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MENTAL HEALTH DISORDERS IN CHILDREN

HEALTH POLICY
by

ANA ROBLETO

on 30 July 2013

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Transcript of MENTAL HEALTH DISORDERS IN CHILDREN

MENTAL HEALTH DISORDERS IN CHILDREN
PREVALENCE OF MENTAL HEALTH DISORDERS IN CHILDREN & ADOLESCENTS
Approx. 4 million children/adolescents have a mental disorder that significantly impacts their social and familial relationships

13- 20% of children in the US experience a mental disorder any given year

1/2 of mental disorders cases begin by age 14

$247 billion are spent each year on treating children with mental disorders
UNTREATED MENTAL HEALTH DISORDERS





HIGHER HEALTH CARE UTILIZATION

More health care services use
Higher health care costs
Limited or non-existent employment opportunities
Poverty in adulthood
ANA ROBLETO
DANIELLE CICHON
JENNIFER KENNEALLY
LUCILA BLOISE
MIKE RICCIARDI
SINDY JARAMILLO

1) Establish a Child Advocacy System that coordinates federal, state, and local services in a unified network to satisfy the mental health and social service needs of children and families.

2) Systems of care (e.g. public and private insurance) should expand the mental health services provided to children and families. They should be tailored to individual needs and minority groups.

3) Increase educational campaigns focused on screening for mental health disorders, especially in early childhood, given the importance of early detection and intervention.

POLICY RECOMMENDATIONS
WHAT SHOULD A PARENT DO?
1. SEEK PROFESSIONAL HELP. If the pediatrician observes early signs of a mental health condition, he/she will discuss treatment options or may recommend a mental health professional.

2. FOLLOW-UP on appointments. Find help groups or educate yourself.

3. TALK TO SCHOOL OFFICIALS. Work with the school to identify interventions that promote positive behaviors and development.

4. CONNECT with other families, and remember that you are not alone.
WHAT IS A MENTAL HEALTH DISORDER?
A pattern of behavioral or psychological symptoms that impact multiple life areas and/or create distress for the person experiencing these symptoms
DIAGNOSIS
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR)
Set Symptoms/Behaviors = Psychological Disorder


PURPOSE OF DIAGNOSIS
Discover solutions, treatments, and information related to the problem
MENTAL HEALTH DISORDERS
MAJOR MENTAL HEALTH DISORDERS

Disruptive Behavioral Disorders
Autism Spectrum Disorders
Mood & Anxiety Disorders

--ADHD is the most prevalent diagnosis among children ages 3 to 17

--The number of children with mental disorders increases with age, excluding ADHD
RISK FACTORS FOR MENTAL HEALTH DISORDERS
BIOLOGICAL INFLUENCES
Biological abnormalities of the CNS influence caused by genetic or environmental influences

STRESSFUL LIFE EVENTS
Health or Financial Problems (like poverty)

MENTAL HEALTH DISPARITIES
GENDER
Girls are less likely to receive mental health treatment (especially for behavior problems and depression)
Girls are more likely to be affected by mood disorders
Boys more likely to have suicidal/behavioral issues

RACE & ETHNICITY
Rate of unmet needs is highest for minority population groups
Hispanic children are least likely to have a mental disorder identified

SOCIOECONOMIC STATUS & INCOME
Employed mothers are more likely to get their children treated for mental health disorders
Poor children and those that live in rural areas have more mental health problems
BARRIERS TO ACCESS MENTAL HEALTH SERVICES


STRUCTURAL BARRIERS
(lack of availability of providers, long waiting lists, lack of insurance or inadequate insurance coverage, inability to pay for services, transportation problems, inconvenient services),

BARRIERS RELATED TO PERCEPTIONS ABOUT MENTAL HEALTH PROBLEMS
(parents’, teachers’, and medical care providers’ inability to identify children’s need for mental health services; denial of the severity of a mental health problem; belief that the problem can be handled without treatment),

BARRIERS RELATED TO PERCEPTIONS ABOUT MENTAL HEALTH SERVICES
(lack of trust in or negative experience with mental health providers, lack of children’s desire to receive help, stigma related to receiving help)
--Untreated mental disorders cause increased severity, difficulties treating, and co-occurring mental illnesses

