Depression and Suicidal Thoughts and Behaviors Among Adolescents Aged 12 to 17 in the Rural and Urban U.S., 2021

This study characterizes the prevalence of behavioral health conditions among adolescents in rural and urban counties across the United States. Specifically, this brief reports on the percentage of adolescents aged 12 to 17 reporting a major depressive episode (MDE) or suicidal thoughts and behavior in 2021.

Key Findings:

• Nationally, in 2021, there was no difference in the percentage of rural vs. urban adolescents aged 12 to 17 years who reported having experienced an MDE in the past year.
• The percentage of adolescents aged 12 to 17 years who reported having an MDE in their lifetime varied significantly across rural-urban subcategories of geography with the highest percentage in the rural areas with larger populations (31.9%) and the lowest percentage in less populated rural areas (23.8%).
• A significantly higher percentage of adolescents aged 12 to 17 years in rural compared to urban counties reported that they had serious suicidal ideation in the past year (18.2% vs. 14.8% with serious thoughts of suicide; 8.4% vs. 6.3% with plans of suicide).
• Nationally, the highest percentage of adolescents who reported serious suicidal ideation (23.1%), planned suicide (11.4%), or attempted suicide (7.0%) in the past year, were from rural counties with larger populations compared to urban counties and more rural counties.
• The percentage of adolescents reporting an MDE (in their lifetime or the past year) varied significantly across Census Divisions, with the highest percentages in the West North Central and Mountain Census Divisions.
• The percentage of adolescents who reported that they had serious suicidal ideation or made suicide plans in the past year varied significantly across Census Divisions. The percentage of adolescents reporting serious thoughts of suicide ranged widely from 9.1% in the New England Census Division to 21.8% in the West North Central Census Division.