Mental distress spikes among Israeli teens - WHO study

More Israeli adolescents are experiencing mental distress on a daily basis and fewer are experimenting with cannabis, while tobacco use and binge drinking are on the rise, according to a new World Health Organization (WHO) Health Behavior in School-aged Children (HBSC) study conducted by Prof. Yossi Harel-Fisch and his research team at the Faculty of Education at Bar-Ilan University (BIU).

In addition, social media use and screen addiction have increased, which may impact adolescent well-being, said the researchers who worked in collaboration with the Health and Education Ministries.  The team said the data are being used to implement intensive evidence-based school strategies to improve adolescent well-being and promote healthy behaviors in Israel. 

The WHO collaborative cross-national study of adolescent health and well-being – carried out in schools – is undertaken every four years using a questionnaire for 11, 13, and 15-year-olds.

The first HBSC survey was conducted in 1983–1984 in five countries. The study has now grown to include 50 countries and regions across Europe and North America, with over 400 researchers in the HBSC international research network. The study is funded at the national level by each of its member countries and regions.

The HBSC study conducted on Israeli youth investigated shifts in risk behaviors and mental health from the period before the COVID-19 pandemic three years ago to when school and community activities resumed in 2022.   

The pandemic disrupted the lives of adolescents 

Here, as around the world, the pandemic disrupted the lives of children and teens. Measures taken to control the spread of the virus, such as school closures, lockdowns, and social distancing, impacted their daily routines and well-being as they navigated a new normal with restrictions and limited social interactions. 

In 2019, about one-fifth of Israeli teens reported daily psychosomatic symptoms such as feeling low, nervous or having difficulty sleeping. This proportion increased to about 30% in 2022, indicating a significant rise in mental distress following the pandemic that continued even after schools reopened.

The teens also reported feeling disengaged in school, lacking a sense of belonging, or not having support, highlighting pupils’ difficulties in re-adjusting to school after such a long period of closure and social distancing.

There was a decline in their reported (illegal) use of cannabis, with only 6.1% in 2022, compared to 9.2% in 2019 before the pandemic and 9% during the pandemic in 2021. 

Over the past 20 years, there has been a consistent drop in cigarette smoking among Israeli adolescents, from 33.6% in 1998 to 10.7% in 2019. This decline in prevalence continued into the lockdown period in 2021 to 7.5%, but immediately after social restrictions were lifted and school and community activities resumed in 2022, it rose to 9.2%. 

Binge drinking – consuming five or more alcoholic drinks within a few hours, a behavior that causes drunkenness – is also a growing concern among youth. Since the implementation of the Israeli national alcohol-prevention program between 2010 and 2014, there has reportedly been a consistent decline in binge drinking among Israeli youth, from 20.6% in 2009 to 7% in 2019 before the COVID-19 pandemic.

This downward trend continued until 2021, with only 5% of adolescents reporting binge drinking while social distancing measures were still in place. 

Data from 2022, however, show that after restrictions were lifted, binge drinking increased dramatically to 12.5%. These findings support the assumption that adolescent drinking is linked to social leisure time activities rather than addiction to alcohol, Harel-Fisch said.

“We are concerned since the troubling increase in both cigarette smoking and binge drinking seems to be associated with the resumption of social nightlife activities and the belief that the two years of social distancing can now be ‘compensated’ by embracing the use of tobacco and alcohol as part of renewed social leisure time activities,” said Yossi Harel-Fisch, who is director of BIU’s International Research Institute on Adolescent Well-Being and Health at Bar-Ilan University in Israel, and Principal Investigator for HBSC Israel. 

Problematic use of social media, which is an indicator of screen addiction, is defined as the extensive use of social media to the extent that it significantly disrupts daily life. Data show that 15.3% of adolescents were classified as problematic social media users in 2022, compared to only 4.3% in 2019. Fortunately, despite the increase in screen addiction, cyberbullying has declined. The study shows a consistent decrease in cyberbullying from 10.4% in 2019 to 7.6% last year.

“This may mean that steps taken by the Child Online Protection Bureau – a joint authority established in 2018 combining law enforcement with education and treatment to ensure the safety of children and teens online – were not adversely affected by the increased exposure to the Internet during the pandemic and continue to bear fruit even in the post-pandemic period,” he concluded.

The findings have been presented and discussed with Israel government agencies, experts, and decisionmakers and are being used to implement intensive evidence-based school strategies to improve adolescent well-being and promote healthy behaviors in Israel.