Student Mental Health and Chronic Absenteeism: What New Research Means for Schools

Nearly one in six U.S. adolescents reported moderate or severe anxiety symptoms in 2024, according to a new study published October 12 in JAMA Pediatrics.

However, a substantial percentage of those experiencing significant symptoms received no mental health treatment.

The findings come as a separate October 1 analysis from the Public Policy Institute of California (PPIC) highlights the relationship between student mental health and absenteeism.

The analysis found that students reporting persistent sadness and suicidal thoughts were more likely to report missing multiple days of school.

Nearly One in Six Adolescents Report Significant Anxiety Symptoms

The JAMA Pediatrics study analyzed data from the 2024 National Survey on Drug Use and Health, including responses from 15,730 adolescents ages 12 to 20.

Researchers found that 16.8% reported moderate or severe anxiety symptoms, including 9.6% with moderate symptoms and 7.2% with severe symptoms. Another 23.7% reported mild anxiety symptoms.

The findings also revealed substantial overlap between severe anxiety and other mental health concerns. Among adolescents with severe anxiety symptoms:

• 65.8% met criteria for a major depressive episode during the previous year
• 48.2% reported suicidal thoughts during the previous year
• 31% reported substance use during the previous month

Female adolescents reported significantly higher rates of anxiety symptoms than males. Approximately 10.8% of females reported severe symptoms, compared with 3.7% of males. Moderate symptoms were also more common among females (13.4%) than males (6%).

Despite the prevalence of these concerns, many adolescents had not received mental health treatment. Approximately 41.2% of those with severe anxiety symptoms and 48.3% of those with moderate symptoms received no mental health treatment during the previous year.

Researchers also identified disparities in treatment utilization. Male adolescents, adolescents from racial and ethnic minority groups, and uninsured adolescents were less likely to receive mental health treatment.

Because anxiety questions were added to the national survey in 2024, the findings establish a baseline for tracking adolescent anxiety symptoms over time rather than demonstrating whether anxiety rates are increasing.

The researchers emphasized that the high prevalence of anxiety symptoms, their frequent co-occurrence with depression and suicidal thoughts, and gaps in treatment underscore the need for earlier identification and improved access to evidence-based care.

The Connection Between Mental Health and School Attendance

While anxiety and other mental health challenges may not always be immediately apparent to school staff, changes in attendance can be one indication that a student is struggling.

The October 1 analysis from PPIC examined findings from the 2023–24 California Healthy Kids Survey, focusing on students in grades 7, 9, and 11.

Among students who reported missing two or more school days, 36% also reported chronic sadness, compared with 24% of students who missed fewer days.

Similarly, approximately 15% of students who missed two or more days reported suicidal thoughts, compared with 10% of students with fewer absences.

Nearly one in four students who missed school identified emotional difficulties, including feeling sad, hopeless, anxious, stressed, or angry, or insufficient sleep as a reason for their absence.

The findings are particularly relevant as schools continue addressing chronic absenteeism. During the 2024–25 school year, approximately 19% of California students, or 1.1 million children, missed at least 10% of instructional days.

Although the survey findings do not establish that mental health difficulties caused students to miss school, research suggests the relationship can work in both directions. Emotional difficulties may contribute to school absences, while missing school can increase isolation, academic stress, and disconnection from peers.

Students may also miss school for reasons unrelated to mental health, including illness, transportation difficulties, family responsibilities, and other barriers. Understanding those circumstances is an important part of determining what support a student needs.

Improving Access to Student Mental Health Support

Research cited in the PPIC analysis suggests that school-based approaches, including student support teams and teletherapy, can help reduce absenteeism by making mental health and other services more accessible.

California has invested in expanding these services through initiatives such as the Children and Youth Behavioral Health Initiative and the California Community Schools Partnership Program.

An evaluation of the community schools program, which integrates academic, health, and other student supports, found reductions in chronic absenteeism.

The PPIC researchers emphasized that addressing absenteeism requires attention to circumstances both inside and outside school, as well as partnerships that help meet students' needs.

For school leaders, the findings reinforce the importance of considering student mental health when addressing attendance concerns. Understanding why students are missing school, including whether emotional difficulties are contributing to their absences, can help schools identify students who may need additional support.