One in three Tennessee parents with school-age or adolescent children report their child has been diagnosed with a mental or behavioral health condition, according to a new Vanderbilt Child Health Poll. The survey of 1,000 parents conducted in late 2025 paints a troubling picture: anxiety and depression rank as the most common diagnoses in adolescents at 19%, while attention-deficit/hyperactivity disorder (ADHD) affects 17% of school-age children. Yet despite these high diagnosis rates, a significant gap exists between identification and treatment. What's Driving Parents' Mental Health Concerns? Mental health topped the list of parental worries in Tennessee, with 35% of parents identifying it as a top concern from a list of 15 options. The concerns don't stop there. Parents also worry about social media use (30% listed it as a top concern), bullying (25%), excessive screen time (25%), and school quality. Derek Williams, MD, MPH, professor of Pediatrics at Monroe Carell Jr. Children's Hospital at Vanderbilt and leader of the research team, explained the broader context: "It is striking that most parents feel their child's generation may be worse off than their own, a sentiment that is informed by a variety of real concerns ranging from mental and physical health, things like anxiety and depression, nutrition, physical inactivity, to safety and well-being, including social media usage, bullying, gun violence, school quality, access to housing and health care, and discrimination." The poll, which has been conducted annually since 2020 and is representative of Tennessee's population, reveals that most Tennessee parents believe their children's long-term health and well-being will be worse than their own. This pessimism reflects genuine concerns about multiple interconnected challenges facing young people today. Why Are So Many Children Not Getting Treatment? Perhaps most alarming is the treatment gap. Of the parents who reported their child has one or more mental or behavioral health conditions, 37% said their child is not receiving specialized services for those conditions. In rural regions, the situation is even more dire, with almost half (48%) reporting they cannot access these services. This disparity highlights a critical access problem that extends beyond diagnosis to actual care delivery. Heather Kreth, PsyD, associate professor of Clinical Pediatrics and clinical director of Inpatient Behavioral Health at Monroe Carell, emphasized the urgency of this gap: "Parents in Tennessee continue to identify mental health as a top concern for their children. Despite consistently high rates of reported diagnoses, parents report barriers to accessing care, and national rankings of mental health care access consistently place Tennessee at the bottom. Additionally, suicide death rates for youth in Tennessee are higher than the national average. It is imperative that we listen to parents' concerns about their child's mental health and work to bridge the gaps with access to care." How to Help Your Teen Navigate Social Media Safely Social media emerged as a significant concern in the poll, with one-third of parents of adolescents ages 13 to 17 reporting their child spends more than three hours daily on social media platforms. An alarming 11% reported five or more hours daily, and 10% said they don't know how much time their teen spends online. The top concerns parents expressed included exposure to explicit sexual content (48%) and false or misleading content (43%). About 90% of parents feel they need to actively monitor their child's social media access. Katherine Spencer, PsyD, associate professor of Clinical Pediatrics and member of the research team, shared evidence-based guidance for parents: "Recent literature demonstrates that younger teens (ages 11 to 14) and girls are at higher risk for negative effects of social media. Longer duration of social media use in girls has been more consistently linked to increased anxiety and depression. More frequent exposure to social media for teens is also associated with increased odds of substance use, sexual risk behaviors, and unhealthy eating behaviors." Spencer highlighted a particularly vulnerable time window: "Emerging research indicates particular vulnerability for teens in the hours before bed, with increased risk for suicidal ideation and planning." - Limit Daily Screen Time: Set clear boundaries on how much time your teen spends on social media each day, with particular attention to reducing use in the hours before bedtime. - Manage Content Access: Use parental controls and privacy settings to filter out explicit sexual content and false or misleading information that could harm your teen's mental health. - Promote Healthy Sleep: Establish a no-screens-before-bed policy to protect your teen's sleep quality and reduce the risk of late-night exposure to harmful content. - Stay Engaged: Have regular conversations with your teen about their online experiences, the content they encounter, and how social media makes them feel. Spencer offered practical recommendations for parents: "Parents can support reduced risk in their teen through limiting time on social media, managing access to unhealthy or explicit content, and promoting healthy sleep behaviors." What Does This Mean for Your Family? The Vanderbilt poll reveals a generation facing unprecedented mental health challenges, yet many families lack access to the support they need. The data suggests that parents are acutely aware of the threats to their children's wellbeing, from the documented harms of excessive social media use to the rising rates of anxiety and depression. The gap between diagnosis and treatment, especially in rural areas, represents a critical public health failure that demands immediate attention. The research team plans to publish additional analyses on the top concerns identified by parents and other child health issues in the coming months. For now, the message is clear: Tennessee parents are worried, and their concerns are grounded in real data about rising mental health diagnoses, social media risks, and barriers to care. Understanding these challenges is the first step toward addressing them.
