{"id":5344,"date":"2024-11-21T15:15:16","date_gmt":"2024-11-21T14:15:16","guid":{"rendered":"https:\/\/www.rivistaeco.com\/?p=5344"},"modified":"2024-11-21T15:15:16","modified_gmt":"2024-11-21T14:15:16","slug":"one-in-seven-children-suffers-from-mental-disorders","status":"publish","type":"post","link":"https:\/\/www.rivistaeco.com\/en\/2024\/11\/21\/one-in-seven-children-suffers-from-mental-disorders\/","title":{"rendered":"One in Seven Children Suffers from Mental Disorders"},"content":{"rendered":"<p><i><span style=\"font-weight: 400;\">It is estimated that one in seven children between the ages of 10 and 19 suffers from a mental disorder. However, there is now greater awareness of the issue, and more sophisticated tools for diagnosing these disorders. Both should be leveraged to organise better responses to children&#8217;s mental health challenges\u2014especially since, thanks to research, we now have a clearer understanding of which interventions are most effective and when to apply them.<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">The mental health of children and young people is becoming a central issue. In 2021, the US Surgeon General\u2014the federal government&#8217;s chief spokesperson on public health\u2014issued an urgent advisory on youth mental health, and the American Academy of Pediatrics declared a national state of emergency. But this concern is not limited to the United States. According to a 2021 UNICEF report titled <\/span><i><span style=\"font-weight: 400;\">The State of the World&#8217;s Children 2021: On My Mind<\/span><\/i><span style=\"font-weight: 400;\">, 16% of European girls and nearly 20% of European boys between the ages of 15 and 19 suffer from a mental disorder.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These alarming statistics raise a crucial question: has youth mental health truly worsened over the past 10 to 20 years, or has it always been this critical? Many point to the rise in social media use and the COVID-19 pandemic as key factors (David Blanchflower and Alex Bryson also discussed this in the June issue editor\u2019s note). However, as early as 1970, a US mental health commission published a report titled <\/span><i><span style=\"font-weight: 400;\">Crisis in Child Mental Health: Challenge for the 1970s<\/span><\/i><span style=\"font-weight: 400;\">, noting that 10-12% of US children had &#8220;serious psychological problems.&#8221;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It is difficult to compare data from the 1970s with today\u2019s figures because definitions of mental health conditions have changed. Nevertheless, the data suggest that a significant number of children and adolescents have always suffered from serious mental health issues\u2014a matter that society seems to be acknowledging and addressing only now.<\/span><\/p>\n<h3><b>Why Youth Mental Health is Important<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Any health problem that compromises quality of life is a cause for concern. The World Health Organization estimates that one in seven children between the ages of 10 and 19 has a mental disorder, and that mental health issues account for 13% of the global disease burden in this age group. Moreover, mental health problems in young people are highly indicative of their future well-being.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For example, in collaboration with Mark Stabile, I studied large, nationally representative samples of US and Canadian children for a mental health screening. We found that, compared to their siblings, children with poorer mental health had lower test scores, were more prone to delinquency, and were less likely to still be in school eight years later. Follow-up research on Canadian children showed that those with mental health problems in childhood were more likely to rely on welfare as adults and were less likely to attend college compared to their siblings.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another reason why children&#8217;s mental health issues are so critical is that they often precede mental health conditions in adulthood: many mental disorders first appear during childhood or adolescence. In the European Union, mental health problems are the leading cause of lost workdays among employed adults and a significant reason why people leave the workforce\u2014consistent with our finding that children with mental health problems are more likely to rely on welfare as adults.<\/span><\/p>\n<h3><b>Seek and You Shall Find<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Although several reports suggest that children&#8217;s mental health is deteriorating, it is surprisingly difficult to build consistent and reliable data over time. Many surveys simply do not include questions on this topic.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another issue is that the definition of mental health conditions has evolved. For instance, the fifth edition of the <\/span><i><span style=\"font-weight: 400;\">Diagnostic and Statistical Manual of Mental Disorders<\/span><\/i><span style=\"font-weight: 400;\"> (DSM-5), published in 2013, grouped autism, Asperger&#8217;s syndrome, pervasive developmental disorder, and childhood disintegrative disorder into the new category of autism spectrum disorder (ASD). Not surprisingly, the number of children diagnosed with ASD\u2014still commonly referred to as autism\u2014has increased significantly. The definition of depression was also expanded to include additional disorders, such as those related to grief. The criteria for attention deficit hyperactivity disorder (ADHD) were broadened to include children who exhibit symptoms up to age 12, rather than only up to age 7.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Similarly, the tenth revision of the International Classification of Diseases (ICD-10) significantly changed the categories for coding mental health disorders and issued new guidelines for physicians. In research with Adriana Corredor-Waldron on adolescents treated in New Jersey emergency rooms, we showed that the change led to a substantial and sudden increase in secondary diagnoses of suicidal thoughts.