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Copenhagen, 13 November 2024
A new report by WHO/Europe and the Health Behaviour in School-aged Children (HBSC) study has revealed alarming declines in social support for adolescents across Europe, central Asia and Canada. The findings are stark: only 68% of adolescents report high levels of family support, a significant drop compared to the previous survey in 2018, while school pressure has increased sharply, particularly for adolescent girls. These trends are affecting the mental health and well-being of millions of young people, particularly older adolescents and those from less well-off families.
The report draws on data from 279 117 young people aged 11, 13 and 15 years across 44 countries and regions who participated in the 2021/2022 HBSC survey. The findings emphasize the need to address the social determinants of health – the non-medical factors that influence health outcomes – as part of a comprehensive approach to supporting young people. To tackle these issues effectively, the report calls for coordinated action at all levels – national, regional and community – to foster more supportive environments, address inequalities and strengthen the various systems that young people rely on.
Key findings at a glance
- Decline in family and peer support. Support systems critical for adolescent mental health have weakened since 2018, with the proportion of adolescents reporting high levels of family support dropping from 73% to 67% and peer support from 61% to 58%. The decline has been particularly pronounced among girls (family support: 72% to 64%; peer support: 67% to 62%).
- Rising school pressure. More students report feeling pressured by schoolwork than in 2018, particularly affecting older adolescents, with stark gender differences emerging. Among 15-year-olds, nearly two-thirds of girls (63%) now report feeling pressured – up from 54% in 2018 – compared to 43% of boys (up from 40%).
- Social inequalities. Adolescents from lower-affluence families consistently report lower levels of support compared to their more well-off peers. For instance, 62% of low-affluence adolescents report high levels of family support, compared to 71% of high-affluence adolescents. Similar patterns are seen in peer support (53% vs 62%) and classmate support (52% vs 58%).
- Gender differences. Significant gender disparities exist across multiple areas of young people’s lives. Fewer girls than boys find it easy to talk with either parent about things that really bother them, with greater gender gaps in communication with fathers (62% vs 78%) than mothers (81% vs 86%). Girls also report lower levels of family support (65% vs 71%) and face substantially higher school pressure (62% vs 43% among 15-year-olds). The one exception is peer relationships, where girls maintain higher levels of support than boys (62% vs 55%).
1. A crisis of declining support
A clear pattern emerges of declining family and peer support for adolescents. Between 2018 and 2022, the proportion of young people reporting high levels of family support (scoring 5.5 or higher on a 7-point scale measuring family help, emotional support and communication) dropped from 73% to 67%, with particularly steep declines among girls (72% to 64%). Similarly, high peer support (measured using the same threshold for questions about friends’ help and emotional support) also declined during this period (61% to 58%), most notably among girls aged 13 and 15. Importantly, adolescents receiving strong support from both family and peers reported better mental health outcomes than those with limited or no support.
2. Escalating school pressure
The study highlights growing school pressure on students, particularly affecting older girls. Among 15-year-olds, the proportion of girls feeling pressured has risen from 54% to 63% since 2018, while boys show only a modest increase from 40% to 43%. This growing gender disparity is compounded by declining support at school: just over a third of 15-year-old girls (36%) report high teacher support (indicating strong agreement that teachers accept them, care about them and can be trusted), compared to nearly half of boys (47%).
Dr Irene García-Moya, one of the report authors, stated: “The rising pressure on adolescents is a multifaceted issue. Girls are often caught between competing expectations of academic excellence and traditional social roles, while boys may face pressure to appear strong and self-reliant, discouraging them from seeking necessary support. We need to create nurturing spaces within our schools where every student feels seen, heard and supported. School health programmes must focus on supporting emotional well-being to foster resilient future generations”.
3. Social inequalities in family and peer support
Adolescents from lower-affluence families are more likely to experience lower family and peer support, fewer opportunities for daily family meals and greater difficulties communicating with parents. These socioeconomic disparities affect access to supportive social environments, ultimately impacting adolescent health outcomes. The report calls for policy interventions to address these disparities and ensure all young people, regardless of socioeconomic status, have the opportunity to thrive.
