Half of U.S. Kids With a Mental Health Disorder Don't Get Treatment
If you're worried that your child may suffer from a mental health condition, such as anxiety, depression or attention-deficit/hyperactivity disorder (ADHD), you have plenty of company.
About one in every six American kids has at least one mental health disorder, new research shows. But the study delivered even more troubling news -- only half of those children are getting treatment.
The researchers also found startling differences in the number of kids being diagnosed and treated between states. For example, the statewide prevalence of kids with at least one diagnosed mental health disorder (including depression, anxiety and ADHD) varied from about 8 percent in Hawaii to 27 percent in Maine.
The prevalence of children with a mental health disorder who didn't get treatment varied from 30 percent in Washington, D.C., to 72 percent in North Carolina, the findings showed.
"The purpose of the study was to look at geographical differences in mental health outcomes for children and adolescents. We did not expect these findings to be this extreme," said senior study author Mark Peterson. He is an associate professor in the department of physical medicine and rehabilitation at the University of Michigan in Ann Arbor.
Peterson said the study wasn't designed to tease out the reasons for the differences. He suggested there could be a lot of factors at play, including policy differences, socioeconomic factors, access-to-care issues or even parents' individual decisions. "We can't assume anything," he said.
However, Peterson did note that the findings indicate "that there is a much larger problem, and the study highlights the need for better care for kids."
For the study, the researchers culled through surveys from a nationally representative group of more than 50,000 children under 18 years of age. From this data, the investigators were able to estimate that 7.7 million children in the United States have at least one mental health disorder.
Dr. Gregory Fritz, past president of the American Academy of Child and Adolescent Psychiatry (AACAP), said the finding that 16.5 percent of children have at least one mental health condition is in line with previous research.
But he said there are probably more kids who haven't been diagnosed and who aren't getting any treatment, so the problem may even be underestimated.
Fritz said there are a number of barriers to care. "Stigma, in its various forms, is a big barrier to care, though it's decreasing. Accessibility to treatment is another barrier. There are too few mental health professionals, and urban areas have a greater concentration of them. Insurance problems are also a barrier," he explained.
Dr. Victor Fornari, director of child and adolescent psychiatry at the Zucker Hillside Hospital in Glen Oaks, and Cohen Children's Medical Center, New Hyde Park, N.Y., agreed that there are many barriers to care.
"Firstly, parents often do not wish to accept the diagnosis in their child. Denial is a powerful force. Youth themselves, often refuse the care, and do not accept the diagnosis or the treatment. Lack of adequate mental health professionals remains a challenge," Fornari said.
"Lack of health care coverage also prevents families from seeking care, although there are mental health clinics throughout the country that provide mental health care regardless of ability to pay," he added.
Fritz said the AACAP actively encourages medical students to choose child and adolescent psychiatry as a specialty, but lengthy training and lower reimbursements compared to other medical specialties may explain why there aren't enough of these doctors available. He said there's a movement to have pediatricians more involved in kids' mental health diagnosis and treatment, particularly since pediatricians see children often as they're growing up.
Fornari noted that there is such a program ongoing at five university medical schools in New York.
"Mental health disorders are prevalent in youth and require early identification and treatment in order to optimize good outcomes for these vulnerable children and adolescents," Fornari said.
Study author Peterson said that parents shouldn't feel like they don't have options. If you're concerned that your child might have a mental health condition, talk with your child's pediatrician and ask them for resources. He suggested that parents of children who have chronic health conditions might want to be more vigilant about looking for signs of mental health disorders.
The findings were published online Feb. 11 in the journal JAMA Pediatrics.
The American Academy of Child and Adolescent Psychiatry has more information on what's normal behavior for children and teens and what's not.
SOURCES: Mark Peterson, Ph.D., associate professor, department of physical medicine and rehabilitation, University of Michigan, Ann Arbor; Gregory Fritz, M.D., past president and member expert, American Academy of Child and Adolescent Psychiatry; Victor Fornari, M.D., director, child and adolescent psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. and Cohen Children's Medical Center, New Hyde Park, N.Y.; Feb. 11, 2019, JAMA Pediatrics, online