Studies and experts point to a concerning trend: fewer Quebec teenagers report being in good mental health than they did a few years ago. Before assessing the impact on insurance claims, however, it is important to understand the phenomenon. Here is an overview of the main factors contributing to the rise in mental health disorders among adolescents.
The latest Quebec survey on the health of high school students (Enquête québécoise sur la santé des jeunes du secondaire) found that only 37 per cent of adolescents considered themselves to have “flourishing mental health” in 2022–2023. Six years earlier, that proportion was 10 percentage points higher. At the same time, diagnoses of anxiety disorders, depression and eating disorders continue to rise.
The trend concerns Dr. Karine Gauthier, psychologist and president of the Ordre des psychologues du Québec (Quebec's professional regulatory body for psychologists). “In clinical practice, we have also seen an increase in requests for help,” says Gauthier, who works primarily with young clients.
According to data from the Institut national de santé publique du Québec (INSPQ), the province's public health institute, diagnoses of anxiety disorders among adolescents, particularly girls, rose from 9 per cent in 2010–2011 to 20 per cent in 2022–2023. Over the same period, the proportion of adolescents diagnosed with depression increased from 4.9 per cent to 7.4 per cent. Diagnoses of attention deficit disorder, with or without hyperactivity (ADD/ADHD), have nearly doubled, rising from 13 per cent 15 years ago to 25 per cent today.
“Although ADHD diagnoses continue to increase, they are not always accurate diagnoses,” the psychologist cautions. “In fact, over the past few years, we have identified far more cases in Quebec than in Ontario. That suggests we have a problem with overdiagnosis.”
Under pressure every day
According to Dr. Gauthier, such a diagnosis is sometimes made without adequately considering the child’s circumstances.
“The child may be dealing with a difficult situation at home or experiencing bullying, for example,” she explains. “If those experiences are weighing on them, that may be the real reason they are having trouble concentrating.”
Since the rise of social media, young people no longer have a refuge from the judgment of others.
“The image they project at school follows them right into their bedroom, which should be a place where they can enjoy some privacy,” says Mélanie Boucher, executive director of the Fondation Jeunes en Tête, which offers workshops aimed at supporting adolescents’ mental health.
“Young people are under tremendous pressure,” she adds. “They feel they have to be perfect everywhere: at school, with their friends, sometimes at work, and also at home.”
That pressure to maintain a positive image also contributes to the adoption of risky eating behaviours, including dieting, prolonged or unsupervised fasting, self-induced vomiting, the use of laxatives or appetite suppressants, skipping meals and excessive exercise. The INSPQ survey also reports that three out of four high school students (76 per cent) had “often or sometimes” engaged in one or more of these behaviours during the six months preceding the survey in an effort to lose weight. Five years earlier, that figure was 10 percentage points lower.
Unfortunately, many young people choose to hide their distress from their parents, either because they do not want to disappoint them or because they do not want to be seen as a burden.
“They follow the news just as adults do. They are constantly connected and they know there are waiting lists for mental health services and that private care is expensive,” Boucher says. “In families that are not financially well off, they understand that seeking help can place additional pressure on household finances.”
The pandemic effect
The COVID-19 pandemic had a significant impact on children’s mental health. The Quebec survey on the health of high school students indicates that “nearly 41 per cent of students believe their mental health deteriorated because of the pandemic.”
That finding does not surprise Dr. Gauthier, who believes that “young people lost their bearings” during the pandemic.“They still talk about it,” she says, drawing on her experience with young clients.
“The pandemic temporarily interrupted their attendance at school, which is where most of their social interactions take place,” the psychologist continues. “For young people, who are still developing, socialization helps them become individuals outside the family and build their own identity through their circle of friends. They were deprived of all of that during the pandemic, while also living with a heightened level of stress.”
Are screens to blame?
During the pandemic, particularly during lockdowns, many young people turned even more to technology to stay in touch with friends and maintain some connection with the outside world.
Screens, particularly social media, are among the leading factors associated with the deterioration of young people’s mental health.
The Quebec survey on the health of high school students found that 25 per cent of young people spend four hours or more each day using screens for entertainment or to communicate with friends. “Among young people, high screen time is associated with depressive symptoms, as is cellphone use in particular. The impact of screen use on their mental health also depends on their sleep habits and the nature of their interactions on social media,” the INSPQ cautions.
In addition to increased sedentary behaviour and a rise in eye and musculoskeletal disorders linked to frequent screen use, the INSPQ notes that heavy consumption of certain social media content can contribute to low self-esteem, anxiety and even eating disorders among adolescents. This is without considering the misinformation that can circulate on various health and nutrition-related topics, potentially leading to behaviours that pose risks to health.
The trend echoes what insurers are already observing among older members of Generation Z, who are now between 18 and 30 years old.
“This is the generation that grew up with the Internet and learned to live with smartphones and social media. It is the first generation for whom technology has been so pervasive,” says Benoît Bilodeau, Vice-President, Brokerage and Consulting, Quebec, at Beneva.
The deterioration in young people’s mental health is not only a concern for psychologists and schools. It is also gradually reshaping the profile of claims in the group insurance market.
Fortunately, it is never too early to take action. “The earlier a child learns to recognize the signs of declining mental health, the better they will learn to manage their emotions. These are life skills that may help prevent future relapses,” Mélanie Boucher says.
