About 21% of teens experienced a major depressive episode and 9% of children and adolescents experienced anxiety even before the stress of the COVID-19 pandemic wreaked havoc on their lives.
A new study from the Centers for Disease Control and Prevention (CDC) published in the Morbidity and Mortality Weekly Report takes an in-depth look at the mental health of children and adolescents from 2013-’19. AAP leaders also weighed in on the findings in a commentary calling for urgent action.
Mental health can impact children’s physical health, relationships, education and future employment, according to the CDC. Support during childhood can help improve their long-term health and functioning.
“Thus, promoting good mental health and addressing mental disorders among children are critical public health issues,” authors wrote.
They pulled data from nine federal surveillance systems and found that among youths ages 3-17 years:
- 10% of children and adolescents had received mental health treatment in the year before the survey,
- 10% had attention-deficit/hyperactivity disorder,
- 9% had experienced anxiety problems,
- 9% had experienced behavioral/conduct problems,
- 8% had taken medication for mental health problems in the previous year,
- 4% had experienced depression and
- 2% met the autism spectrum disorder surveillance case definition.
Some of the data sets looked specifically at adolescents/teens, including age ranges of 12-17 or 14-18 years. These data showed:
- 37% persistently felt sad or hopeless for at least two weeks,
- 26% received mental health services,
- 21% had experienced a major depressive episode,
- 19% had seriously considered attempting suicide in the previous year,
- 9% had attempted suicide in the previous year,
- 7/100,000 adolescents ages 10-19 years died by suicide in 2018 and 2019, and
- 4% had a substance use disorder in the previous year.
Previous studies indicate 40% of children will have met the criteria for a mental health condition by the time they reach adulthood. The stress of the pandemic has exacerbated these issues.
Late last year, the AAP, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association declared a national emergency in children’s mental health, and the U.S. surgeon general issued an advisory calling for action to protect the mental health of youths.
The CDC noted in today’s report it is working to improve the surveillance systems to provide even more actionable data and help connect families to services. The report includes data on trends in race, sex, geographic location and parents’ income and education for each mental health condition studied.
In a commentary published today in Pediatrics, AAP leaders called for surveillance systems to include data on the impact of structural racism and childhood adversity and trauma on children’s mental health and said urgent action is needed to address these harms. Authors Ruth Shim, M.D., M.P.H., associate dean of diverse and inclusive education and director of cultural psychiatry at the University of California, Davis; AAP President Moira A. Szilagyi, M.D., Ph.D., FAAP, and AAP Past President James M. Perrin, M.D., FAAP, also said systems could be improved by including long-term data on the trajectory of children’s mental health conditions and treatment.
“Direct attention to SDoH (social determinants of health) through household income support, housing, nutrition, and others will help lower rates of health conditions,” they wrote. “Specific preventive interventions must be designed to protect children and adolescents from these harms, and to appropriately intervene with trauma-informed, antiracist care provided by a pediatric and mental health workforce with specific training on successful interventions, in a health care system designed to minimize such harms.”
Resources
- AAP mental health initiatives
- AAP interim guidance on children’s emotional and behavioral health during the pandemic
- Information for parents from HealthyChildren.org on mental health during the pandemic
- COVID-19 parental resources toolkit on mental health from the CDC
- U.S. surgeon general advisory “Protecting Youth Mental Health”
- Information from the American Medical Association on integrating behavioral health care into a clinical practice
