Background: Childhood mental illness is a major factor of overall lifespan of children continuing into adulthood. Population based surveys and public health surveillance provide the much needed evidence to understand mental health promotion, prevention, and treatment of mental illness in children in the United States. Objective: To review available current national survey data regarding mental illness in children over the past decade and to review the global implications of childhood mental illness. Results: Altogether, 13% - 20% of children experienced a mental health disorder from 1994 to 2011. The prevalence of depression among children of 3 - 17 years old was 3% and the prevalence of lifetime and past year major depressive episode were 12.8% and 8.1% respectively among adolescents of 12 - 17 years old, with a prevalence of depression in the preceding 2 weeks of 6.7%. 7.1% of children of 12 - 17 years old ever had a diagnosis of depression, 3.5% had current depression and 5.1% had a diagnosis of depression in the past year. Overall, 28.5% of high school students of 14 - 18 years old reported feeling so sad or hopeless every day for two weeks or more in a row that they stopped doing usual activities, higher among girls (35.9%) than boys (21.5%), and greater in Hispanic students (32.6%) than white non-Hispanic (27.2%) or black non-Hispanic students (24.7%). The overall rate of suicide in children in 2010 was 4.5 per 100,000. Conclusions: Mental illness presents serious departures from the expected cognitive, social, and emotional development in children, and an important area for prevention in the U.S. and globally. Mental illness will be managed effectively when there is adequate access to treatment services to reduce its associated morbidity and mortality.
Mental illness refers to all diagnosed mental disorders characterized by sustained, abnormal alterations in thinking, mood, or behavior associated with distress and impaired functioning [
Perou and colleagues [
The National Health Intervention Survey (NHIS) is administered by the National Center for Health Statistics on the health of the civilian noninstitutionalized U.S. population. It monitors the health of the U.S. population through the collection and analysis of data on a broad range of health topics by in-person household interviews. About 40,000 households per year were interviewed as of 2010.
The National Health and Nutrition Examination Survey (NHANES) employed by the National Center for Health Statistics accesses the health and nutritional status of children in the U.S. It collects information derived from interviews, physical examinations, laboratory tests, nutritional assessment, and DNA repositories. As of 2008, approximately 5000 persons per year were interviewed.
The National Vital Statistics System (NVSS) assembles mortality statistics from death certificates filed in the U.S. and processed by the Centers for Disease Control and Prevention (CDC).
The National Violent Death Reporting System (NVDRS) is a population- based active surveillance system used by the CDC to provide a census of violent deaths in participating states, including child maltreatment deaths, intimate partner homicides, and suicides, and legal intervention deaths.
The National Survey on Drug Use and Health (NSDUH) is a primary source of statistical information of alcohol, tobacco, illicit drug and non-medical use of prescription drugs in the U.S. derived from in-person interviews of representative samples of the non-institutionalized population.
The Autism and Developmental Disabilities Monitoring (ADDM) network is a surveillance system conducted by the CDC that estimates the prevalence of Autism Spectrum Disorders (ASD) among 14 population-based sites from health and educational records of health providers and schools.
The National Survey of Children’s Health (NSCH) is a cross-sectional, random-digit population-based telephone survey that collects information on the physical and emotional health of noninstitutionalized children age 17 years or under to provide state and national estimates of child health.
The School-Associated Violent Death Surveillance Study (SAVD) is administered by the CDC in collaboration with the U.S. Department of Education and the Department of Justice to describe the epidemiology of school-associated violent deaths and potential risk factors thereof.
The National Youth Risk Behavior Survey (YRBS) employs a three-stage cluster design to produce representative samples of health-risk behaviors in public and private high school students grades 9 - 12 that contribute to leading causes of death, disability, and social problems.
