Can 20% of U.S. Kids Really Have Some Kind of Mental Health Disorder?

As many as 20 percent of American kids have a mental illness, says a recent report from the Centers for Disease Control and Prevention (CDC). That means 1 in 5 children in the U.S. have a mental health disorder, a figure that might sound inflated: is there something really, really wrong with children in the U.S., or with how Americans raise kids?

Conversely, the CDC’s findings have a positive approach, as they suggest that we are doing a better job at diagnosing children with mental health issues. The report also points out that, in 2010, suicide was the second leading cause of death among children aged 12-17 in the U.S. Identifying depression, anxiety or other conditions in kids is the first step to helping them and, even more, preventing the tragedy of a child taking her or his own life.

CDC Report on U.S. Kids’ Mental Health

The CDC reports that, among children aged 6-17 years, 3.5 percent have behavioral or conduct problems, 3 percent have anxiety disorders, just over 2 percent have depression, just over 1 percent are on the autism spectrum and a small percentage (0.2) have Tourette’s Syndrome. 11 percent of school-age children — and 1 in 5 high school-age boys — have a medical diagnosis of ADHD. Treating children with these disorders, via health care, hospitals, special education or juvenile justice, is estimated to cost $247 billion annually.

It is possible that there is a real, actual increase in the number of children with mental health disorders. The CDC notes other factors, though, including changes in policies and access to health care, that could influence a child being diagnosed with ADHD or another condition. As the report says, children with health insurance had a higher prevalence of ADHD, autism spectrum disorders (ASDs) and anxiety. Children without health insurance had lower rates of these and were more likely to be reported as having substance use disorders.

Education and economic levels were also found to be correlated to certain mental health conditions. The report found that, ”as household education decreased, the prevalence of parent-reported behavioral or conduct problems, depression, and anxiety increased.” In addition, households in more distressed economic circumstances had children with greater rates of these disorders, as well as ADHD and drug and cigarette use.

Race, ethnicity and economic circumstances were also linked to different rates of mental health disorders. For instance, ADHD was found to be lowest among Hispanic children, behavior or conduct problems were diagnosed at the highest rates among black non-Hispanic children and ASDs were found to be higher among white non-Hispanic children. Anxiety was more common among white non-Hispanic children than black non-Hispanic children.

Mental Health Disorders are Still Diagnosed By Observation, Not Biological Symptoms

These results reflect an ongoing challenge in diagnosing mental health disorders. In most cases, there are no actual biomarkers, no biological tests, that say, clear and simply, “you have ADHD.” ADHD, autism and depression are all diagnoses that are made based on the observations of psychiatrists and other medical professionals, with the input of parents and others to see if a child meets the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

The result can be what Dr. Joel Paris of McGill University calls “diagnostic epidemics.”

…  “major depression” is a very disparate collection of signs and symptoms that cannot be used to determine the correct treatment. Bipolar disorder is being diagnosed in patients who do not have its classical features, and has even been applied to young children. Attention deficit hyperactivity disorder (ADHD) has no definite boundaries, and is being greatly over-diagnosed, both in children and adults. Autism spectrum disorders, once considered rare, are now being seen as among the most common of all conditions that professionals see.

To further complicate the matter, the very DSM criteria used to diagnose mental health disorders have just undergone a substantial revision that has been full of controversy. A number of conditions such as grief and what could be called tantrums in children now are listed in the new DSM-5.

The rise in prevalence rates could be the result of changes in the definition of the disorder or also changes in the public understanding of mental disorders. Better diagnosis has frequently been pointed out as a factor in the rise in the rate at which autism has been diagnosed, with rates now estimated to be as high as 1 in 100 or even 1 in 50.

Indeed, while my teenage son Charlie was dubbed “classically autistic” by clinicians, behavioral psychologists and teachers when he was young, I’ve now found myself being asked “does he just have autism”? After years of saying “yes,” my husband and I have begun to qualify saying that Charlie is autistic with statements such as “he doesn’t have actual seizures but” and “he does have abnormal EEGs.”

A German company, SAP, recently announced it wil be recruiting “hundreds” of autistic people, noting that they have a “unique talent for information technology.” But I don’t think that SAP is looking for an individual like Charlie. He can do more than many (including his parents) often realizes he can. But (after years of constant instruction) he does not read and seems more likely to end up with a job involving physical effort, such as recycling or janitorial work.

The DSM system is “flawed but necessary,” as Dr. Paris puts it; the manual gives clinicians a vocabulary of terms to use. What needs still to change is not asking whether or not someone has a clinician-diagnosed mental health condition but why we still attach so much stigma to mental illness and fear to get a child the help that can make a difference in her or his life.

 

Photo from Thinkstock

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140 comments

Kelsey Valois
Kelsey Valois1 years ago

I have Aspergers Syndrome, but I'm not too sure I've been "medically diagnosed." But I do have most of the symptoms and few serotonin receptors, and obviously firsthand i know i have very severe anxiety and depression.
And I'm 13, living in a very nice, somewhat stressed, household.

Paul M.
Paul M.2 years ago

Jane D. I loved your double post … very witty.

