Child Mental Health
Children’s mental health problems are real and common – but they are also treatable. One in seven children in the U.S.—nearly 7.7 million children and teenagers—have at least one diagnosable mental health issue, but because of the lack of funding, a national shortage of child psychiatrists, and the stigma attached to mental illness, half of the children who need treatment do not receive help.
Mental health care treatment is very effective, especially if begun early in a child’s life. Left untreated, mental health disorders can have a debilitating impact on children’s healthy growth and transition to adulthood, leaving them at increased risk of contact with the criminal legal system, becoming homeless, developing other preventable health conditions, and even suicide.
Child Mental Health & COVID-19
A Harvard study that followed children ages 7 to 15 late in 2020 found that about two-thirds of them had clinically significant symptoms of anxiety and depression, as compared to 30 percent before the pandemic. Symptoms were more common in children who had experienced a family member hospitalized or dying from COVID-19, or a parent losing a job. According an August 2021 JAMA Pediatrics study—one of the largest studies on children’s mental health during the pandemic—depression and anxiety have essentially doubled among children worldwide, with 1 in 4 children suffering from clinically elevated symptoms of depression and 1 in 5 from increased signs of anxiety.
At least 40,000 children have lost a parent to COVID-19. Black children, who comprise only 14 percent of children in the US, accounted for 20 percent of children who lost parents to the virus. The result has been a huge surge in childhood anxiety and depression.
Children who lose a parent are at elevated risk of traumatic grief, depression, poor educational outcomes, and unintentional death or suicide, and these consequences can persist into adulthood. Sudden parental death, such as those occurring during the COVID-19 pandemic, can be particularly traumatizing for children and leave families ill prepared to navigate its consequences.
Pandemic-related physical health, mental health, economic and social consequences increased stress in Black families. While white youth still die by suicide at a higher rate, the rate of Black youth suicide is increasing faster than any other racial or ethnic group.
Despite data showing more people experienced worse mental health last year, use of mental health services declined in 2020 among people covered by Medicaid and the Children’s Health Insurance Program (CHIP). For the 43 million children on Medicaid and CHIP, the difference was a dramatic 34 percent decline in the use of mental health services.
The proportion of mental health-related emergency room visits increased 24 percent for young children and 31 percent for kids ages 5-11 between March to October of 2020 compared to 2019. For children who were ages 12 to 17, that number rose 31 percent. Emergency departments are often the first point of care for children experiencing mental health emergencies, particularly when other services are inaccessible or unavailable.
COVID-19 has serious implications for the mental health of LGBTQ youth. In a 2021 national survey, 70 percent of LGBTQ youth stated that their mental health was “poor” most of the time or always during COVID-19. In the same survey, 42 percent of LGBTQ youth reported considering attempting suicide in the past year—including more than half of transgender and nonbinary youth. 48 percent of LGBTQ youth reported they wanted counseling from a mental health professional but were unable to receive it in the past year. Suicidal ideation is very high for LGBTQ youth even in ordinary times. In 2019, 39 percent of LGBTQ youth seriously considered attempting suicide.
Child Mental Health & Foster Care
Children living in poverty and those involved in child welfare systems, who are disproportionately LGBTQ+ and Black children, face profound mental health challenges.
It is estimated that up to 80 percent of the over 400,000 children in foster care in America suffer from a mental health issue compared to 18-22 percent of the general population of children.
As many as 60 to 80 percent of children with severe mental health conditions demonstrate a positive response to therapeutic treatment, but less than 25 percent of children in foster care have received any mental health services after a year in state custody.
Youth in foster care experience PTSD at two times the rate of US war veterans.
Because their trauma is often untreated, children living in foster care engage in behavior that is symptomatic of the trauma they have experienced. That is the primary reason why one-third of foster youth crossover into the juvenile justice system, spending at least one night in detention.
Youth in foster care are 3-13 times more likely to be prescribed psychotropics medications than other minors.
About 20,000 youth age out of foster care every year without the support of family and with significant mental health needs. Youth aging out of the child welfare system with untreated mental health illness quickly slide into homelessness and incarceration.
Every year, roughly 20 percent of the young adults who age out of foster care in America — more than 4,000 — immediately become homeless, studies show. And thousands more — rising to as much as 46 percent in some parts of the country — are homeless within four years of aging out.
By age 17, over 50 percent of youth in foster care have experienced an arrest, conviction, or overnight stay in a correctional facility. Instability of foster care exacerbates mental health problems and leads to criminalization of behavior – 90 percent of youth with 5 or more placements in foster care enter the juvenile justice system.
Most states have a lack of adequate home and community-based mental health support for children and families even though these services cost less and have better outcomes. This too often leads to children being placed in facilities that cost 7-10 times more than community-based services provided to children living with families.
Because of the lack of community-based providers, some states send children in foster care out of state to receive mental health treatment. In 2019, 19,415 children in foster care were placed out of state and every state had children placed out of state. Most states have hundreds, but some have thousands placed out of state.
Childhood deserves better. Take our #HealthyKidsHealthyMinds Pledge to help build awareness for this national crisis and call for change to ensure children have access to the home and community-based supports they need.