Mental disorders increasing among US children

By Matthew MacEgan
25 May 2013

A new report from the Centers for Disease Control and Prevention (CDC) shows that 13 to 20 percent of children living in the United States experience a mental disorder within a given year. Continued study has also shown that these conditions increased between 1994 and 2011.

The report, “Mental Health Surveillance Along Children—United States, 2005-2011” was authored by several doctors representing many CDC divisions across the US, led by Ruth Perou, the Child Development Studies Team Leader of the CDC’s National Center on Birth Defects and Developmental Disabilities.

The report begins by stating that mental disorders among children are an important public health issue in the United States due to “prevalence, early onset, and impact on the child, family, and community.” The estimated total annual cost of mental disorders in the United States is $247 billion. This cost includes health care, use of special education services, juvenile justice, and decreased productivity. Accordingly, mental disorders were the most costly conditions to treat in children in 2006.

The CDC defines mentally healthy children as those who “have a positive quality of life and can function well at home, in school, and in their communities.” In opposition to this, they describe mental disorders as “serious deviations from expected cognitive, social, and emotional development.”

The most common disorders reported by parents of US children aged 3 to 17 are attention-deficit/hyperactivity disorder (ADHD), behavioral or conduct problems, anxiety, depression, autism spectrum disorders, and Tourette syndrome.

Suicide, which can result from the interaction between mental disorders and other factors, was the second leading cause of death among children aged 12 to 17 in 2010. The overall suicide rate of persons aged 10 to 19 was 4.5 suicides per 100,000 during that year.

Recently, the term mental, emotional, or behavioral disorders have been extended to include substance use disorders. Nearly 5 percent of adolescents aged 12 to 17 years reported an illicit drug use disorder sometime throughout the past year while more than 4 percent reported an alcohol abuse disorder over the same period. Nearly 3 percent had cigarette dependence in the last month.

One indicator of mental health used among numerous other techniques and systems was the determination of healthy versus unhealthy days over the course of a month. When asked the question, “Now thinking about your mental health, which include stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?” approximately 8 percent of adolescents reported 14 or more mentally unhealthy days during the past month.

Other recent studies have focused on insurance claims for services concerning mental disorders in children. One particular study showed that approximately 20 percent of the privately insured population aged below 65 in the United States has made such claims. The same report revealed a 24 percent increase between 2007 and 2011 in inpatient mental health and substance abuse admissions among children. A second study reported that in 2010, mood disorders (depression) were the most common principal diagnoses for all hospital stays among children in the United States. The rate of such hospital stays increased dramatically between 1997 and 2010, by 80 percent.

The CDC states that mental disorders may result in serious difficulties at home, with peer relationships, and in school. Such disorders may be associated with substance abuse, criminal behavior, and other risk-taking activity. Persons with mental disorders frequently have more than one disorder. Children with mental disorders are also more likely than their peers to have other chronic health conditions such as asthma, diabetes, and epilepsy.

The report suggests that mental disorders in children are associated with an increased risk for mental disorders in adulthood, which may result in “decreased productivity, increased substance use and injury, and substantial costs to the individual and society.”

The CDC also explicitly states that “all demographic groups are affected by mental disorders in childhood,” with conditions and indicators varying by race and ethnicity as well as gender. Ultimately, most of the disorders increased in prevalence with age, and boys were more likely than girls to have most of the disorders.

However, the greatest correlation is with social status and poverty. Reportedly, as household income decreased, the prevalence of behavioral or conduct problems, depression, and anxiety increased. As poverty levels increased, prevalence of ADHD, behavioral or conduct problems, depression, and anxiety also increased, as did illicit drug use disorders and cigarette dependence.