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Addressing the unprecedented behavioral-health challenges facing Generation Z 

Erica Coe is a partner in McKinsey’s Atlanta office and coleads the Center for Societal Benefit through Healthcare, Jenny Cordina is a partner in the Detroit office and leads McKinsey’s Consumer Health Insights research, Kana Enomoto is a senior expert in the Washington, DC, office and coleads the Center for Societal Benefit through Healthcare, Raelyn Jacobson is an associate partner in the Seattle office, Sharon Mei is an expert in the New York office, and Nikhil Seshan is a consultant in the Philadelphia office. 

The authors wish to thank Tamara Baer, Eric Bochtler, Emma Dorn, Erin Harding, Brad Herbig, Jimmy Sarakatsannis, and Boya Wang for their contributions to this paper. 

A series of consumer surveys and interviews conducted by McKinsey finds Gen Zers reporting the least positive life outlook, including lower levels of emotional and social well-being than older generations. 

Nearly two years after the COVID-19 pandemic began in the United States, Gen Zers, ranging from middle school students to early professionals, are reporting higher rates of anxiety, depression, and distress than any other age group.1 The mental-health challenges among this generation are so concerning that US surgeon general Vivek Murthy issued a public health advisory on December 7, 2021, to address the “youth mental health crisis” exacerbated by the COVID-19 pandemic.2 

A series of consumer surveys and interviews conducted by McKinsey indicate stark differences among generations, with Gen Z reporting the least positive life outlook, including lower levels of emotional and social well-being than older generations. One in four Gen Z respondents reported feeling more emotionally distressed (25 percent), almost double the levels reported by millennial and Gen X respondents (13 percent each), and more than triple the levels reported by baby boomer respondents (8 percent).3 And the COVID-19 pandemic has only amplified this challenge (see sidebar, “The disproportionate impact of the COVID-19 pandemic”). While consumer surveys are, of course, subjective and Gen Z is not the only generation to experience distress, employers, educators, and public health leaders may want to consider the sentiment of this emerging generation as they plan for the future. 

In our sample, Gen Z respondents were more likely to report having been diagnosed with a behavioral-health condition (for example, mental or substance use disorder) than either Gen Xers or baby boomers.4 Gen Z respondents were also two to three times more likely than other generations to report thinking about, planning, or attempting suicide in the 12-month period spanning late 2019 to late 2020. 

Gen Z also reported more unmet social needs than any other generation.5 Fifty-eight percent of Gen Z reported two or more unmet social needs, compared with 16 percent of people from older generations. These perceived unmet social needs, including income, employment, education, food, housing, transportation, social support, and safety, are associated with higher self-reported rates of behavioral-health conditions. As indicated in a recent nationwide survey, people with poor mental health were two times as likely to report an unmet basic need as those with good mental health, and four times as likely to have three or more unmet basic needs.6 

As these young adults’ work to develop their resilience, Gen Zers may seek out the holistic approach to health they have come to expect, which includes physical health, behavioral health, and social needs, as future students, employees, and customers. 

Characteristics of Gen Z consumers in the healthcare ecosystem 

Gen Z’s specific needs suggest that improving their behavioral healthcare will require stakeholders to increase access and deliver appropriate, timely services. 

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