Depressed Kids Less Likely Than Disruptive Ones to Get Mental Health Services
WebMD News Archive
Nov. 16, 1999 (Atlanta) -- Children who misbehave regularly are more likely
to receive mental health services at school than children suffering from
depression, according to a recent study. Researchers who did the study,
published in a recent issue of the Journal of the American Academy of Child
& Adolescent Psychiatry, suggest that children with depression probably
don't get help because their parents don't recognize the symptoms. Another
likely reason: parents and school personnel are more likely to intervene when a
child is disruptive than when he or she appears depressed.
"It's very easy for depressed children to fade into the wallpaper, but
they are as seriously disturbed as children who misbehave," researcher
Hector R. Bird, MD, tells WebMD. Bird's report analyzes the most recent data
from the National Institute of Mental Health on treatment -- and access to
treatment -- of children with mental disorders. Bird is a professor of clinical
psychiatry at Columbia University College of Physicians and Surgeons in New
Currently, 75% of U.S. children using mental health services get the help at
school, and for many, school services are the only care they receive. The
report is one of few that looks at patterns of usage of mental health services
in children with depression or conduct disorders such as attention deficit
hyperactivity disorder (ADHD).
The researchers found that parents were more apt to see a need for mental
health services for children with disruptive disorders than for those with
depression. On the other hand, children were more likely to see a need for
mental health services for depression than for disruptive conduct disorder.
Both findings are disturbing, say psychiatrists. "[T]his latest report
confirms the [inadequate] attention and services for children with depression
when compared with those with ... conduct disorders," Jeff Q. Bostic, MD,
EdD, writes in a separate article accompanying the report. "Perhaps even
more troubling, while juveniles with depression recognized their need for
mental health services, their parents and teachers frequently were unaware of
the child's depression."
Based on the report's findings, the researchers promote expanding and
improving school-based mental health services. "Schools provide a single
point of access to services in a non-threatening atmosphere, and thus reduce
the barriers to children['s] receiving help for emotional, behavioral, and
drug-related problems," they write.
Bird offers an extra note of caution for doctors treating children for
disruptive disorders: Be sure you test thoroughly to confirm that the behavior
disorders aren't being caused by underlying depression -- which is sometimes
the case. "I think the likelihood is that a child may misbehave because of
underlying depression," Bird tells WebMD. "These things are so closely
linked, and ... sometimes if [doctors] treat the depression, the behavior
disorders will go away as well."
Future studies should be done to determine whether depression leads to
conduct disorders or vice versa, Bird adds.