Columbia University Mailman School of Public Health

Report: Adolescent Mental Health in Crisis
One in Five Teens Has Diagnosable Disorder, Yet Many Do Not Receive Vital Care

New York City, June 3, 2009 - Researchers report that 20 percent of adolescents have a diagnosable mental disorder, and among adolescents in the juvenile justice system, the proportion jumps to a staggering 70 percent. But in spite of these disturbing figures, there is a paucity of available, accessible, mental health services appropriate for adolescents.

The National Center for Children in Poverty (NCCP), part of Columbia University’s Mailman School of Public Health, cites these numbers among a series of troubling facts on adolescent mental health in the new fact sheet Adolescent Mental Health in the United States: Facts for Policymakers.

The fact sheet also reports that as many as 33 percent of adolescents with diagnosable mental health disorders do not receive the care they need. Most of the time, they either forego care due to barriers to entry or lack access to adequate services.

The consequences of untreated mental health problems include poor school performance, school dropout, strained family relationships, involvement with the youth justice system, and increased substance abuse and sexual risk taking. In addition, existing mental health issues become increasingly complex the longer they go untreated, and can lead to suicidal behaviors, chronic mental health problems, or difficulty functioning, any of which may persist in adulthood.

“There is a profound lack of specialists trained to work with adolescents who have mental health issues,” notes Susan Wile Schwarz, the NCCP researcher who wrote the fact sheet. “Adolescents are at a unique point in their development and have unique vulnerabilities that can’t be addressed by treatments designed for children or adults, but of the 213 accredited pediatric residency programs in the country, only 25 of these allow specialization in adolescent medicine.”

Lack of stable living conditions and threats to confidentiality also create barriers to care. Rates of serious mental health disorders can be as high as 50 percent among homeless adolescents, and despite their high need for treatment, they rarely make use of formal treatment programs. In addition, there are high rates of depressive symptoms and suicide among adolescents who forgo care due to confidentiality concerns, but more than half of states do not ensure confidentiality for outpatient services to minors.

Janice Cooper, PhD, NCCP’s director and a specialist in child and adolescent mental health policy, notes that in order to provide crucial mental health services to adolescents with mental health conditions, state and federal government need to start with policies rooted in sound research about what works for youth and invest in age-appropriate care.

“A functioning prevention and response system is crucial to helping the huge number of teens who desperately need care, but aren’t getting it,” she states. “We need to combine adequate funding and a range of services designed with adolescents in mind if we’re serious about fostering mental health for this age group.”

To promote improved services and access to care for adolescents, NCCP recommends that lawmakers in states and territories and at the federal level:

  • Invest in programs that address the unique vulnerabilities and opportunities for positive change that characterize adolescence;
  • Provide funding for school-based health centers that provide both physical and mental health care, and encourage the establishment and expansion of services in venues that increase access, such as youth centers and adolescent-specific health and wellness centers;
  • Make use of research-supported prevention and intervention strategies, and educate parents about recognizing mental health problems in their children;
  • Pass legislation that effectively protects confidentiality and ensures adolescents know their confidentiality rights when accessing services; and
  • Promote health care workers’ training in adolescent health and ensure that workers are trained to provide culturally sensitive, comprehensive care.

More information about NCCP’s adolescent health focus and the fact sheet Adolescent Mental Health in the United States: Facts for Policymakers are available on the NCCP website.

The National Center for Children in Poverty (NCCP) is the nation’s leading public policy center dedicated to promoting the economic security, health and well-being of America’s low-income families and children. Part of Columbia University’s Mailman School of Public Health, NCCP uses research to inform policy and practice with the goal of ensuring positive outcomes for the next generation.