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Hospital admissions for mental health climb sharply among young children

Dominika Osmolska Psy.D.'s picture
Mental Health

A new study reveals that children’s rate of hospitalizations for mental illness has skyrocketed over the last decade. To be more precise, the rate has jumped a whopping 80% for 5-13-year-olds and by 42 percent for older teens. The statistics are alarming and leave many public health advocates baffled.

Overall, short-term hospital admissions for mental illness rose from 156 to 283 per 100,000 children per year over the ten-year study period, based on data from the National Hospital Discharge Survey. For adolescents, the rate increased from 683 to 969 per 100,000, while it went up from 921 to 996 for adults and dropped from 978 to 808 for people 65 and older. In other words, while hospitalizations for mental health episodes remained relatively steady or even declined in the adult and geriatric populations, they have gone through the ceiling for younger children, and increased significantly for teens.

"This occurs despite numerous efforts to make outpatient services for the more vulnerable kids more widely available," said Joseph C. Blader of Stony Brook State University of New York, whose findings appear August 1 in the Archives of General Psychiatry.

Hospitalizations for episodes of acute mental illness are a last line of defense, which is why the statistics are all the more alarming. There are few other life changes that are more traumatic for parents than having their child admitted to the psych ward. Clearly, they would rather opt out of that path if they could.

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Many mental health professionals feel that kids are being overdiagnosed with bipolar disorder these days. Bipolar disorder is a disorder of mood regulation characterized by alternating periods of depression and manic activity. Blader said, however, that this was unlikely to be hiking the rates., even if true. That's because hospitalizations are based on whether or not people are considered a danger to themselves or others, not on psychiatric labels.

What this means on a practical level is that short-term psychiatric hospitalizations are generally due to aggressive, volatile behavior that leads to assaults on family members or peers. These may or may not lead to enduring psychiatric diagnoses.

The trend demonstrates that today’s children – and in particular, younger children – are increasingly unable to cope with conflict or stress in constructive ways. They lack the necessary emotional self-regulation skills to calm themselves down in stressful and interpersonally challenging situations. Clearly, outpatient community resources such as child guidance clinics are not keeping up with the enormity of the problem.

The study also noted a decline in the proportion of hospital stays paid for by private insurers. While study authors cautiously note that it is unclear whether that reflects a growing quality gap in mental health care or is a consequence of increased government coverage, I vote for the former. Anyone who believes that government spending on health care, and particularly mental health, has increased, is clearly out to lunch. The finding underscores the reality that it is the more impoverished segments of our population whose children are at ever increased risk for mental health disorders – disorders which are likely to persist and cause more social problems down the road.

Arch Gen Psychiatry
"Acute Inpatient Care for Psychiatric Disorders in the United States, 1996 Through 2007"
Joseph C. Blader, PhD
August 1, 2011