By: Hannah Heitz
According to Costello, et al. only 45% of youth with disorders utilize treatment. Youth are more likely to receive services for externalizing disorders, such as ADHD and conduct disorder, while children with internalizing disorders, like anxiety and depression, are less likely to receive treatment. Additionally, 40% of children with one mental illness have at least one other co-morbid illness. Mental illnesses have varying ages of onset, for example, anxiety has the earliest onset around six years old, whereas risk for substance use disorder increases with age. About one quarter to one fifth of youth with mental illness have severely impaired functioning.
The complexity of co-morbid mental illnesses, and mental illnesses in general, is difficult to treat without specialized training. As shown in the research, only one fourth of youth with mental illness get access to specialty care. While there are numerous other sources for care, such as the school counselors and primary care providers, few providers have training comparable to that of specialty mental healthcare providers. As seen in the work of the Georgia Center of Excellence in Child and Adolescent Behavioral Health (COE), school mental health is often provided by overworked counselors with numerous other responsibilities. A recent COE initiative provided child counselors in schools part-time in underserved communities. Following the success of this program, policymakers should consider implementing the program at a wider, sustainable scale with thorough evaluation of its effects.
1: Costello EJ, He JP, Sampson NA, Kessler RC, Merikangas KR. Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey-Adolescent. Psychiatr Serv. 2014 Mar 1;65(3):359-66. doi: 10.1176/appi.ps.201100518
2: Merikangas KR, He JP, Burstein M, Swendsen J, Avenevoli S, Case B, Georgiades K, Heaton L, Swanson S, Olfson M. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2011 Jan;50(1):32-45.