first-time diagnoses rose 24% and first-time therapy courses increased 26%.
The steepest increases hit hardest among girls. Antidepressant prescriptions shot up 137% among girls ages 6 to 12 and 65% among girls ages 13 to 18. Researchers estimate roughly 40,000 more girls across the country began antidepressant treatment after the pandemic compared to before it.
"Youth mental health was already worsening before the pandemic, which further accelerated these trends," said Raman Baweja, a professor of psychiatry and behavioral health at Penn State and the study's lead author. "This suggests that the rise in psychiatric treatment for mental health not only followed the pandemic, but also a decade-long rise in heightened emotional distress among young people, documented by the CDC."
The study also looked at ADHD medication use. Among the youngest children in the study — ages 3 to 5 — prescriptions for stimulant medications rose 147%, though this group started from a much smaller base and still had far lower rates overall than older kids.
Baweja said the findings show a clear shift: more young people are now entering mental health care for the first time, rather than children already in treatment receiving more services. For her, the numbers tell a story of a generation that was already struggling before COVID-19 arrived, and a system that is now finally reaching more of them. "It didn't hit everyone the same," she said. "Some groups, girls especially, were affected more."
The researchers hope their work helps communities better understand where to direct resources. By knowing which groups saw the biggest increases, schools, hospitals, and policymakers can work to get help to the young people who need it most.