PORTLAND, Ore. – More than one in five Oregon eighth- and 11th-graders experienced unmet mental or physical health care needs in 2022, according to a new state Student Health Survey (SHS) report developed with Oregon youth using the most recent data available.
The findings paint a sobering picture of the challenges youth face in accessing essential care, and the critical role adults play in helping them feel heard and supported.
Key themes from the report include:
- Emotional isolation: Students with unmet mental health needs often expressed feelings of defeat and deep isolation, indicating a lack of accessible support systems and trusted adults.
- Systemic barriers: Responses cited obstacles such as lack of insurance, long wait times, transportation issues and stigma around seeking help.
- Invalidation and silence: A recurring theme in students’ narratives was a sense of being dismissed or not taken seriously. Without meaningful adult intervention, many students reported that their needs were ignored or minimized.
“The data confirm what students have been saying for years: many are struggling, and they don’t feel seen,” said Tom Jeanne, M.D., M.P.H., deputy state health officer and epidemiologist at Oregon Health Authority. “Mental and physical health are deeply interconnected, and when students can’t access care, it affects every part of their lives—including their ability to learn and thrive.”
Read the full Unmet Needs Report and learn more about the Student Health Survey.
Students report barriers to accessing health care in all phases of their lives, from individual to systemic challenges. Some students struggle to disclose or even identify their own health care needs. Those able to communicate their needs might have a hard time finding supportive adults who will validate their concerns. Adding to this are the logistical barriers of insurance coverage, out-of-pocket costs, transportation, age of medical consent, scheduling and limited provider availability.
The report underscores the importance of fostering environments in which students feel safe discussing their health needs and adults—parents, educators and health professionals—are empowered to listen and respond effectively.
OHA administers the anonymous, school-based survey annually, collecting responses from more than 45,000 students statewide. The students represent 85 school districts, 327 schools and 29 counties. The SHS was administered at schools between October 2022 and January 2023. Among students reporting unmet health needs, more than 4,200 responded to open-ended questions about the barriers they encountered.
Student responses reflect a complex relationship between physical and mental health. While unmet mental health needs were often reported independently, unmet physical health needs frequently involved emotional or mental health challenges—suggesting that the two cannot be addressed in isolation.
Alexis Zou, a senior at Lake Oswego High School, was a primary author of the Unmet Needs Report and a member of the Oregon Youth Data Council (YDC).
The YDC is an OHA-sponsored program that invites Oregon youth to contribute to decision-making about the survey. Members are involved in all aspects of the survey, including:
- Reviewing survey content.
- Making sense of the results.
- Deciding how to talk about and use the survey.
“It was really interesting to look at the different trends that we observed. In particular, some alarming ones that we noticed (were) that over 23% of Oregon eighth grade and 11th-graders said that they have unmet physical and mental health needs. We also noticed that these unmet health needs were associated with missed school, so that’s a really big problem that school districts are facing right now. We also observed that many students said they felt isolated or didn’t have a trusted adult that they could reach out to,” said Zou.
Call to action to support youth
Addressing barriers to care requires cooperation from individuals and institutions at each point of health care access, according to the report, and Oregon youth “deserve a sustained investment in health care infrastructure and community or school-based health services.”
Gov. Tina Kotek recently championed new investments in Oregon’s behavioral health system to ensure access to services that promote youth social and emotional wellness and prevent youth substance use disorders. These investments include $6 million to support school-based health centers (SBHCs) increase mental health services, substance use disorder screening, and prevention programs. An additional $1 million was dedicated to support culturally specific suicide prevention efforts.
Students participating in the 2022 survey also emphasized the importance of logistical and emotional support from friends, family and trusted adults to get their health needs met. Youth said social norms need to shift to address the stigma around mental health and medical care, particularly among parents, caregivers, teachers and clinicians.
For more information on supporting Oregon youth, see pages 10–14 of the Unmet Needs Report. To learn more about the Youth Data Council, visit www.oregon.gov/YDC.
OHA and partner organizations are using this data to inform policy, guide resource allocation, and develop new strategies for improving youth access to care across the state.
Identifying and addressing Oregon students’ unmet health needs aligns with OHA’s 2025-2027 Strategic Plan. Among the plan’s key strategies is to “expand access to health and social services resources and supports for children, parents and families.”
