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Concerns about adolescent mental health and substance use have increased recently, particularly in light of gun violence and the COVID-19 pandemic. In recent years, many adolescents have experienced worsened emotional health, increased stress, and a lack of peer connection. Other mental health and substance use concerns are on the rise – including drug overdose deaths, self-harm, and eating disorders. Simultaneously, adolescents are spending more time on screens and many report adverse experiences such as parental abuse, hunger, and job loss – all of which can be linked to poor mental health outcomes.This brief explores the state of adolescent mental health and substance use in recent years, highlighting differences observed by sex, racial and ethnic groups, and sexual orientation. Throughout this analysis, we define adolescents as individuals ages 12 to 17. Although data on adolescent mental health is limited, where possible, we draw upon data from the 2020 National Survey of Children's Health (NSCH), which asks parents or guardians questions on behalf of their children and adolescents. We also include data from the Centers for Disease Control and Prevention (CDC) and other surveys conducted during the pandemic.