4. Gender differences in social support and well-being
Gender disparities are evident across multiple indicators. When asked about their ability to get help and emotional support from family members, boys generally reported higher levels of family support, easier communication with parents and more frequent family meals compared to girls. Conversely, girls reported higher peer support (measured by their ability to share problems and get help from friends) but experienced greater school stress and lower teacher support.
The widening gender gap in family support, combined with the increasing gender gap in school pressure, with girls experiencing both lower support and higher pressure than boys, points to a concerning trend that places adolescent girls at a higher risk of poorer mental health outcomes. The report calls for gender-sensitive interventions that address these unique challenges and provide the necessary support to adolescent girls, particularly as they transition through critical developmental stages.
“These findings point to a critical and widening gap in support structures for adolescent girls, who not only face greater school-related pressures but also experience less support from family and teachers compared to boys,” warned Dr Natasha Azzopardi-Muscat, Director of Country Health Policies and Systems at WHO/Europe. “This is not the first time that our HBSC studies point to different health impacts between boys and girls. This means we have to take this gender dimension into careful consideration when looking at interventions by schools and health authorities, and in other social settings, so that we can enable environments where both girls and boys have equal opportunities to thrive emotionally and mentally.”
The legacy of the COVID-19 pandemic
The COVID-19 pandemic has had a profound impact on adolescents’ social environments, with lasting effects that continue to shape their well-being. Social distancing measures, school closures and disruptions to normal routines coincided with changes in reported family and peer support and less positive school experiences, exacerbating the challenges faced by young people during an already vulnerable period of their lives. The report underscores the need for continued efforts to support adolescents as they navigate the ongoing effects of the pandemic on their social and emotional well-being.
Roadmap for action
“Adolescents today are facing unprecedented challenges in their social environments, from declining support at home to increasing pressure at school, with potentially long-term consequences for their health and future life prospects. These findings should be a wake-up call for all of us to act now to improve the conditions in which our young people are growing up,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “Our findings clearly indicate that no single sector or industry can address these challenges alone. Building safer and more inclusive school environments, providing economic support where it is needed, and implementing gender-sensitive interventions, all require the involvement of different spheres, from education to health to public policy.”
WHO/Europe urges coordinated action to tackle the issues highlighted by the HBSC survey. To improve adolescent well-being, the following steps are recommended:
- Strengthen family-focused policies and economic support. Governments should implement targeted financial support for low-income families and invest in evidence-based parenting programmes. Specific measures could include child benefits, family-oriented subsidies and programmes that build parents’ skills in supporting their children’s developmental needs, particularly for adolescent girls.
- Create inclusive school environments. Schools must prioritize student well-being through concrete actions: reducing class sizes, implementing mentorship programmes and integrating social-emotional learning into the curriculum. Teacher training should focus on supporting students’ mental health, with an emphasis on creating safe spaces where students feel seen and heard.
- Address academic pressure. Schools must tackle rising stress levels through systematic approaches, implementing balanced homework policies, providing study skills support, scheduling regular student-teacher check-ins, and ensuring teachers are trained to recognize and respond to signs of academic stress, particularly among girls.
- Address socioeconomic disparities with community-based interventions. Policies should promote equitable access to community services, such as extracurricular activities, mental health resources and health services, particularly in underserved areas.
- Promote gender-sensitive interventions and empowerment programmes. Interventions must specifically address the distinct needs of adolescent girls, including addressing the pressures they face at school and in their social environments. Establishing safe spaces where girls can openly discuss their challenges and access mental health services is crucial.
- Implement post-pandemic recovery programmes for adolescents. Governments and schools should develop recovery programmes to address the social and emotional effects of the COVID-19 pandemic. This can include providing mental health counselling in schools and establishing peer-support groups.
Building a better future for adolescents
“The findings are a sobering reminder of the importance of social contexts in shaping the health and well-being of adolescents,” concluded Dr Kluge. “As young people face increasing challenges at home, in school, and in their broader social environments, it’s crucial that when designing investments or policies to address these challenges, young people are involved at every stage of the process as co-creators. This is a key function of WHO/Europe’s flagship Youth4Health initiative, ensuring young people have a far greater say on decisions that impact their lives.”
About the HBSC study
The HBSC study is a cross-national research project conducted in collaboration with WHO/Europe. It collects self-report data on the health behaviours, well-being and social environments of adolescents aged 11, 13 and 15.
