Mental and behavioral disorder-related mortality among US adolescents, 1999-2023

Mental and behavioral disorders are a major contributor to adolescent morbidity and mortality, yet long-term national trends in related deaths remain insufficiently characterized. This study examined 25-year trends (1999-2023) in mental and behavioral disorder-related mortality among US adolescents aged 15-24 years using data from the CDC Wide-ranging Online Data for Epidemiologic Research. Mortality was defined using ICD-10 codes F01-F99 listed as a contributing cause of death. Overall mortality rates, disparities by sex, age, race and ethnicity, and geographic region, and temporal trends were assessed using joinpoint regression. Between 1999 and 2023, 67,984 deaths were recorded, corresponding to a rate of 6.37 per 100,000 population. Males and individuals aged 20-24 years had higher mortality than females and those aged 15-19 years. Racial and ethnic disparities were observed, with American Indian or Alaska Native adolescents experiencing the highest burden. Geographic variation was evident, with the highest rates in the South. Two periods of increase were identified (1999-2006 and 2009-2021), while overall trends remained stable. These findings highlight persistent and emerging disparities in adolescent mental and behavioral disorder-related mortality and underscore the need for targeted, equity-focused public health interventions and improved mental health and substance use prevention strategies.