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Children May Not Have as Many Mental Health Disorders as Suspected

ByAllison EckNOVA NextNOVA Next
Methylphenidate, sold under the trade name Ritalin, is widely prescribed for ADHD.

Despite concerns that mental illness is rapidly spreading, a new report in the New England Journal of Medicine has found that in children, rates of treatment are going up and rates of diagnosis are going down.

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Surveys from government organizations like the C.D.C. or the National Survey of Children’s Health have suggested that childhood mental disorders have become more prevalent. But this new study, authored by Columbia University psychiatrist Dr. Mark Olfson and his colleagues, calls those findings into question. Chiefly, it says that government surveys relied on flawed assessments that don’t adequately account for varying degrees of impairment.

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Here’s Benedict Carey, writing for The New York Times about the new study:

In the study, researchers analyzed mental disability in 53,622 youngsters aged 6 to 17, based on ratings provided by parents. The parents scored their children on a so-called impairment scale.

The scale asks, for instance, how much of a problem a child has with “Feeling unhappy or sad?” “Having fun?” “Getting along with other kids?” “Feeling nervous or afraid?” The scale had 13 items in all, and parents assigned each one a “0,” for no problem, up to “4,” for a “very big problem.” Children whose scores were 16 or higher qualified as severely impaired. The data was drawn from in-depth household surveys performed by the Agency for Healthcare Research and Quality.

Between 1996 and 2012, the percentage of children and teenagers in that severe category dropped to 10.7 percent from 12.8 percent. That is a 16 percent decrease, and it was entirely unexpected, said Dr. Mark Olfson, of Columbia University, the study’s lead author.

Olfson posits that despite our modern worries about technology, social media, and “helicopter parenting,” a greater percentage of adults are being more attentive to their children’s health needs. As a result, children with psychiatric problems are being treated earlier on in life. In that same time period (1996 to 2012), the rate of young people undergoing therapy for mental disorders went from 9% to 13%. And among the most severely impaired, that figure rose from 26% to 44%. In total, there are about 2 million more children being treated for mental health disorders.

Autism may offer another example. A recent study in the journal Psychological Medicine noted that autism rates went from 7.5 in 1,000 in 1990 to 7.6 in 1,000 in 2010, a statistically insignificant result. Any apparent increase beyond that very minor bump may indicate that we’re doing a better job at identifying—and accommodating—children on the spectrum.

Part of the problem with quantifying increases or decreases in childhood mental health is that symptoms are murky and definitions even murkier. The new study attempts to cope with that by focusing on a sliding scale of behavioral tendencies, Still, the data is based on numerical scores, which themselves aren’t terribly nuanced, and it may be further limited by having emotionally-involved parents make those assessments.

Photo credit: Kurt Faler/Flickr (CC BY-NC-ND)

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