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One in six U.S. kids have mental health disorders

(Reuters Health) – Roughly in six U.S. kids have at least one mental health disorder, and only about half of them receive treatment from a mental health professional, a new study suggests.

Nationwide, an estimated 7.7 million children ages 6 to 17 have at least one mental health disorder, or about 16.5 percent of school age kids, the study found. The prevalence of childhood mental health problems ranged from a low of 7.6 percent in Hawaii to a high of 27.2 percent in Maine.

Half of kids with conditions like depression, anxiety, and attention deficit/hyperactivity disorder received no care from mental health professionals. But this varied by location, from a low of 29.5 percent in Washington, D.C. to a high of 72.2 percent in North Carolina.

“Mental health disorders are certainly stigmatized conditions, and can be very debilitating in terms of healthful growth, especially for children and adolescents,” said study co-author Daniel Whitney of the University of Michigan in Ann Arbor.

“What was concerning from these findings was that almost half of the children across the U.S. with a mental health disorder did not receive treatment or counseling from a mental health professional,” Whitney said by email. “Gaps in treatment for clinical conditions could worsen these and other health disparities, thus providing a mechanism for impeding healthful growth into adulthood that may otherwise be prevented.”

Researchers assessed the prevalence of diagnoses and treatment for childhood mental health problems based on data from the 2016 National Survey of Children’s Health, a nationally representative parent-proxy survey of U.S. kids under 18 years old.

Parents responded to a prompt: “Has a doctor or other health care provider EVER told you that this child has” a mental health disorder. “If yes, does this child CURRENTLY have the condition?”

Then, the survey also asked parents who reported a mental health condition: “During the past 12 months, has this child received any treatment or counseling from a mental health professional (including) psychiatrists, psychologists, psychiatric nurses, and clinical social workers?”

A few states stood out for having high proportions of children with mental health disorders and high proportions of untreated kids: Alabama, Mississippi, Oklahoma, and Utah.

Poor children and kids with a single mother were about 40 percent more likely to have a mental health problem than children from more affluent households or with two parents at home, the study also found.

The study wasn’t a controlled experiment designed to prove whether or how specific factors might directly impact how many kids are diagnosed or treated for mental health disorders.

Many things may play a role in the varying rates of diagnosis and treatment, Whitney said. These include differences between states in the affordability and accessibility of mental health care for kids as well as distinct local or regional levels of stigma around these conditions.

Individual patient and family characteristics probably also play a role, Whitney added.

If anything, the current study probably underestimates the scope of the problem, said Katherine Lamparyk, a pediatric psychologist at Cleveland Clinic Children’s Hospital in Ohio who wasn’t involved in the study.

“These estimates do not account for the children that were never seen by any health professionals or were never diagnosed in the first place,” added Lamparyk.

“In today’s age of 15 minute primary care appointments, it is likely that many of these diagnoses are overlooked in a standard well-child visit,” Lamparyk said by email.

It’s very unlikely that children diagnosed with mental health disorders aren’t in treatment because they no longer need it, Lamparyk added.

Instead, it’s more likely that there are too few providers where they live, that their families can’t afford care, or that families don’t think treatment is useful or make decisions informed by stigma surrounding mental illness, Lamparyk said.

“Mental health diagnosis is just part of a larger picture of our overall health and well-being and tied to most, if not all, other aspects of general health and well-being,” Lamparyk said. “Unfortunately, it is not always recognized or (understood) this way by individuals or insurance companies.”

SOURCE: JAMA Pediatrics, online February 11, 2019.

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