Andrew Yockey, PhD, assistant professor at the University of Mississippi.

Andrew Yockey, PhD

Sex, Age, Racial Disparities Persist in Adolescent Depression, With Andrew Yockey, PhD

Although national data show a nearly 40% decline in adolescent 

 between 2021 and 2024, persistent disparities across sex, age, and race and ethnicity continue to shape clinical risk assessment and care delivery, according to Andrew Yockey, PhD, assistant professor at the University of Mississippi.

, Yockey discussed findings from a recent analysis of the National Survey on Drug Use and Health data, which reported a 

decrease in past-year major depressive episodes

 among adolescents aged 12–17 years from 20.5% in 2021 to 14.8% in 2024. Despite the overall improvement, girls, older teens, and multiracial youth were more likely to experience depression. Girls had 3-fold greater odds of having depression than boys.

Yockey emphasized that clinicians should respond to this disparity with more targeted and developmentally informed screening and treatment approaches. He noted that girls may be more vulnerable to risk factors such as rumination, body image concerns, and social comparison, all of which can contribute to depressive symptoms during adolescence. He also stressed the importance of screening earlier and more frequently, rather than relying on single assessments.

“Someone gets screened, and then they don’t get screened for another 10 years,” Yockey said. “This just does not go away.”

He encouraged clinicians to move beyond the misconception that depression primarily presents as sadness. Instead, screening should include irritability, somatic complaints, lack of motivation, and other nontraditional symptoms. Yockey also pointed to social media exposure, peer dynamics, academic pressure, and gender expectations as additional contributors that clinicians may consider during assessment.

The study also found that older adolescents had greater odds of major depressive episodes, consistent with the broader understanding that late adolescence is a critical developmental period for mental health challenges.

“This a very stressful time in your life,” Yockey said. “If you think about adolescence, it's navigating the unknowns in life…it's also discovering yourself.”

Older adolescents are more likely to experiment with substances, encounter academic and social pressures, and navigate transitions toward independence, he noted. These stressors can coincide with the onset of mental health disorders, making early and repeated screening particularly important. Yockey also highlighted the role of parent education, encouraging clinicians to help families recognize warning signs and support adolescents as they approach adulthood.

Yockey noted that clinicians need to increase screening and raise awareness of mental health difficulties.

“We're still in this phase that, when people hear about depression, it's, ‘oh, just don't be sad.’ Well, that's easier said than done,” he said.

The analysis also identified racial and ethnic differences, with multiracial teens being more likely to experience depression. While some minoritized groups reported lower odds of depression, Yockey cautioned that these findings may reflect underdiagnosis rather than lower true prevalence. For example, Black adolescents may report lower diagnosed depression but experience greater unmet mental health needs and more severe outcomes.

Yockey attributed these patterns to multiple factors, including reduced access to care, stigma surrounding mental health, and cultural differences in symptom expression. He encouraged clinicians not to rely solely on screening scores and instead engage adolescents in conversations about how they experience stress, sadness, or irritability. Asking culturally sensitive questions may help identify symptoms that standardized tools miss.

Building trust with families and communities was another key recommendation. Yockey noted that historical mistrust and stigma continue to affect engagement in mental health care. Involving caregivers, respecting family beliefs, and addressing misconceptions may improve uptake and retention in treatment.

He also highlighted the importance of follow-up, noting that minoritized adolescents are more likely to disengage from care. Strategies such as early follow-up visits, reminder check-ins, and monitoring engagement, not just symptoms, may help improve continuity of care.

Yockey stressed that clinicians should not assume improvements at the population level translate to reduced risk for individual patients, particularly those within greater-risk groups.

Andrew Yockey R, Apu A, Grigsby T, Bleasdale J, Mattingly D, Hoopsick R. Decreasing prevalence in youth depressive episodes: Evidence from the 2021-2024 national survey on drug use and health. J Psychiatr Res. 2026 Mar 25;198:188-191. 

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Yockey discusses why girls, older teens, and multiracial youth remain at greater risk for depression despite overall post-pandemic improvements.

 Adolescent Depressive Episodes Declined From 2021- 2024, With Andrew Yockey, PHD

New national survey data reveal a nearly 40% decline in adolescent 

following the pandemic, but experts caution that improvements should not overshadow persistent disparities, diagnostic challenges, and gaps in care.

 investigator Andrew Yockey, PhD, assistant professor at the University of Mississippi, discussed findings from a recent analysis of the 2021–2024 National Survey on Drug Use and Health (NSDUH), which found a notable decline in past-year major depressive episodes (MDE) among 43,828 US adolescents aged 12 to 17 years. Prevalence decreased from 20.5% in 2021 to 14.8% in 2024, representing a 38.5% relative reduction.

“I think there is a partial recovery,” Yockey said. “During COVID, I think things just got hammered, and things just got very bad in terms of mental health, and we don’t know enough about the recovery time. Seeing that decline really helps.”

Yockey said other factors could contribute to the decline in depressive episodes, including better screening, an uptick in telehealth services, and reduced stigma of mental health care through national campaigns.

“Things are getting better, but let's not mitigate the issue here that 1 in 5 adolescents have mental health conditions,” he said.

The study confirmed several well-established risk patterns. Girls had > 3-fold greater odds of a major depressive episode compared with boys, and older adolescents were at increased risk. Racial and ethnic differences were also observed, with multiracial adolescents experiencing greater odds of depression. Alcohol and marijuana use were associated with increased odds of major depressive episodes, reinforcing the importance of integrated behavioral health approaches that address both mood symptoms and substance use.

Although girls continue to have greater rates of depression, boys have higher suicide completion rates, illustrating the importance of nuanced assessment. Yockey encouraged clinicians to recognize that adolescent depression may present beyond sadness, including irritability, substance use, emotional withdrawal, and loss of direction.

Yockey emphasized the need for broader and more nuanced research to determine whether improvements are sustained. Priorities include examining neurobiological and cognitive factors, as well as emotional processes such as rumination and emotional suppression. Intersectionality was also identified as an underexplored area, as adolescents with overlapping marginalized identities may experience unique stressors affecting mental health that are not captured in current screening approaches.

Yockey also highlighted the need to modernize screening tools, noting that traditional instruments may not fully capture irritability, cultural distress, or evolving symptom presentations among adolescents. He stressed the importance of connecting adolescents to treatment pathways, including therapy, medication when appropriate, and community-based resources.

“One of the things that I've always envisioned is having youth support groups in schools,” Yockey said. “We know from our research that if youth are involved with their parents or they're involved in a social activity, they’re less likely to report depression and substance use, so getting better ways to engage youth is critical.”

Survey data show a nearly 40% drop in adolescent depressive episodes post-pandemic, though clinicians should remain vigilant for disparities and unmet care needs, Yockey says.

Andrew Yockey, PhD

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