- Escalation of mental health needs in children over the past decade has worsened under the COVID pandemic.
- Evidence-based services for children's mental health are not sufficiently accessible.
- Three major organizations (AAP, AACAP, CHA) call for significantly increased investment in improving children's mental health.
Earlier this week, three highly respected professional organizations jointly declared a national emergency in children’s mental health. It is fitting that this comes during ADHD Awareness Month. Children with ADHD are one of the most vulnerable population groups in the face of dislocation, losses, or trauma. I documented the vulnerability of youth with ADHD to emotionally traumatic experiences and unusual stressors in Getting Ahead of ADHD (2017) and nothing has changed that set of findings since then.
The three professional organizations that made this statement on October 19, 2021, are the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association. Their concern is well placed. Indeed, as I noted in earlier posts this year, it may well be that the greatest toll imposed on the population by the COVID-19 pandemic is not the physical illness itself, but the enduring worsening of mental health needs.
Evidence of increased mental health needs in children
I have written already during the past 2 years in this space about some of the drivers of this concern. As noted in the announcement, these include reports cited in the announcement from the U.S. Centers for Disease Control of a 25-30% increase in children reporting to hospital emergency rooms for mental health crises, including a 50% increase in visits related to suicide attempts by teen girls. Indeed, as I noted previously in this space, suicide among young people aged 10-24 has steadily increased in the past decade and is now the second leading cause of death in this age group. The list of stressors faced by children and teens is daunting at present—from losing a loved one to COVID, disruptions in peer relationships by school shut-downs, delays, and setbacks in the educational process, and increases in family violence related to COVID shutdowns and recent economic stressors. Despite incredible and crucial recent progress on vaccinations, the mental health impacts continue. This has long been the finding after public or community disasters. The mental health effects are not limited to the crisis period but persist long after.
Recommendations to policymakers
These professional groups point out that many of the issues going on require policy-level responses. They issued 10 recommendations to policymakers calling for more investment, much of it at the federal level, in programs and services to bring evidence-based evaluation and care to address this need. The recommendations are well taken.
I would add that the need also remains acute for increased investment in basic and translational research to better understand the causes, buffers, and moderators of outcomes for children’s mental health needs. Compared to the cost of these problems, the national investment is astonishingly small relative to other health burdens. Such research continues to be necessary to continue to improve and strengthen the knowledge base for how evaluation and treatment are conducted.
The evidence for ADHD requiring additional treatments to be developed remains notable, as I highlighted earlier this month. The same is true for other childhood mental health conditions. The Center for ADHD Research at OHSU remains committed to strong progress on that front, including new treatment trials, as I noted in my post about nutrition intervention two weeks ago.
It is to be hoped that policymakers can come together to heed the recommendations from these eminent organizations and that both they and the philanthropic community will be inspired to make necessary investments.
Meantime, thank you to the many professionals who are working extra hours to provide care to children and families, to parents out there who are hanging tough in tough times to care for their families, and to the children who continue to find a way to make it through. We’ll get there.
Good health to all.
If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 contact the National Suicide Prevention Lifeline, 1-800-273-TALK, or the Crisis Text Line by texting TALK to 741741. To find a therapist near you, see the Psychology Today Therapy Directory.
Please note: Dr. Nigg cannot advise on individual cases for ethical, legal, and logistical reasons.
AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health. American Academy of Pediatrics. (2021, October 19). Retrieved October 21, 2021, from https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-dev…
AAP, AACAP, CHA declare national emergency in children’s mental health. AAP News: The Official Newsmagazine of the American Academy of Pediatrics. (2021, October 19). Retrieved October 21, 2021, from https://www.aappublications.org/news/2021/10/19/children-mental-health-…
Leeb, R. T., Bitsko, R. H., Radhakrishnan, L., Martinez, P., Njai, R., & Holland, K. M. (2020). Mental Health-Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic - United States, January 1-October 17, 2020. MMWR. Morbidity and mortality weekly report, 69(45), 1675–1680. https://doi.org/10.15585/mmwr.mm6945a3
Nigg, J. T. (2017). Getting Ahead of ADHD: What Next-Generation Science Says about Treatments That Work—and How You Can Make Them Work for Your Child. Guilford Press.