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Sounding the Alarm on the National Emergency in Child and Adolescent Mental Health

April 26, 2022

This week in Pediatrics, we are early releasing a Commentary by Shim et al that highlight findings recently reported by the Centers for Disease Control and Prevention in their Morbidity and Mortality Weekly Report (10.1542/peds.2022-056611) documenting the prevalence of mental health disorders in children. A key finding in that report is that 20% of children (annually) have a mental health disorder and up to 30% of children in military families. Shim et al also highlight the variables associated with worse mental health outcomes, i.e. socioeconomic status, race/ethnicity, access to care, etc. On a more sobering point, the commentary authors also comments on the abysmally low access (~10%) that children/adolescents have to receiving appropriate treatment for their mental health disorders.

The commentary takes the problem of there being a high prevalence of mental health disorders in youth and adolescents and compounds it with a discussion outlining the challenges that the mental health surveillance system has, as captured in the National Survey of Children’s Health. These challenges include the following:

  1. Incorporation of child adversity and trauma: lack of comprehensive inclusion and recognition of the effect adverse childhood experiences and social determinants of health have on mental health
  2. Accountability for structural racism: lack of reporting on groups (especially children who are indigenous) known to have a disproportionately high incidence of mental health disorders as a result of the social environments in which they are living
  3. Surveillance shortcomings: ensuring that data collection encompasses how mental/behavioral conditions change over time throughout a patient’s development

Shim et al assert that better surveillance may increase the likelihood of identifying other areas of improvement (eg risk stratification, treatment initiation, etc.) and to do so means attention to the aforementioned challenges that are well summarized with a call to action in this important commentary.

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