Diagnosing Mental Health

Childhood psychiatric disorders affect current functioning and predispose individuals to more severe adult mental health problems. Provider survey research has suggested that children’s mental health problems are increasing; observed changes may be due to increased illness or improved access to care. The authors sought to quantify trends in the prevalence of diagnosed and treated mental health conditions, outpatient treatment; but psychiatric medication prescriptions in a large population of children who were continuously insured.
Diagnosed mental health conditions, pharmaceutical treatment, and outpatient visits for mental health all increased among U.S. pediatric military dependents from 2003 to 2015, according to a study published online April 10 in Psychiatric Services.

Diagnosing mental health conditions

Elizabeth Hisle-Gorman, M.S.W., Ph.D., from the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and colleagues retrospectively reviewed diagnosed mental health conditions, treatment, and psychiatric medication prescriptions among 1,798,530 children (aged 2 to 18 years) who were military dependents from 2003 to 2015.
The authors performed a retrospective trend study of diagnosed mental health conditions, treatment; but psychiatric medication prescriptions from 2003 to 2015; while in children ages 2–18 who were military dependents (N=1,798,530). Poisson regression analyses and Cochran-Armitage tests determined trends; but in the prevalence of treated psychiatric diagnoses overall and by subcategory, rates of outpatient mental health visits; and psychiatric medication use overall and by specific class.
During the study period, the researchers found that the prevalence of children; with diagnosed mental health conditions increased from 9.2 to 15.2% (rate ratio, 1.04). There was a 20 percent increase per year in identified suicidal idealization prevalence, a 2% annual increase in mental health care visits; and a 3% annual increase in psychiatric medication prescriptions. Larger increases seeing older children.

Pharmaceutical treatment

“These increases did not appear to be directly related to a parent’s deployment; since we did not see spikes in children’s mental health diagnosis, care, or pharmaceutical treatment; during periods of increased deployment,” Hisle-Gorman said in a statement.

From 2003 to 2015, the prevalence of children with diagnosed mental health conditions; increased from 9.2% to 15.2% (rate ratio=1.04, 95% confidence interval=1.04–1.05, p<0.001). Identified suicidal ideation prevalence increased by 20% a year. Mental health care visits increased by 2% a year; and psychiatric medication prescriptions increased by 3% a year between 2003 and 2015, with larger increases seen among older children. Prescriptions for children with identified mental health conditions did not increase.