Severe Mental Illness in Youth Makes Surprising Drop in Last Decade — What’s Behind It?

“We must be doing something right.” (Photo: Getty Images)

A surprising new report published this week found that the rate of severe mental impairment in children and teens has declined in the past decade —findings that seemingly contradict other information collected on youth mental health.

The report, published in The New England Journal of Medicine, analyzed mental health in nearly 54,000 kids and teens aged six to 17. It was based on ratings provided by their parents, who scored their children on an impairment scale (as opposed to reporting on an actual diagnosis their child might have received).

The scale, which had 13 total items, asked things like how much of a problem a child has with feeling happy or sad, having fun, feeling nervous, and how they get along with other kids. Parents would rate a zero if their child had no problem, up to a four if they had a “very big problem.” Children with a 16 or higher were labeled as “severely impaired.”

The percentage of kids and teens who fell into the severe category dropped from 12.8 percent in 1996 to 10.7 percent in 2012.

The study also discovered that more young people are receiving outpatient mental health services. (The rate increased from 9.2 percent in 1996-1998 to 13.3 percent in 2010-2012). Children and teens that had more severe mental health impairment had the largest increase in getting treatment — 26 percent to 44 percent.

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What does all this data mean? More people are seeking mental health treatment for their children, while the overall rate of severe mental problems in kids and teens has gone down.

That’s a good sign, lead researcher Mark Olfson, MD, MPH, a professor of psychiatry at Columbia University Medical Center tells Yahoo Health, who says the results took him by surprise: “I was expecting that the trend line would be flat and that only mental health treatment would have increased.”

This new report is markedly different from data collected by the Centers for Disease Control and Prevention, which found the rates of severel mental impairment in children and teens is actually increasing.

According to the CDC, one in 68 children had autism in 2010 (the most recent year data was collected), compared to one in 150 in 2000. The organization also found that 11 percent of children aged 4-17 have been diagnosed with ADHD since 2011, up from 7.8 percent in 2003, and that 4.3 percent of 12-17-year-olds currently suffer from depression.

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(It’s worth noting that the CDC looked at actual diagnoses vs. the symptoms that Olfson’s study tracked.)

Olfson says it’s not possible to accurately determine why the number of kids with serious mental health impairment has dropped, but notes that the trend lines up with a recent decline in arrests of young people, youth binge drinking, and high school dropout rates. However, he says it’s possible that more effective treatments, better parenting, and more kids participating in health-promoting activities in school might be at play.

“It’s really anyone’s guess, but we must be doing something right,” he says.

While the new study results found that more people are receiving care, it only looked at whether someone had been given a diagnosis or got a prescription at some point, says child and adolescent psychiatrist Gabrielle Carlson, MD, a professor of psychiatry and pediatrics at the Stony Brook School of Medicine. “The findings are promising, but it doesn’t mean they’re continuing in treatment or getting the right treatment,” she tells Yahoo Health.

Carlson says over-diagnosis might be a problem in some instances, such a parent who pressures a doctor for a prescription in order to keep a child with behavioral issues in school, but notes that only about one percent of the people who see her don’t have some form of impairment. “In those cases, I’m happy to say ‘That’s nothing to worry about,’” she says.

Both Carlson and Olfson stress that while more children and teens who need help are getting it, there are still many who are left without treatment. Says Olfson: “Clearly more needs to be done by primary care physicians, school teachers, and other concerned professionals to discuss with parents various options for getting their kids who need it safe and effective mental health care.”

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