The results of the 2019 Minnesota Student Survey released Thursday showed some troubling numbers regarding emotional health among girls, officials said.

The Minnesota Department of Health, in a news release, pointed to an area of concern in the student survey. More Minnesota students than ever reported having long-term mental health, behavioral or emotional problems, from 18% of all students surveyed in 2016 to 23% in 2019.

Among 11th grade girls, the number of students reporting such problems has more than doubled since the 2013 survey, the Department of Health noted. Of the 11th grade girls who reported missing a full or partial day of school during the previous 30 days, nearly one in four said they missed school because they felt very sad, hopeless, anxious, stressed or angry.

For the first time, the survey not only asked students if they have missed school in the last 30 days but also asked their reasons why they missed school. The reasons included illness, doctor appointments, vacations, emotional health and not getting enough sleep.

The data also shows female students are more likely to be bullied and more frequently than their male counterparts. The data showed that 62% of girls in fifth grade reported they had been bullied once or more in the last 30 days, compared to 58% of fifth grade boys. In eighth grade, 61% of girls reported being bullied once or more in the last 30 days compared to 46% of boys. In ninth grade, the percentage of girls was 56% compared to 39% for boys and in 11th grade, the percentage of girls was 48% compared to 32%

Girls were also more likely to be cyberbullied. The data showed that 20% of girls in fifth grade reported they had been cyberbullied once or more in the last 30 days, compared to 17% of fifth grade boys. In eighth grade, 19% of girls reported being cyberbullied once or more in the last 30 days compared to 11% of boys. In ninth grade, the percentage of girls was 17% compared to 10% for boys and in 11th grade, the percentage of girls was 14% compared to 9%.

“Girls deserve to grow up seeing the boundless possibilities that lie before them — that so many are instead buried in stress and anxiety is unacceptable,” Minnesota Human Services Commissioner Jodi Harpstead said in a news release. “This survey shows that we need to continue to support efforts to bring mental health services to students at school, like the school-linked mental health program.”

Female students are more likely to be bullied for size, weight and physical appearance more than anything. Female students are also more likely to have mean rumors or lies spread about them, compared to their male counterparts. Boys who were bullied reported they were physically assaulted and threatened to be beaten up more than any other form of bullying.

Statewide bullying and harassment increased for fifth grade students, from 17% reporting weekly bullying in 2013 to 21% in 2019. Cyberbullying rates have remained largely the same between 2016 and 2019.

“Our students are talking to us and we must listen,” Minnesota Education Commissioner Mary Cathryn Ricker said in a news release. “No matter what is happening in students’ lives outside of school, we must make sure that they feel supported, safe, and welcomed when they’re in the classroom so they can succeed academically. My fellow commissioners and I will be working with our school communities so we can better meet the needs of all of our students.”

Every three years, Minnesota’s fifth, eighth, ninth and 11th grade students complete this voluntary, anonymous survey. It includes questions on school climate, out-of-school activities, healthy eating, emotional health, substance use, connections with school and family, and many other topics. More than 170,000 students participated in the 2019 survey.

All school districts are invited to participate in the survey. In 2019, 81% of Minnesota’s school districts participated. Schools administered the surveys from January through May 2019.