Cited by 408Mental Health Treatment and AccessChild and Adolescent Psychosocial and Emotional DevelopmentPsychology and Mental Health

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Trends in Mental Health Care among Children and Adolescents

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Olfson, Mark, Druss, Benjamin G., Marcus, Steven C.·2015·New England Journal of Medicine

DOI 10.1056/nejmsa1413512

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Abstract

BACKGROUND: Increasing mental health treatment of young people and broadening conceptualizations of psychopathology have triggered concerns about a disproportionate increase in the treatment of youths with low levels of mental health impairment. METHODS: We analyzed the 1996-1998, 2003-2005, and 2010-2012 Medical Expenditure Panel Surveys, which were nationally representative surveys of U.S. households, for trends in outpatient use of mental health services by persons 6 to 17 years of age; 53,622 persons were included in the analysis. Mental health impairment was measured with the use of the Columbia Impairment Scale (range, 0 to 52, with higher scores indicating more severe impairment); we classified youths with scores of 16 or higher as having more severe impairment and those with scores of less than 16 as having less severe impairment. RESULTS: The percentage of youths receiving any outpatient mental health service increased from 9.2% in 1996-1998 to 13.3% in 2010-2012 (odds ratio, 1.52; 95% confidence interval, 1.35 to 1.72). The proportionate increase in the use of mental health services among youths with more severe impairment (from 26.2% to 43.9%) was larger than that among youths with less severe or no impairment (from 6.7% to 9.6%). However, the absolute increase in annual service use was larger among youths with less severe or no impairment (from 2.74 million to 4.19 million) than among those with more severe impairment (from 1.56 million to 2.28 million). Significant overall increases occurred in the use of psychotherapy (from 4.2% to 6.0%) and psychotropic medications (from 5.5% to 8.9%), including stimulants and related medications (from 4.0% to 6.6%), antidepressants (from 1.5% to 2.6%), and antipsychotic drugs (from 0.2% to 1.2%). CONCLUSIONS: Outpatient mental health treatment and psychotropic-medication use in children and adolescents increased in the United States between 1996-1998 and 2010-2012. Although youths with less severe or no impairment accounted for most of the absolute increase in service use, youths with more severe impairment had the greatest relative increase in use, yet fewer than half accessed services in 2010-2012. (Funded by the Agency for Healthcare Research and Quality and the New York State Psychiatric Institute.).

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Authors: Olfson, M., Druss, B. G., & Marcus, S. C.
Affiliations: Emory University (US)
University of Pennsylvania (US)
ORCID: Olfson, Mark
Druss, Benjamin G.
Marcus, Steven C.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2015-05-21
Volume: 372
Issue: 21
Pages: 2029-2038
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmsa1413512
OpenAlex: W1559191608
Cited by: 408
References: 34
Citations by year: 2026: 17 · 2025: 32 · 2024: 35 · 2023: 29 · 2022: 32 · 2021: 37 · 2020: 44 · 2019: 63 · 2018: 50 · 2017: 32 · 2016: 30 · 2015: 5
FWCI: 63.97
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Health and Human Services
Agency for Healthcare Research and Quality (U19HS021112)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
Keywords: outpatient mental health services, children and adolescents, psychotropic drug use, psychotherapy, stimulants, antidepressants, antipsychotic drugs, Medical Expenditure Panel Survey
MeSH terms: Adolescent, Mental Disorders, Child, Child Health Services, Humans, Mental Health Services, Psychotherapy, Psychotropic Drugs, United States, Adolescent Health Services

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Trends in Mental Health Care among Children and Adolescents

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