The boys we’re losing — and the prevention we’re missing

He sits in a circle, shoulders slightly hunched, eyes down. When asked how he is doing, he shrugs. “I’m good,” he says, the way many boys are taught to respond. Around him are other male-identified youth and adult mentors. No one is there to lecture or fix him. They are there to listen. Slowly, the room shifts. Another young person shares something real. Then another. Eventually, he looks up. He speaks. Not perfectly, but honestly. And in that moment, something begins to change.

This is what prevention looks like. It is also what too many boys never experience.

One of the most overlooked mental health crises in this country is the emotional isolation of boys. It is shaped by long-standing norms that reward suppression and discourage vulnerability. Many boys learn early, often before they can fully name their emotions, that showing feelings is unsafe.

“Do not cry. Do not ask for help. Do not talk about what hurts.”

By adolescence, many have internalized the belief that connection comes at the cost of acceptance.

The consequences are visible. Rates of loneliness, depression, suicide and violence among male-identified youth continue to rise. Some boys withdraw. Others shut down. Some act out. For boys and young men of color, the impact is even more pronounced, as their lived experiences are often absent from the broader public conversation despite the disproportionate challenges they face. According to the Centers for Disease Control and Prevention, emotional distress among youth is at alarming levels, with 40% of students reporting persistent sadness or hopelessness. Suicide is now the second leading cause of death for young people, and male-identified youth account for nearly 80% of those deaths, underscoring the urgent need to address isolation and disconnection.

This is not simply an individual issue. It is systemic.

At every level, the conditions that shape boys’ emotional lives are reinforced. Individually, many lack the tools to understand and regulate their emotions. Relationally, they often do not have consistent, trusted adults with whom they can be fully honest. In schools and communities, there are few structured spaces that support emotional expression. At the systems level, no single institution has taken responsibility for addressing these root causes in a sustained way.

[Related: Youth mental health is personal. Our solutions need to be systemic.]

At the same time, there is a clear mismatch between need and response. Boys exhibit some of the highest indicators of risk related to violence, substance use and mental health challenges, yet prevention-focused programming designed specifically for them remains limited. Stigma, gender expectations and discomfort with addressing boys’ experiences directly have contributed to this gap. Funding frequently prioritizes national initiatives and research, while local, community-based prevention efforts remain under-resourced, particularly in communities navigating layered challenges.

As a daughter, mother, sister, cousin, partner, aunt and soon-to-be grandmother, “Lovey”, this is not theoretical for me. I have seen the consequences of this silence across generations. I watched my father’s health decline as he avoided seeking help because he believed that was what being a man required. I have loved a partner who carried pain without speaking it. I have seen systems respond with incarceration where support should have existed long before a crisis. I have sat with my own son as he struggled to find language for what he was feeling, only reaching that point when things had already escalated.

And now I think about my grandson. I think about whether he will grow up in a world that asks him to suppress who he is or one that supports him in becoming whole.

Prevention is possible. It is also already happening.

Boys to Men Tucson is a community-rooted organization focused on prevention, creating intentional spaces specifically for boys and masculine-identified youth to build connection, accountability and healthy relationships. In our Restorative Group Mentoring circles, boys develop emotional awareness, practice communication and experience vulnerability without shame.

The impact occurs across levels. Individually, youth develop the ability to identify and express emotions. Relationally, they build trust with mentors who show up consistently and without judgment. Within schools and communities, these circles help shift culture toward openness and mutual respect. At a broader level, this work represents a scalable, prevention-focused approach that addresses a gap not currently owned by any one system.

[Related: How visual arts workshops can help youth achieve mental health goals]

In many ways, this is a return to something that once existed. Across cultures, rites of passage provided structure, accountability and belonging as young people moved into adulthood. In their absence, boys are left to navigate identity, emotion and expectation without guidance, or with guidance that reinforces disconnection.

We cannot continue to treat the outcomes while ignoring the conditions that produce them. The boys sitting in circles are not a future problem to manage. They are young people asking, often without words, to be seen and supported.

And when that support is present, the outcome changes.

I think about my son. I think about my father. And I think about my grandson, growing up in a world where this work is not rare, but expected.

Connection is prevention. One circle at a time.

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Erica Smith is CEO of Boys to Men Tucson. She has worked nearly 30 years in public health, focusing on racial and social equity, community health needs and workforce development.