Deciphering the evidence on mental health in youth

kid-and-stressWe often hear in media reports about the rise of autism and attention disorders in our society. A few years back, New York magazine ran a feature article titled, “Is Everyone on the Autism Spectrum?”  that described the “cultural epidemic” of identifying with an autism-spectrum disorder such Asberger’s, obsessive-compulsive disorder or attention deficit disorder. But are these maladies really growing at alarming rates? And are our youth at risk?

A new report in the New England Journal of Medicine calls into question what we know about the mental health of youth in America. The article analyzed the nationally-representative Medical Expenditure Panel Surveys to identify trends in the use of outpatient mental health services by youth ages 6 to 17, and then used a mental health impairment scale to classify the severity of the child’s impairment.  More than 53,000 families participated in the survey.

The researchers found some surprising results. According to their analysis, the overall number of youth using mental health services, including counseling and prescriptions medicines, increased from 9 percent in 1996 to 13 percent in 2012.

But over that same time period, the incidence of severe mental impairment among youth decreased by 16 percent, from 12.8 percent to 10.7 percent.

The study authors point out that parents answered the surveys from the studies, and may not be able to accurately assess their children’s mental health status, especially among teenagers.

That’s a major departure from how mental health is typically assessed in youth because there are often significant differences in parent and adolescent reports of mental health function, said Janis Whitlock, a research scientist in the Bronfenbrenner Center for Transnational Research and Director of the Cornell Research Program on Self-Injury and Recovery.  But the research found an decrease in severe mental illness, conditions that parents are more likely able to identify.

“These results underscore the need for broad agreement on how to best measure mental health in youth,” Whitlock said. “The inherently slippery nature of conceptualizing, quantifying and identifying often invisible psychological and neurological processes frustrates attempts to understand important mental health trends. Nevertheless, results such as these signal some hope that the high rates of mental health challenges in youth may, at long last, be declining.”

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