Dr. David Palmiter's Blog for Hectic Parents

Two recent studies in the Journal of the American Academy of Child and Adolescent Psychiatry remind us of a critically important problem in the United States: millions of youth are suffering from mental health disorders for which they receive no care.

The first study, whose first author is NIH researcher Dr. Kathleen Ries Merikangas, reports on results from a large national survey of over 10 thousand adolescents. Similar to findings from multiple regional studies that came before it, the researchers found that 22.2% of the teens were suffering from severe impairment or distress, while 49.5% were “…affected by at least one class of (mental health) disorder….” The rates for the four most common types of disorders were as follows: anxiety disorders (31.9%), behavioral disorders (19.1%), mood disorders (14.3%) and substance abuse disorders (11.4%). Some rates for specific disorders were as follows: ADHD (8.7%), Oppositional Defiant Disorder (12.6%) and eating disorders (2.7%). Anxiety disorders had the youngest average age of onset (age 6) while mood disorders had the highest rates of severe impairment (11.2%). The abstract for this October, 2010 article can be found here.

The second study, which had the same first author, examined rates of mental health service usage for over 6 thousand adolescents from the same data set as the first study.  Also similar to multiple regional studies that came before it, the researchers found that 63.8% of teens with a mental health disorder received no care for such. As is consistent with findings in clinical practice, the kids who were most likely to get care were those suffering from ADHD (59.8%) and behavioral disorders (45.4%). Only 17.8% of the teens suffering from the most prevalent category, anxiety disorders, got care. Moreover, only 37.7% and 15.4% of teens suffering from mood and substance abuse disorders, respectively, received care. Even among those considered to be in a severe category, less than half received care (47.4%). Finally, and quoting from the authors: “Of adolescents with mood disorders, Hispanics and non-Hispanic Blacks were much less likely than Whites to report having received mental health treatment, and a similar pattern was observed for Hispanic youth with anxiety disorders.” The abstract for this January, 2011 article can be found here.

Please also note that even when kids get care, they often have been suffering for years before they get the care or the care they receive is truncated. For instance, in the second study above it was found that one half of those who received care for ADHD, behavioral disorders or substance abuse disorders “…received six or fewer lifetime outpatient mental health visits…” What would we think about ourselves as a culture if the same statistics applied to our kids’ dental health?

Want to take some action steps? This is what you can do:

√ Educate yourself. I have written several blog posts to help:

• Signs that a kid needs mental health services.

• Seven common myths about counseling.

• Affording mental health care.

Please also see my Twitter posts or the mental health links on my website for a stream of related information.

√ Ask your pediatrician to consider screening for mental health problems in her or his practice. One tool that is available, that is easily administered and is free to download, is the Pediatric Symptom Checklist. Click here to obtain it.

√ Take your child for a mental health  evaluation if you suspect that she or he could benefit. To find a clinician near you click here. Don’t let your baby be one of the millions of youth in this country who suffer needlessly.