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The wider use of mental health screenings has also contributed to higher diagnosis rates. As with any illness, the more people are screened, the more likely cases will be diagnosed. In 2011, the US Preventive Services Task Force recommended annual depression screenings for women and girls aged 12 and up. Starting that year, the Affordable Care Act required insurance to cover these screenings at no cost to patients. Unsurprisingly, our study with Adriana Corredor-Waldron shows that these changes led to an increase in diagnoses of suicidal ideation among girls, as depression screening tools typically include questions to identify suicidal thoughts. For example, in 2018, the American Academy of Pediatrics updated its preventive services guidelines to recommend that paediatricians include suicide-related questions in annual check-ups for children.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In some cases, the spread of screening has been incentivised by other regulations. In South Carolina, the public health insurance program for children (Medicaid) changed its reimbursement rules for children with chronic conditions, penalising doctors who did not perform adequate health screenings on insured children. In research with Anna Chorniy, we found that the change significantly increased both screenings and new diagnoses of mental health conditions, including depression and ADHD. Interestingly, the change also led to an increase in asthma diagnoses and other physical health conditions, suggesting that broader health screenings for children help detect a wide range of conditions.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">We should also note that the reduction in stigma surrounding mental health may have influenced the number of confirmed cases, although it is difficult to quantify the exact impact. Over the past 25 years, there have been significant improvements in mental health knowledge, treatment, and the willingness to seek help. Both patients and doctors are more likely to recognise mental health disorders when there is less stigma, and when they are better trained to identify the signs. The reduction in stigma may also affect the number of suicides reported, which many consider to be a key measure of mental health in the population. Not all suicides are captured in mortality data, as unclear intent can lead to a suicide being classified as an accidental death to avoid shame on the deceased or their family. As stigma decreases, more cases may be classified as suicides, while fewer deaths are recorded as due to injury.<\/span><\/p>\n<h3><b>How to Improve Youth Mental Health<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Research shows that it is possible to prevent childhood mental health problems through targeted interventions during pregnancy and early childhood. The intrauterine period is particularly important for a child&#8217;s development. When pregnant women suffer from illness, malnutrition, or severe stress, there are often long-term consequences for their children. For instance, Dutch individuals conceived during the &#8220;Hunger Winter&#8221; of 1944 were more likely to suffer from schizophrenia as adults. Similarly, in Denmark, among identical twins, the child with the lower birth weight is more likely to suffer from ADHD.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Supporting pregnant women, therefore, seems like an effective way to improve children&#8217;s mental health. For example, the US WIC (Women, Infants, and Children) program offers pregnant women nutritional supplements, counselling, and easier access to medical care. In research with Anna Chorniy, we compared seven- to nine-year-old children whose mothers had participated in the program with their siblings born after a pregnancy in which the mother did not use the program. Our results indicate that the program significantly reduced the incidence of ADHD and other mental health conditions diagnosed in early childhood.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another ideal time for preventive intervention is early childhood. Programs targeting this age group have proven capable of improving children&#8217;s psychosocial readiness for school and reducing behaviours associated with ADHD and conduct disorders. In Norway, a program aimed at young children of parents with mental health disorders halved the likelihood that those children would be diagnosed with a mental health problem during adolescence.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Improving the treatment of mental health conditions is extremely important, as many areas still suffer from severe care shortages and long waiting lists. In research with Emily Cuddy, we found that even when children receive treatment, it is often of questionable quality. For example, children are sometimes prescribed multiple psychiatric medications without receiving any therapy. Some of these medications are dangerous in case of overdose, are addictive, and are not recommended for children. Poor-quality treatments result in worse mental health outcomes compared to those that follow clinical guidelines. While this study involved U.S. children with private insurance, in subsequent research with Jonathan Zhang on Canadian children with public insurance, we found that all these questionable practices are more commonly offered to children from low-income families.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Children spend much of their time in school, which can be a crucial setting for providing mental health services. However, school can also be a very stressful environment for some children, with peaks in mental illness and suicide occurring around the start of the school year and during major exams. The presence of licensed mental health professionals in schools increases the use of mental health services, improves discipline, and reduces suicide attempts.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The child mental health crisis is not new. However, growing awareness of the issue on the one hand, and the proven effectiveness of certain interventions on the other, should lead to a more organised and robust societal response. Efforts to improve children\u2019s mental health must be holistic, addressing all areas of their lives, from the prenatal period and early childhood to both education and healthcare.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><em><span style=\"font-weight: 400;\">Bio<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400;\">Janet Currie is the Henry Putnam Professor of Economics and Public Affairs at Princeton University and co-director of the Center for Health and Wellbeing at Princeton. She is also co-director of the Program on Families and Children at the National Bureau of Economic Research.<\/span><\/em><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>It is estimated that one in seven children between the ages of 10 and 19 suffers from a mental disorder. 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