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Adolescent Mental Health: Key Data Indicators

Gwendolyn J. Adam, Ph.D., L.C.S.W.

Assistant Professor - Department of Pediatrics

Section of Adolescent Medicine and Sports Medicine

MCHB-funded Leadership Education in Adolescent Health (LEAH) Program

Baylor College of Medicine

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Adolescent Mental Health

Using Key Data Indicators to Motivate Strategic Action:

Why We Need a Bracelet

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Key Data Indicators

• World Health Organization evidence indicates that internationally:– by 2020 childhood neuropsychiatric disorders

will rise proportionately by over 50%– neuropsychiatric disorders will become one of

the five most common causes of morbidity, mortality and disability among children

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Key Data Indicators

• In the United States:– 1 in 10 children / adolescents suffers from

mental illness severe enough to result in significant functional impairment

– Youth with mental disorders are at much greater risk of dropping out of school and suffering long-term impairments

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Key Data Indicators: Depression

• In 2004 in the United States:– 3.5 million youth (14%) ages 12-17 have

experienced at least one major depressive episode in their lifetime

– Major Depressive Episode defined as:• 2 weeks or more of:

– depressed mood / may be irritability in adolescents

– loss of interest or pleasure in daily activities

– 5 of 9 remaining DSM-IV criteria

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Key Data Indicators: Depression & Suicidal Thoughts

• Among youths ages 12-17 who had experienced a Major Depressive Episode:– 2.3 million youths (9%) thought during their

worst or most recent MDE that it would be better if they were dead

– 1.8 million youths (over 7%) thought about killing themselves during their worst or most recent MDE

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Key Data Indicators: Depression & Suicidal Thoughts

• Youth ages 14 through 17 are significantly more likely to have had a Major Depressive Episode accompanied by thoughts of better off dead or thoughts of committing suicide than ages 12-13

• MDE with suicidal thoughts – not varied by urbanicity – (large, small and non-metro similar)

• Females aged 12-17 more likely than male peers:– Major Depressive Episode in lifetime– Thought about killing themselves at worst or most

recent MDE

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Key Data Indicators: Depression and Suicidal Plans and Attempts

• Among youth ages 12–17 experiencing or having experienced MDE:– 900,000 youths (3.6%) made a plan to kill

themselves during worst or most recent MDE – 712,000 youths (2.9%) tried to kill themselves

during such an episode– Females more likely to have made a plan or

attempted suicide than males

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Key Data Indicators: Completed Suicide

• As reported by the CDC for 2001 in adolescents ages 10-24:– Suicide was the 3rd leading cause of death –

accounted for 11.7% of all deaths in this cohort– 4,243 adolescents ages 10-24 completed suicide – Male suicide rates averages five times greater

than female suicide rate

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Key Data Indicators:Completed Suicide

• Between 1960 and 2000 the suicide rate among adolescents increased 128% as compared to an increase of 2% in the general population.

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Key Data Indicators: High School Students and Suicide

• Roughly 1 in 5 (21.3%) female adolescent high school students seriously considered suicide in 2003 as compared to 12% of same-age males

• Female Hispanic high school students are more likely to attempt suicide than all other students

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Key Data Indicators: Co-Morbidity Issues – Drug Use

• For adolescents ages 12-17 during 2004:– Those who had experienced a MDE in past year

were more than twice as likely to have used illicit drugs than peers without MDE in past year

– 15,000 emergency department visits for suicide attempts involving drugs (75% of these serious to warrant admission)

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Key Data Indicators: Co-Morbidity Issues – Drug Use

• For adolescents ages 12-17 in 26 states reporting to SAMHSA Treatment Episode Data Set:– 16,000 (21%) admissions for treatment

involved a co-occurring psychiatric problem in addition to drug / alcohol problem

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Key Data Indicators: Parent Mental Health

• Of the 18 million women aged 18 or older parenting at least one youth aged 12-17– 2.1 million mothers (11.9%) had a serious mental

illness in past year

– 3.2% of mothers had both a serious mental illness and reported illicit drug or alcohol use in the past month

– Youth living with a mother with a serious mental illness were more likely to have used illicit drugs or alcohol in the past month than their peers living with mothers without a serious mental illness

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Key Data Indicators: Treatment

• During 2004 - of the 2.2 million adolescents aged 12 to 17 who had experienced at least one MDE in the past year, 40.3% reported having received treatment for depression in the past year.

• Approximately 886,600 youth reported receiving no treatment.

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Key Data Indicators: Treatment

• Reasons for Mental Health Treatment in Past Year for Youth Ages 12-17 (non drug-related):– Felt depressed (52%)

– Breaking Rules / Acting Out (28%)

– Felt Very Afraid or Tense (21%)

– Thought about or Tried Killing Self (19%)

– Family or Home Problems (13%)

– School-Related Issues (11%)

– Social / Friend Problems (8%)

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Key Data Indicators: Treatment

• It is estimated that 5-7% of children / adolescents receive some type of specialty mental health services

• It is estimated that 20% of children / adolescents have a diagnosable mental disorder

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Key Data Indicators: Impact of Mental Health Issues Uncertain

• Limited consistent national data on impact of mental health issues in other areas:

• Violence • Disordered eating• Education problems• Criminal Justice • Child Welfare• “Unintentional Injuries and Motor Vehicle

Accidents” – the other two leading causes of death

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Key Data Indicators Demonstrate that Mental Health Issues:

• are prevalent among adolescents• lead to lethal thoughts and acts • minimally present as the 3rd leading cause of death for adolescents• impact other behavioral health risks – e.g. drug and alcohol use• have family system implications - parent mental health affects

adolescent health risk behavior• are not adequately addressed for adolescents - less than half of

depressed adolescents receive treatment when they need it

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References

• Blueprint for Change: Research on Child and Adolescent Mental Health, Report of the National Advisory Mental Health Council’s Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment, Executive Summary and Recommendations (2000)

• DASIS Report: Adolescents with Co-Occurring Psychiatric Disorders: 2003

• National Adolescent Health Information 2004 fact Sheet on Suicide: Adolescents and Young Adults. NAHIC (2004).

• National Survey on Drug Use and Health Report: Depression Among Adolescents. Substance Abuse and Mental Health Services Administration (2004).

• National Survey on Drug Use and Health Report: Mother’s Serious Mental Illness and Substance Use Among Youths. Substance Abuse and Mental Health Services Administration (2004).

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References

• National Survey on Drug Use and Health Report: Office of Applied Studies. Substance Abuse and Mental Health Services Administration (2003-2004).

• National Survey on Drug Use and Health Report: Suicidal Thoughts Among Youths Aged 12 to 17 with Major Depressive Episode. Substance Abuse and Mental Health Services Administration (2004).

• New DAWN Report: Disposition of Emergency Department Visits for Drug-Related Suicide Attempts by Adolescents, 2004

• Preventing Child and Adolescent Mental Disorders: Research Roundtable on Economic Burden and Cost Effectiveness (2004)

• U.S. Public Health Service, Report of the Surgeon General’s Conference on Children’s Mental Health: A National Action Agenda. Washington, DC: Department of Health and Human Services, 2000.