Linda M. Thank you for a good post. I liked how even-handed you were; point 4, for example. Point 5, “REMOVE THE STIGMA” is so important; not just in this context, but in so may areas.

The research into aspergers (I’ve seen it spelt at least 2 ways) is very interesting … I particularly like this one: “Scientists and autism: When geeks meet” http://www.nature.com/news/2011/111102/full/479025a.html

Samantha D. “What if the "ROOT" of those mental/behaviour disorders stem from "Domestic Violence" in the home?” What impact does domestic violence has on mental health is an important question. You have worded your comment without references to other causes, which I think must be acknowledged, but your focus is definitely worthwhile. Research on the influence of visual exposure to violence is starting to cohere.

Jane Davidson
Jane Davidson2 years ago

With all the stress, bad diet and chemical compounds in the envirment, my heart foes out to all children, and it is a miracle how they survive. Think about those who have inadequate nutrition and depend on donations, most of which are junk and processed food produced by corporations and worse. Then parents ask why they aren't achieving in school. Corporations win again by selling medications to calm them down, which injures their delicate systems more. Kids are also constantly inhaling volatile organic compounds and petroleum distillates from laundry detergents, fabric softeners, frangrances and air fresheners. No wonder they have problems and can't concentrate!!!

Jane Davidson
Jane Davidson2 years ago

With all the stress, bad diet and chemical compounds in the envirment, my heart foes out to all children, and it is a miracle how they survive. Think about those who have inadequate nutrition and depend on donations, most of which are junk and processed food produced by corporations and worse. Then parents ask why they aren't achieving in school. Corporations win again by selling medications to calm them down, which injures their delicate systems more. Kids are also constantly inhaling volatile organic compounds and petroleum distillates from laundry detergents, fabric softeners, frangrances and air fresheners. No wonder they have problems and can't concentrate!!!

Carol M.
Carol M.2 years ago

It's the food they eat. Garbage in, garbage out.

B A Robinson
BA R.2 years ago

Yes ! at least 20%. and that is probably a conservative estimate

ER C.
ER C.2 years ago

Debbie W._______

Call your granddaughter's regular doctor & explain the difficulties you are having finding a doctor that
will see her a.s.a.p.

Sometimes a doctor's reference will get you into a specialist's office fast !

Have you looked into psychiatrists for children yet?

Sometimes they will have earlier appointments available.

It's good that you have the knowledge of the illnesses in your family history.

In some families.....relatives in the past with mental issues were considered "crazy".

And, that relative’s issues were kept quiet.

Dark dirty little secrets that the family did not want anyone to know about.

In the situation that I am in with a close family member’s mental disorder,

It took that family member's suicidal attempt & hospital stay before other family members starting
talking about similar symptoms that were experienced by past relatives.

If your granddaughter is a minor and is endangering herself, you can call 911 & get her to an ER fast.
The ER doctor will ask you if you want to have her admitted to a psych center for children her age.

ER C.
ER C.2 years ago

Debbie W._______
……………………………..continued

These centers are not the crazy scary ones as stigmatized on TV.
You will go with her for admission & if you do not approve of the settings, you are free to not have her
admitted.

Many children get mad at their parents / caregivers for being put in a center.

BUT being admitted to one, can help to get her help fast.

Keep an eye out for your granddaughter's actions at all times.

Just do it in a way that she won't get paranoid about it.

Watch for scratches on her arms & legs – some people cut their arms & legs because the pain from the
cuts distract them from their mental anguish. Disposable razors are sometimes the tool of choice.

I know this must be wearing you out.

I hope you have someone that you can confide in to help you cope too.

You have to TAKE CARE of YOU so that you can take care of her.

Be patient & loving.
Never yell at her, criticize her or judge her.

It sounds like you have a lot of love for this child and SHE IS FORTUNATE FOR THAT.

I will pray for the both of you to be able find the right doctor to help her very soon.

I’m not an expert on the subject, just been there & sharing info I thought might help.

ER C.
ER C.2 years ago

Crud… I didn’t know that there is a word limit on comments._____

Instead the patient might wind up seeing only a nurse practitioner - no psychiatric knowledge - just the authority to write an Rx.

It is not the child’s fault, and in many cases not the parent’s fault.

Especially if the problem is inherited.

In many cases now days scientists & doctors are agreeing that mental disorders are inherited & do not skip generations as they once thought.

Sometimes what the child is suffering with might be called a ‘phase’

Keep a good eye out on how the child reacts to certain things.

Seek medical help.

This could even be PTSD from a traumatic event in the child’s life.

The child needs to have A parent / caregiver that can provide:
1) UNCONDITIONAL LOVE
2) PATIENCE
3) KEEP A JOURNAL even if it seems to be redundant, looking back on your notes could amaze you.
4) ANOTHER COMPASSIONATE ADULT TO HELP THE PARENT / CAREGIVER COPE
5) SEEK MEDICAL HELP
6) RESEARCH…there are a few books out there that will bring up symptoms that you are seeing too.

I pray for all children & parents that are going through these issues to have the strength to get life closer to normal.

SORRY I got so long winded. Just speaking from the heart….things I know from experience.
8~}

ER C.
ER C.2 years ago

...TO WRITE an Rx.