American high schools are witnessing an increasing population of young people who are unhappy, in poor physical health and unable to visualize a future that is particularly bright. This may sound like a particularly ominous outlook; however, it’s a reality we must face if we are going to improve the prospects of advancement for our nation’s youth.  

Evidence suggests that this is an unaddressed national crisis. One of every four to five American adolescents has some kind of mental health challenge, many of them struggling with various levels of depression and anxiety, yet many do not receive treatment. Additionally, roughly 15 percent of our youth are overweight and 17 percent are classified as obese. In essence, these percentages indicate that millions of U.S. teens are on a course that will have negative ramifications on their futures, as well as on the country’s health care systems, social service programs and economy. 


The problem is that our educational systems are functioning as if this problem is not taking place. It’s not just that teens are falling through the proverbial cracks; the inherent weakness lies in the fact that the majority of schools don’t have the programs and creative, evidence-based approaches in place to address the needs of students with mental and physical challenges. 

We must do better recognizing what is obvious and implementing solutions that make a difference in classrooms. One such tool is cognitive behavioral therapy (CBT), which has been used successfully by mental health professionals. CBT helps patients become aware of the negative thoughts that lead them to feeling anxious or depressed and making unhealthy decisions. With CBT, individuals are able to view their stressful daily challenges more clearly and respond to them constructively. So, if cognitive behavioral approaches can work well for therapists, why wouldn’t they have a similar impact in our classrooms? 

New research suggests, in fact, that young people will benefit from teaching teens cognitive-behavioral skills. Recently, a study funded by the National Institutes of Health/the National Institute of Nursing Research involved nearly 800 teens in the southwestern United States. Half of the group was engaged in the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise and Nutrition) cognitive behavior program, which was recently included in the National Cancer Institute’s database of Research-Tested Intervention Programs. The other half attended conventional health classes that taught topics like road safety, dental care and the importance of immunizations. 

The COPE curriculum combined sessions to help develop better cognitive behavior skills with nutrition lessons and 20 minutes of physical activity that ranged from dancing to kick-boxing. The results have been striking.  

In a follow-up evaluation one year after this program concluded, less than five percent of the teens in the COPE program were overweight (with none classified as obese). Among the youths who participated in the conventional health curriculum, double that number became overweight or obese. And, in fact, among teens whose households were enrolled in public assistance program – often connected with high rates of obesity – there was a significant decline in body mass percentile. 

Behaviorally, students in the COPE program who began this study with severely elevated depressive symptoms had significantly lower symptoms of depression that were in the normal range, again with much more progress in this area than the students who were not involved in the cognitive behavioral classes. 

This study tells us there is a need to rethink how we address mental and physical health in our nation’s high schools. Our current trajectory clearly isn’t working, not when we’re graduating students who are ill-equipped to cope with daily, real-world challenges and who face the high likelihood of chronic illnesses like diabetes and heart disease that accompany excessive body weight. 

Our rhetoric about our children being our future should be accompanied by evidence-based educational approaches that can generate healthy, productive lives. Our youth deserve that chance.

Melnyk is dean of Ohio State University’s School of Nursing, OSU associate vice president for Health Promotion and chief wellness officer.