Parents think teens get the emotional support they need. Kids disagree.

As families navigate an ongoing national mental health crisis among American children, a new report reveals that while most parents think their teens are receiving the social and emotional support they need, the teens themselves often don’t agree.

The report, released this month by the Centers for Disease Control and Prevention, analyzed data gathered by the National Health Interview Survey, which queried nearly 1,200 American adolescents ages 12-17 and about 4,400 parents between July 2021 and December 2022. The survey marked a rare opportunity for a nationally representative sample of teens to share their thoughts about their mental and emotional health, said Ben Zablotsky, lead author of the report.

“The majority of surveys that were capturing teenager health at that level were parent-reported surveys, and we wanted to address this gap and understand teen health from teens themselves,” he said. “So we asked parents and teens the same question.”

That question was: How often do you get the social and emotional support you need? (Parents were asked a comparable question about their children’s needs.) The response options were “always,” “usually,” “sometimes,” “rarely” and “never.”

The results highlighted a striking disparity: Over three quarters of parents (77 percent) said their teenager always received the social and emotional support they needed, while only 28 percent of teens reported the same.

“We anticipated some disagreement,” between parents and teens, Zablotsky said. “But I think we were surprised to see the level of disagreement, and we were surprised to see it across the board for a variety of subgroups we explored. … When a disconnect this large exists, it’s worth talking about.”

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Teens who indicated that they “sometimes,” “rarely” or “never” received the support they needed were more likely to report experiencing anxiety or depression symptoms, Zablostky noted, as well as other negative health impacts. “They’re also more likely to report having low life satisfaction, and they’re more likely to report having low sleep quality,” he added.

The report raised new questions that Zablotsky and his colleagues hope to answer, he says. Because the survey didn’t explicitly define social and emotional support, additional qualitative research is planned “to better understand what teens are thinking of when they answer these questions,” he said.

The age cohort included in the survey has experienced a burgeoning mental health crisis for years, one that has received more public attention and concern since the onset of the pandemic. In 2021, a CDC report found that 42 percent of U.S. high school students described feeling persistently sad or hopeless, and 29 percent reported experiencing poor mental health. The level of social isolation across the youth population has also steadily grown, and the U.S. surgeon general released an advisory last month emphasizing the importance of social connection and community.

Tamar Mendelson, professor and director of the Center for Adolescent Health at the Johns Hopkins Bloomberg School of Public Health, says the mental health crisis is amplified for children in vulnerable communities - a fact also underscored by the recent survey analysis.

“In marginalized communities, a lot of the young people are dealing with trauma symptoms, symptoms of post-traumatic stress disorder and related mental health issues, because they are just having to handle things that no kid should have to handle - food insecurity, housing instability, community violence,” she said. “We’re seeing growing economic inequality in this country, and for young people who are living in poverty or are experiencing effects of structural racism, that has some really profound mental health implications that I think we tend to forget.”

The new report also reflected a disproportionate impact on certain teen populations: Girls, Black and Hispanic teenagers, and children who identified as LGBTQ were some of the least likely groups to report that they “always” or “usually” received the support they needed. Lower family income and lower parental education level were also associated with lower rates of perceived emotional and social support.

Mendelson said she wasn’t shocked that the survey revealed disagreement between teens and their parents.

“It is a large discrepancy, and it is concerning because obviously this is a really important developmental period where parents can support their kids,” Mendelson said. But: “Particularly during adolescence, this is a time when young people are developing more independence. … If they are struggling socially, or they’re having mental health symptoms, or there’s stuff going on with them, many are not going to confide in their parents.”

She hopes the results might focus attention on what parents can do to more meaningfully engage with their teens, which can be difficult at this age, she said.

“What’s tricky about being the parent of a teenager is they are giving you mixed messages,” she said. “They may be saying ‘I’m fine,’ or ‘No, I don’t want to talk to you about this,’ or ‘No, I don’t want to hang out with you on Saturday.’ Part of their job is to push you away, because they’re growing up. But part of a parent’s job is to not let that dissuade you from really staying present with your teenager.”

And while many parents are constantly electronically tethered to their children - and many children have less independence and free time than prior generations have experienced - Mendelson noted that this kind of oversight and overscheduling is not the same thing as supportive involvement.

“In some ways, helicopter parents create some stress for their kids: ‘You need to be engaged in all these activities, you need to be constantly performing or achieving’ - you know, that’s a very different message,” she said. “I do think there is a big difference between parents providing supervision or structure versus support.”

She suggests that parents keep an open mind and create opportunities to start a dialogue with their teens. Many parents have told her that it’s easier to talk to their kids in settings that feel more casual - for instance, in the car, where they might be more relaxed and are not sitting face-to-face.

“This [survey] is a reminder to not assume that you are providing the kind of support that your teen wants - and to not give up on that,” she said. “What I take away from it, as a parent and a researcher, is this: We need to slow down and not assume that we know what’s going on with our teenagers, and really check in with them.”