Unmet Need for Mental Health Services Among High School Students Experiencing Persistent Feelings of Sadness or Hopelessness — Youth Risk Behavior Survey, United States, 2025

For the first time, in 2025, CDC's nationally representative Youth Risk Behavior Survey (YRBS) included an item assessing U.S. high school students' use of mental health services. Data from this survey were used to examine the prevalence of persistent feelings of sadness or hopelessness among U.S. high school students and their receipt of counseling or therapy. Overall, 33.3% of students reported persistent feelings of sadness or hopelessness, with a higher prevalence among female than male students (43.4% versus 23.9%). Among students reporting persistent feelings of sadness or hopelessness, 29.6% reported receiving counseling or therapy, 28.8% reported an unmet need for counseling or therapy, and 41.5% reported no perceived need for counseling or therapy. A higher prevalence of female students than male students reported receiving counseling or therapy (33.2% versus 23.3%) and an unmet need for counseling or therapy (31.7% versus 23.8%) among those reporting persistent feelings of sadness or hopelessness. Conversely, a higher prevalence of male students than female students reported no perceived need for counseling or therapy (52.9% versus 35.1%). Asian and Black or African American students had both the lowest prevalence of receiving counseling or therapy (15.7% and 15.4%, respectively) and the highest prevalence of an unmet need for counseling or therapy (38.4% and 33.9%, respectively). After controlling for sex, grade, and race and ethnicity, students with persistent feelings of sadness or hopelessness were approximately twice as likely to report receiving counseling or therapy and three times as likely to report an unmet need compared with students who did not report these feelings. These findings highlight potential opportunities for tailored interventions to support adolescent use of mental health services, particularly approaches that address the unmet need for mental health services among female students and the low perceived need for services among male students. Strategies that might improve access to care include school-based mental health services and culturally appropriate family and community engagement.