Feb. 12, 2019 -- Mental health problems in U.S. children are common, according to a new survey, with about one in six children of school age affected.
The survey asked parents about anxiety, depression, and attention deficit hyperactivity disorder, or ADHD, because they are the most common. They also pose the greatest risk for long-term problems if not treated early, says study senior author Mark D. Peterson, PhD, an associate professor of medicine at the University of Michigan, Ann Arbor.
Peterson found that, based on the nationally representative survey and estimates, about 7.7 million U.S. children, or about 16.5%, have at least one of those disorders.
“Of those 16.5%, almost 50% did not get treatment,” Peterson says. Whether children got treatment varied greatly by state, he says.
He hopes the report will raise awareness and improve access to care. "Parents should be aware of the fact there is a risk of [these mental health issues] in kids, even young kids," he says. The study was published in JAMA Pediatrics.
The researchers took data from the 2016 National Survey of Children's Health, a nationally representative survey of children in the U.S. younger than 18 years old. (For this study, children without current health insurance and those younger than 6 years were excluded.)
Parents were first asked if a doctor or other health care professional had told them their child has a mental health disorder. If so, they were asked if the child had the condition currently. And if the child did, the parents were asked whether it was depression, anxiety, or ADHD, the conditions the researchers focused on.
Parents then told the survey whether the child had gotten treatment for the condition in the past year.
The survey also had state information for each person who took part, Peterson says. On the state level, children with at least one mental health issue ranged from 7.6% in Hawaii to more than 27% in Maine.
The researchers say that state-level policies and practices play a role in both health care needs and use, perhaps explaining the disparities.
The analysis confirms what previous studies have suggested, says Andrew Adesman, MD, chief of developmental and behavioral pediatrics at the Cohen Children's Medical Center in New Hyde Park, NY. "Tragically, some of the states with the highest prevalence of mental health disorders were also among those states with the highest proportion of children who did not receive mental health services within the past year." Since those without health insurance were excluded, ''it is likely that this analysis has underestimated the proportion of children with mental health disorders and their treatment by mental health professionals."
The findings of this survey are not surprising, agrees Mary C. Lamia, PhD, a clinical psychologist and clinical program professor at the Wright Institute in Berkeley, CA. She cites many challenges parents face in getting mental health help for their children, such as coverage limits for mental health treatment.
Finding a provider can be daunting, she says. And low-income families on state-issued insurance may have an extra challenge, as there may be a limited number of providers who accept their plan. Community clinics, another option, often have long waiting lists.
She suggests another way: turning to independent graduate schools, whose student-therapists must do many hours of practice to get licensed to give therapy.
Take-Homes for Parents
While pediatricians talk about developmental milestones with parents, such as crawling, walking, and language, they may not ask directly about mental health issues, Peterson says. "It's something parents should not be afraid to ask their pediatrician or other health care provider about," he says.
He suggests parents bring up the topic at well-child visits with their primary care doctor or pediatrician if they are at all concerned about any mental health problems. "Don't be shy about asking for additional assistance for these concerns."
Awareness about children's mental health issues is growing, Peterson says, among researchers and health care providers. "We didn't think kids could have issues with depression," he says, but experts know now that's not true.
Lamia offers these tips for parents:
- If you can't find a mental health provider through your insurance, check in with your insurance carrier and express your frustration; request an out-of-network provider if necessary.
- Learn about emotions in your children. The American Psychological Association has a book division, Magination Press, that covers topics of interest such as bullying. Lamia is on the Magination Press editorial board.
- Stay connected with your child; encourage talk about feelings and challenges they’ve faced during the day.
- Don't buy into the stigma some feel about mental health problems; get help.