Two years after the COVID-19 pandemic began in the United States, Gen Zers, ranging from middle school students to early professionals, have higher rates of anxiety, depression, and distress than any other age group. 

The mental-health challenges faced by this generation are so serious that on December 7, 2021, US Surgeon General Vivek Murthy issued a public health advisory to address the “youth mental health crisis” exacerbated by the COVID-19 pandemic.

McKinsey conducted a series of consumer surveys and interviews that revealed stark differences between generations, with Gen Z reporting the least positive life outlook, as well as lower levels of emotional and social well-being than older generations.

One-quarter of Gen Z respondents (25%) reported being more emotionally distressed, nearly 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 exacerbated the situation (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 be distressed, employers, educators, and public health leaders may want to consider this generation’s sentiment.

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

In addition, Gen Z reported having the most unmet social needs of any generation. 5 Fifty-eight percent of people in Generation Z reported two or more unmet social needs, compared to 16 percent of people in previous generations. Unmet social needs, such as income, employment, education, food, housing, transportation, social support, and safety, are linked to higher self-reported rates of behavioral-health conditions. According to a recent nationwide survey, people with poor mental health were twice as likely as those with good mental health to report an unmet basic need, and four times as likely to have three or more unmet basic needs.

Gen Z consumer characteristics in the healthcare ecosystem

The specific needs of Generation Z suggest that improving their behavioral healthcare will necessitate stakeholders increasing access and providing appropriate, timely services.

Gen Z is less likely to seek assistance.

When compared to other generations, Gen Z respondents were more likely to report having a behavioral-health diagnosis but less likely to seek treatment (Exhibit 1). For example, Gen Z is 1.6 to 1.8 times more likely than millennials to report not seeking treatment for a behavioral health condition. Several factors could explain Gen Z’s reluctance to seek help: development stage, disengagement from healthcare, perceived affordability, and stigma associated with mental or substance use disorders in their families and communities.

Gen Z is dissatisfied with the behavioral-health services that are available to them.
Gen Zers believe the behavioral healthcare system as a whole is failing to meet their expectations—Gen Zers who received behavioral healthcare were less likely than other generations to be satisfied with the services they received.

For example, when compared to older generations, Gen Z is less satisfied with behavioral-health services received through outpatient counseling/therapy (3.7 out of 5.0 for Gen Z vs. 4.1 for Gen X) or intensive outpatient treatment (3.1 for Gen Z, compared with 3.8 for older generations).

The most significant barrier to care, according to one Gen Z respondent, was “struggling to find a psychologist whom I was comfortable with and cared enough to remember my name and what we did the week before.”