21 Януари 2001 05:44

One in 10 U.S. Kids Mentally Ill

Surgeon General's Report Cites Mental Health Crisis


By Jeff Levine
WebMD Washington Bureau Chief


Reviewed by Dr. Dominique S. Walton


Jan. 3, 2001 (Washington) -- One in 10 American children and teens suffers from mental illness -- and just one in five of those receives treatment, according to U.S. Surgeon General David Satcher, MD, PhD.


In a 52-page wake-up call released today, Satcher calls the situation a "public health crisis in mental health for children and adolescents."


"Growing numbers of children are suffering needlessly because their emotional, behavioral, and developmental needs are not being met by those very institutions which were explicitly created to take care of them," writes Satcher in the report, which he calls "a blueprint for change."


Specifically, the surgeon general wants to promote public awareness of children's mental health issues, reduce the stigma of these diseases, and improve the ability to recognize symptoms of mental health in children. "We need to help families understand that these problems are real, that they often can be prevented, and that effective treatments are available," he writes.


The nation's top doctor also takes a swipe at institutions charged with providing mental health services to kids. The treatment they offer should be better coordinated and integrated with other elements of the health care system, he says. Satcher also complains that wide disparities in children's mental health services exist among racial groups and the poor.


Another big problem is the stigma associated with children's mental problems, according to Satcher. David Fassler, MD, agrees. The psychiatrist is chair of the American Psychiatric Association's Council on Children, Adolescents, and Their Families and was the APA representative at a national conference last September's on children's mental health. Issues raised at that conference served as the basis for the present report.


Refusing to deal with mental illness can lead to long-term consequences, says Fassler, including poor school performance, trouble on the job, and low self-esteem. "The good news is that most of these problems are treatable. We can help all children and adolescents with psychiatric problems," Fassler tells WebMD.


Among the most common mental health issues for kids are attention deficit hyperactivity disorder (ADHD), depression, anxiety disorders, conduct disorders, substance abuse, and eating disorders, says Fassler.


Although it takes some skill to sort out which problem is the most pressing, Fassler says a dozen visits or less to a therapist can make a "remarkable" difference. In fact, he says, treating children within a family context can begin in infancy. If a child is biting other children in a day care setting, for instance, that can be a sign of potentially treatable emotional distress, he says.


The report also recommends universal and comprehensive health care for all Americans. The movement toward providing parity between physical and mental conditions is gaining momentum, Fassler says, and a majority of states currently mandate equality of benefits.


And though a number of promising programs, such as State Children's Health Insurance Program, exist to help parents pay for treatment, advocates for the mentally ill say that still is not enough.


The new report is an "astounding" step in the right direction, says Brenda Souto, associate director for child and adolescent programs for the National Alliance for the Mentally Ill, in Arlington, Va. Still, having raised a child with an autism-like disease, Souto says the question of funding is critical.


"There's going to be a whole generation of children who are emotional cripples and may end up in jail because there were no treatment facilities available to them. ... It all comes down to the bottom line," Souto tells WebMD.


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