--Only 20% of children with mental disorders are identified
SUICIDE

Third leading cause of death in youth ages 15-24
More teenagers and young adults die from suicide than from any chronic diseases
Over 90% of children and adolescents who commit suicide have a mental disorder
States spend nearly $1 billion annually on medical costs associated with suicides/suicide attempts by youth
SCHOOL FAILURE

About 50% of students age 14 and older with a mental illness drop out of high school
Highest dropout rate of any disability group
JUVENILE AND CRIMINAL JUSTICE INVOLVEMENT

Youth with unidentified and untreated mental disorders may end up in prison (as young as 8 y.o.)

65% of boys and 75% of girls in juvenile detention have at least 1 mental illness
Cherry K. What Is a Psychological Disorder? Definition, Diagnosis, and Prevalence. About.com. http://psychology.about.com/od/psychotherapy/tp/psychological-disorders.htm. Accessed July 20, 2013.

Children's Mental Health- A New Report. The Center for Disease Control and Prevention. http://www.cdc.gov/features/childrensmentalhealth/. Published May 16, 2013. Accessed on July 12, 2013.

Facts on Children’s Mental Health in America. National Alliance on Mental Illness. http://www.nami.org/Template.cfm?Section=federal_and_state_policy_legislation&template=/ContentManagement/ContentDisplay.cfm&ContentID=43804. Published July 2010. Accessed July 20, 2013.

Risk Factors Related to Children’s Mental Health. Community Action Network. http://www.caction.org/health/PrescriptionForWellness/MentalHealth/Child/RiskFactors.htm. Updated April 18, 2010. Accessed July 27, 2012.

Stagman S, Cooper JL. Children’s Mental Health: What Every Policymaker Should Know [brief]. NCCP. 2010.

Howell E. Access to Children’s Mental Health Services under Medicaid and SCHIP. The Urban Institute. 2004; 64(B-60):577-585. Available from: http://www.urban.org/uploadedPDF/311053_B-60.pdf. Accessed July 20, 2013.

Lenardson JD, Ziller EC, Lambert D, Race MM, Yousefian A. Mental Health Problems Have Considerable Impact on Rural Children and their Families [brief]. Rural Health Research & Policy Centers. 2010.

Koppelman J. The June Issue: Children with Mental Disorders: Making Sense of Their Needs and the Systems That Help Them [brief]. NHPF. 2004;(799):1-24.

Owens PL, Hoagwood K, Horwitz SM, et al. Barriers to Children’s Mental Health Services. Journal of the American Academy of Child and Adolescent Psychiatry. 2002;41(6):731-738. DOI:10.1097/00004583-200206000-00013.

Facts on Children’s Mental Health. Judge David L. Bazelon Center for Mental Health Law. http://www.emqff.org/press/docs/bazelon_mental_health.pdf. Accessed July 20, 2013.

Tuma JM. Mental Health Services for Children. American Psychologist. 1989; 44(2):188-199.
REFERENCES
PSYCHOLOGICAL INFLUENCES
Severe parental relationship problems
Large families
Overcrowded homes
Parent's psychopathology or Criminality
Abuse
Exposure to Violence
Continued...
CHILDHOOD MALTREATMENT
Over 3M children are maltreated every year
Psychological maltreatment is more common than physical maltreatment

PEER & SIBLING INFLUENCES
Maladaptive Peers
Sibling Rivalry
Increase the likelihood of behavioral issues


Continued...

4) To ensure that all mental health needs are met, insurance companies should also provide parity in coverage with medical care for services.

5) To address the needs of minority groups, the mental heath field would benefit from cultural competency trainings to promote ethnic and racial diversity.

6) To address the shortage of mental health professionals, the mental health field would also benefit from providing financial incentives to college students to encourage them to join the field.

7) To further address the issue of access to mental health services, primary care providers need to be trained in screening for mental health disorder signs to ensure early intervention.
Key Stakeholders:
children
their parents
the community at-large
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