Transcript Adolescent Mental Health: Population

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
1
Adolescent Mental Health
Using Key Data Indicators to
Motivate Strategic Action:
Why We Need a Bracelet
2
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
3
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
4
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
5
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
6
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
7
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
8
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
9
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.
10
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
11
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)
12
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
13
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
14
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.
15
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%)
16
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
17
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
18
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
19
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).
20
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.
21