August 21st, 2013

Study highlights prevalence of children with mental disorders

Up to one in five U.S. children experience a mental disorder, finds a new U.S. Centers for Disease Control and Prevention report reviewing various federal efforts tracking childhood mental health.

“Mental Health Surveillance Among Children – United States, 2005-2011,” the first comprehensive report on children’s mental health released last May, estimates $247 billion annually is spent on the 13 to 20 percent of American children living with mental disorders.

ADHD (6.8 percent) was the most prevalent parent-reported diagnosis among children aged 3-17 followed by behavioral or conduct problems such as ODD or conduct disorder (3.5 percent), anxiety (3 percent), depression (2.1 percent) autism spectrum disorders (1.1 percent) and Tourette’s disorder (0.2 percent among children 6-17.)

Eight percent of adolescents aged 12-17 reported 14 or more mentally unhealthy days in the past month. Suicide was the second leading cause of death among this age group in 2010. An estimated 4.7 percent of 12-17 year-olds reported an illicit drug use disorder in the past year while 2.2 percent reported an alcohol abuse disorder and 2.8 percent had cigarette dependence.

The CDC reviewed data collected between 1994 and 2011 cited recent studies reporting substantial increases in use of mental health services for children. One found an 80 percent increase in hospital stays for mood disorders among children between 1997 and 2010. The report suggests increased prevalence over time could be attributed to “changes in case definition, changes in the public perception of mental disorders or improvements in diagnosis, which might be associated with changes in policies and access the health care.”

The report will also draw attention to the critical need for child and adolescent mental health care providers. In 2007, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) issued a report projecting the need for 12,624 child and adolescent psychologists by 2020, which far exceeds the projected supply of 8,312.

“Anybody who works in child mental health care knows that there aren’t enough mental health services to go around. In that way, this is a really great study because it points out the need and you can’t fix the need unless it’s actually quantified,” says Ellen B. Braaten, Ph.D., assistant professor at Harvard Medical School and director of the Learning and Emotional Assessment Program (LEAP) at Massachusetts General Hospital.

“Just in Boston where we have a plethora of mental health services compared to other areas of the country, kids still wait at the clinic that I direct – and I’m not proud of this – but kids still wait six to 12 months to get an evaluation.”

The wait had been two years before LEAP opened at MGH in July 2008, Braaten says. The program treated about 440 children in its first full year of operation and last year treated 887 patients. The program now has a clinical staff of seven full-time psychologists plus seven postdoctoral fellows and interns. Like the CDC study found, the most common disorder among LEAP patients was ADHD, Braaten says.

More children could have mental disorders than the CDC study suggests, says Wendy A. Plante, Ph.D., staff psychologist at the Bradley Hasbro Children’s Research Center at Rhode Island Hospital and Hasbro Children’s Hospital and clinical associate professor of psychiatry and human behavior at Brown University’s Alpert Medical School. Much of the data the study collected was obtained by asking parents if their child had ever been diagnosed with a disorder.

“That’s only capturing kids who have seen a mental health professional or seen their doctor who gave them a diagnosis. So it’s really not capturing kids who aren’t getting services and we know that access can be a big problem,” Plante explains.

Both Plante and Braaten say ADHD and behavioral conduct disorders – problems that cause other people grief – are more likely to be reported than depression and anxiety.

“It’s great that these federal agencies are putting their data together that address children,” Plante says. “Oftentimes, kids are an afterthought when people think about medical care and in particular, mental health.”

By Janine Weisman

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