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For Teens, Scandinavia is No Longer The Happiest Place On Earth

JON HAIDT AND ZACH RAUSCH


Starting in 2010, the National Board of Health and the National Institute for Public Health at the University of Southern Denmark have conducted a series of health surveys on Danish adults called the National Health Profile. The survey gathers data from thousands of Danes, aged 16 to 74, on various health matters, including mental health. Mental health is measured using the mental component of the Short-Form 12 (SF-12), which assesses self-reported mood and energy levels over the past four weeks on a 6-point scale. A score below 35.76 indicates poor mental health (corresponding to the lowest 10% of scores on the scale). 

Figure 12 presents the percentage of Danish girls and women with poor mental health between 2010 to 2021 (across four data collection cycles: 2010, 2013, 2017, and 2021).  

Figure 12. Percent of Danish Women with Poor Mental Health. Data from the National Health Profile. See 3.1.2 in Nordic Adolescent Mood Disorders since 2010.



Between 2010 and 2013, poor mental health increased across all age groups, with the largest absolute increase among the 16-24 year-olds (though this rise was quite small). From 2013 to 2021, similar trends continued, but both the absolute and relative increases became much larger across all age groups. Young women aged 16-24 rose from 15.8% in 2010 to 34.4% in 2021, a 117.7% increase (the largest absolute increase across all age/gender groups). Notably, much of the rise in poor mental health preceded the COVID–19 pandemic.

Figure 13 displays responses from men to the same item.

Figure 13. Percent of Danish Men with Poor Mental Health. Data from the National Health Profile. See 3.1.2 in Nordic Adolescent Mood Disorders since 2010.



As usual, the youngest male cohorts experienced the largest increases in poor mental health between 2010 and 2021. Rates for 16-24-year-old young men jumped from 8.3% in 2010 to 21.2% in 2021, a 155.4% increase (the largest relative increase across all age/gender groups). The 25-34-year-old men closely followed, rising from 9.3% in 2010 to 20.4% in 2021, a 119.4% increase. 

In general, poor mental health increased for both men and women across all age groups from 2010 to 2021, with a particularly notable rise among young women aged 16-24 and young men aged 16-34. 

But what does the behavioral data reveal?

In 2021, researchers Simon Victor and Anne Amalie Elgaard Thorup analyzed pediatric psychiatric emergency department visits in Glostrup, Copenhagen between 2012 and 2017. Using nurse-kept registration logs, they found a 50% increase in visits between 2012 and 2013 and a doubling of visits over five years, from around 1,000 visits to just over 2,000. Importantly, most patients were female adolescents, and the primary reason for inquiry was suicidality. 




Figure 14. Trends in a pediatric psychiatric emergency room in Copenhagen, 2012-2017 (Ages 5-17). Graphed by Victor & Elgaard Thorup (2021). See 6.3.3 in Nordic Adolescent Mood Disorders since 2010.


In contrast, a 2020 study in Social Psychiatry and Psychiatric Epidemiology reported different results. Utilizing Denmark’s national administrative registers, the researchers tracked hospital-treated non-fatal self-harm from 2000 to 2016 for those individuals aged 10 to 19. As illustrated in Figure 15, self-harm rates peaked in 2007 for both boys and girls and then steadily declined for both genders through 2016.



Figure 15. Temporal trends in the annual incidence of self-harm by sex (3-year moving averages), ages 10–19 years. See 6.3.3 in Nordic Adolescent Mood Disorders since 2010. The study does not provide detailed statistics for self-harm rates, which is why I do not include the percent change since 2010. Regraphed with a vertical line.


Because of the truly representative nature of the national register data, I am inclined to believe that the self-harm rates have indeed been dropping since 2012. However, the absence of more recent data prevents a clear understanding of whether self-harm trends remained low or increased, similar to other countries during this period. 

Despite declining self-harm rates, the deteriorating mental health of Danish youth remains a significant concern for health leaders in Denmark. In September 2022, the Danish Health Authority and the WHO convened a meeting to address the growing mental health crisis among Nordic and Baltic nations. The report directly addressed the mental state of young Danes with the following remarks,

[There’s been an] increase in mental health conditions from 2010 to 2021, especially in young people, with nearly 35% of women and 20% of men aged 16-24 reporting poor mental health; and a huge increase in health-seeking behavior for hospitals over last 10 years, with nearly twice as many young people (<19 years of age) using hospital services for mental health.

In sum, the results in Denmark varied, with two studies and the report from the Danish Health Authority revealing declines in self-reported mental health and increases in psychiatric emergency department visits, while another showed declining rates of non-fatal deliberate self-harm among Danish adolescents.

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