Surveillance survey tools estimate the prevalence and trends in mental illness using symptom patterns. The diagnostic terminology used to describe mental illness diagnostic categories may vary. The American Psychiatric Association recognizes diagnostic categories based on symptoms observed by a health professional or reported by the patient and classified mental disorders that are published in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) [
Childhood mental disorders include several categories some of which are primary mental illnesses while others have a close association with a mental disorder [
The prevalence of depression among children age 3 - 17 years was 3% according to the NSCH whereas the NSDUH and NHANES estimated the prevalence of lifetime and past year major depressive episode (MDE) to be 12.8% and 8.1% respectively among adolescents age 12 - 17 years, with a prevalence of depression in the preceding 2 weeks of 6.7%. According to the NHIS, 7.1% of children age 12 - 17 years ever had a diagnosis of depression, 3.5% had current depression and 5.1% for had a diagnosis of depression in the past year. The YRBS reported that 28.5% of high school students age 14 - 18 years reported feeling so sad or hopeless every day for two weeks or more in a row that they stopped doing usual activities, higher among girls (35.9%) than boys (21.5%), and greater in Hispanic students (32.6%) than white non-Hispanic (27.2%) or black non-Hispanic students (24.7%).
Parent-reported anxiety among children in the U.S. estimated by the NSCH that focused primarily on phobias in children age 2 - 17 years noted a prevalence of 4.7% of ever having anxiety, and a 3% prevalence of current anxiety disorders. NHANES noted a prevalence of self-reported generalized anxiety disorder of 0.7%, and phobias and fears in 2.6%. NHANES estimated that 8.3% of self-reported adolescents age 12 - 17 years had 14 or more mentally unhealthy days in the preceding month as a marker of mental distress.
Data on suicide gathered from the NVSS and NVDRS among 16 states noted an overall suicide rate among children age 10 - 19 years of 4.5 per 100,000 (NVSS), with 4.2 suicides per 100,000 between (NVDRS). White non-Hispanic children and non-Hispanic children had higher rates of suicide than black non- Hispanic and Hispanic children. The commonest modes of self-injury were hanging, suffocation, and firearms. Among suicides reported by the NVDRS, 29.5% disclosed an intent to die by suicide before the act; while 35.5% had a diagnosed mental disorder at the time of death; and 26.4% were under treatment for a current mental disorder at the time of death. Overall, 21% had made a previous suicide attempt.
Mental health disorders are substantial public health concerns because of their prevalence, early onset, impact and associated costs to the child, family and community. CDC-sponsored surveys such as NHANES and NHIS are useful in the development of national policies and in tracking the progress toward national health goals for children. The BRFSS survey provided data at state and local levels useful in planning. About 13% to 20% of children living in the U.S. experienced a mental disorder in a given year from 1994-2011 [
Parent-reported anxiety among children age 2 - 17 years was 4.7% for ever being anxious and 3% for a current anxiety disorder. Self-reported mentally unhealthy days dichotomized at 2 or more weeks in the past month was a useful indicator for the severity of anxiety and depressive disorders so noted in 8.3% of children overall. The overall suicide rate for persons aged 10 to 19 years old was 4.5 per 100,000 persons. Adolescent boys age 12 to 17 years were more likely than girls to suffer suicide, similarly, white non-Hispanic children and non- Hispanic children of other races than black non-Hispanic and Hispanic children.
Mental illness is among the most important causes of sickness, disability, and in certain age groups, premature mortality in developing countries [
About 30% of the population globally are affected by a mental disorder and more than two-thirds of those affected do not receive needed care. With 14% of the global disease burden attributed to neuropsychiatric disorders, 1 in 17 people have a serious mental health condition [
According to the WHO, health inequalities are defined as “differences in health status or in the distribution of health determinants between different population groups” [
With a mismatch of mental health resources to those in need varying from 1 psychiatrist for every 100,000 people in much of south-east Asia, to less than one for every 1 million people in sub-Saharan Africa [
Studies of MDD in twins and families show increased heritability however, molecular studies have failed to identify susceptibility genes convincingly. Genome-wide association studies (GWAS) of single nucleotide polymorphisms (SNPs) are important in the study of the genetic basis of MDD and recurrent depressive disorder [
Childhood mental illness is a major factor of overall health that continues the lifespan of children continuing into adulthood. Population based surveys and surveillance provide much of the evidence needed to understand mental health promotion, mental illness prevention, and treatment programs in the United States. Childhood mental health disorders present serious deviations from expected cognitive, social, and emotional development, which are an important public health issue in the United States and worldwide.
The author has nothing to disclose.
Younger, D.S. (2017) Epidemiology of Childhood Mental Illness: A Review of U.S. Surveillance Data and the Literature. World Journal of Neuroscience, 7, 48-54. https://doi.org/10.4236/wjns.2017.71005