Mental Health Prevalence & Substance Use Decreased Among Adolescents & Young Adults From 2021 To 2025

The prevalence of several mental health conditions, suicidal thoughts and behaviors, and substance use measures decreased among adolescents and young adults between 2021 and 2025. Among adolescents ages 12 to 17, past-year major depressive episodes declined, along with substance use disorders and serious thoughts of suicide. Among young adults ages 18 to 25, major depressive episodes, serious mental illness, substance use disorders, and suicidal thoughts and behaviors also declined, according to the 2025 National Survey on Drug Use & Health (NSDUH).

Among adolescents ages 12 to 17, the prevalence of a past-year major depressive episode declined from 20.8% in 2021 to 15.1% in 2025, while major depressive episodes with severe impairment declined from 15.2% to 11.0%. The prevalence of co-occurring major depressive episodes and substance use disorders also declined during the period.

The prevalence of serious thoughts of suicide among adolescents declined from 12.9% in 2021 to 10.4% in 2025. The percentage who made a suicide plan declined from 6.2% to 5.1%, and the percentage who attempted suicide declined from 3.6% to 2.9%. All three represented statistically significant downward trends over the five-year period. The report notes that estimates of adolescent suicidal thoughts and behaviors may be conservative because some respondents indicated that they were unsure or did not want to answer the questions.

Substance use also declined across several measures for adolescents. Past-month tobacco use declined from 2.9% in 2021 to 2.0% in 2025. Past-year drug use disorder declined from 7.3% to 5.9%. Other statistically significant declines included past-month alcohol, binge alcohol, and marijuana use; past-year illicit drug and marijuana use; initiation of alcohol, nicotine vaping, and marijuana use; and past-year substance use disorder and alcohol use disorder.

Among young adults ages 18 to 25, the prevalence of a past-year major depressive episode declined from 19.3% in 2021 to 14.2% in 2025, while major depressive episodes with severe impairment declined from 13.8% to 10.2%. The prevalence of co-occurring major depressive episodes and substance use disorders declined from 7.5% to 5.7%. Other mental health measures with statistically significant declines included any mental illness, serious mental illness, co-occurring any mental illness and substance use disorder, and co-occurring serious mental illness and substance use disorder.

Suicidal thoughts and behaviors also declined among young adults. The percentage reporting serious thoughts of suicide fell from 13.4% in 2021 to 10.8% in 2025. The percentage who made a suicide plan declined from 5.2% to 4.0%, and suicide attempts declined from 2.8% to 1.9%.

Young adults also experienced statistically significant declines across several substance use measures. Past-month tobacco use declined from 17.5% in 2021 to 14.1% in 2025, while past-month nicotine product use declined from 30.0% in 2022 to 27.9% in 2025. Other measures with downward trends included cigarette use, alcohol use, binge drinking, marijuana use, past-year illicit drug use, cocaine and hallucinogen use, misuse of prescription stimulants, tranquilizers or sedatives, and opioids, as well as past-year substance use disorder and alcohol use disorder.

The findings are based on the 2025 NSDUH, an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey provides nationally representative estimates for the civilian, noninstitutionalized U.S. population age 12 and older. It includes people living in households and noninstitutional group settings, such as shelters, college dormitories, boarding houses, and halfway houses. It excludes active-duty military personnel, people without a fixed address who are not living in shelters, and people living in institutional settings such as jails, nursing homes, mental health institutions, and long-term care facilities.

For the 2025 survey, screening was completed for 180,506 addresses, resulting in 60,447 completed interviews, including 10,933 adolescents ages 12 to 17 and 49,514 adults age 18 and older. Respondents could complete the survey online or in person; 44.3% of interviews were completed online and 55.7% were completed in person. The survey used a probability sample designed to be representative of the United States as a whole and each of the 50 states and the District of Columbia.

The report examined changes in substance use and mental health measures from 2021 through 2025 for measures with at least four years of comparable data. SAMHSA used linear trend testing to determine whether each measure showed a statistically significant increase, decrease, or no change during the period. Because NSDUH shifted to multimode data collection beginning in 2021, SAMHSA cautioned that estimates from 2021 through 2025 generally should not be compared with estimates from 2020 or earlier.

For more information, contact: Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, Maryland 20857; Fax: 240-276-2135; Email: media@samhsa.hhs.gov; Website: https://www.samhsa.gov/