A Comprehensive Guide to Understanding & Addressing Mental Health Challenges in Children & Adolescents

Approximately 20% of children and adolescents are affected by mental health conditions, such as mood disorders, attention-deficit/hyperactivity disorder (ADHD), substance use disorders, and post-traumatic stress disorder (PTSD). Moreover, the rates of suicidal behaviors in high school students increased by over 40% from 2009 to 2019.[1]

Mental health disorders in children and teenagers are a critical issue that demands our urgent attention and compassionate understanding. These conditions in young people can manifest in various ways, negatively affecting their emotions, behavior, academic performance, development, and daily functioning. 

Mental illness in this population presents unique issues that differ significantly from those in adults, requiring tailored approaches to diagnosis and treatment. Young people are at a critical stage of emotional, social, and cognitive development, making them particularly vulnerable to the effects of mental health disorders. Symptoms of mental illness in children and teens can often be misunderstood or overlooked, as they can manifest as behavioral problems or be attributed to typical development changes. 

Additionally, the stigma surrounding mental health can discourage young individuals from expressing their struggles, leading to delays in seeking help. The social environment, peer relationships, and family dynamics play pivotal roles in a young person’s mental health, and having a supportive community can make all the difference.

This is why, as mental health concerns in young people continue to rise, parents, caregivers, educators, and healthcare professionals must be equipped with accurate information and effective strategies to provide the necessary support. Recognizing the signs of mental illness among children and adolescents can allow us to respond with empathy and informed care so we can support their path to recovery.

Approximately 20% of children and adolescents are affected by mental health conditions.

Demographics, Risk Factors, & Trends

• Children who have experienced racial or ethnic discrimination are about 11% more likely to have one or more psychiatric conditions.[2]
• About 22% of children living below 100% of the poverty line have a mental, developmental, or behavioral disorder.[2]
• Boys between the ages of 2 and 8 are more likely than girls of the same age to have a mental health condition.[2]

• Adolescents and teens are about 65% more likely to have a mental illness than children between 6 and 11.[3]
• LGBTQ+ youth report higher rates of self-harm, emotional distress, anxiety symptoms, mood disorder symptoms, suicidal thoughts, and suicidal behaviors than cisgender, heterosexual peers.[4]

Mental Illness Prevalence & Impact

• Over 17% of children between 2 and 8 have a diagnosed mental health condition.[2]
• About 10% of children and teens have ADHD.[2]
• More than 9% of youth are diagnosed with an anxiety disorder.[2]
• Over 4% are diagnosed with depression.[2]
• Nearly 75% of children with depression have co-occurring anxiety.[2]
• In 2018-2019, approximately 15% of adolescents experience a major depressive episode.[1]
• Between 2016 and 2020, the number of young people diagnosed with depression increased by 27%.[1]

Substance Misuse in Adolescents

• More than 4% of adolescents have a substance use disorder or addiction.[1]
• Over 3% of adolescents have an illegal drug use disorder.[1]
• 1.6% of adolescents have an alcohol use disorder.[1]
• 14% of high school students report misusing prescription painkillers like Percocet.[6]
• 15% of high school students report using illegal drugs like heroin, cocaine, and methamphetamines.[6]

Treatment Rates for Young People

• About 38% of children and teens receive the treatment they need for a mental health disorder.[7]
• 36% of teens vs 11% of children receive treatment for depressive disorders.[7]
• 64% of children vs 20% of adolescents receive treatment for anxiety disorders.[7]
• Asian children are less likely than Hispanic, Black, and White children to receive mental health treatment.[8]
• White children are more likely than Hispanic and Black children to have received therapy or counseling.[8]
• Latinx and Black youth are about half as likely to receive mental health care than their white peers.[5]

Treatment disparities are due to many factors like stigma, cultural barriers, language barriers, lack of health insurance, lack of transportation to treatment, discrimination and racism, lack of culturally competent providers, and more.

Treatment disparities are due to many factors like stigma, cultural barriers, language barriers, lack of health insurance, lack of transportation to treatment, discrimination and racism, lack of culturally competent providers, and more.

Youth Suicide Rates

• Nearly 37% of adolescents have persistent feelings of hopelessness or sadness.[2]
• Over 15% of adolescents have had a major depressive episode.[2]
• About 9% of adolescents have attempted suicide.[2]
• Over 15% of adolescents have made a suicide plan.[2]
• From 2017 to 2018, the suicide death rate for Black youths nearly doubled.[1]
• Suicide is the leading cause of death for Asian, Pacific Islander, American Indian, and Alaska Native youths ages 10-14.[1]

Suicide is the leading cause of death for AAPI, American Indian, and Alaska Native youths ages 10-14.

Treatment Provider Bias & Diagnosis

Treatment provider bias can significantly affect the diagnosis of mental health disorders in children and teenagers, often leading to misdiagnosis, underdiagnosis, or overdiagnosis. Common biases include:

• Cultural
• Racial
• Gender
• Sexuality
• Socioeconomic

These biases can influence how a healthcare provider perceives and interprets symptoms. For instance, cultural or racial biases may result in misinterpreting culturally specific behaviors or expressions of distress as symptoms of a mental disorder. Children from marginalized backgrounds might be less likely to receive accurate diagnoses and appropriate treatment due to these biases. 

For example, Black children and adolescents are more likely to be diagnosed with oppositional defiant disorder (ODD) whereas white children are more likely to receive an ADHD diagnosis. ODD is extremely stigmatized and has limited treatment options, whereas ADHD is highly researched and has many interventions.[9]

Similarly, gender biases can lead to boys being more frequently diagnosed with behavioral disorders, while emotional disorders in girls might be underdiagnosed. Moreover, discrimination against transgender or queer children may also negatively affect care and diagnosis.

Socio-economic factors also play a role, as children from low-income families might face additional stressors that affect their mental health, but providers might overlook these contextual factors and misattribute symptoms to behavioral problems rather than underlying mental health conditions.

Such biases can result in inadequate or inappropriate treatment plans, further exacerbating the child or teen’s mental health issues. It is important for mental health professionals to engage in ongoing training and self-reflection to recognize and mitigate their biases, ensuring a more accurate and equitable approach to diagnosing and treating mental health disorders in young people.

Unique Treatment Concerns for Children

When it comes to diagnosing and treating mental health conditions in children and adolescents, there are many unique concerns to consider, including:

• Developmental considerations: Tailoring treatments to suit the cognitive and emotional developmental stages of children and adolescents.
• Family involvement: Engaging family members in the treatment process to provide support and ensure consistency at home.
• School coordination: Collaborating with schools to support the child’s educational and social needs.
• Stigma reduction: Addressing and reducing stigma associated with mental health issues to encourage children and teens to seek help.
• Communication strategies: Using age-appropriate language and methods to communicate effectively with young patients.
• Medication management: Carefully considering the effects and side effects of medications on developing brains and bodies.
• Therapeutic approaches: Implementing therapies specifically designed for young people, such as play therapy, art therapy, and cognitive-behavioral therapy (CBT) adapted for youth.
• Peer relationships: Addressing the impact of peer relationships and social dynamics on mental health.
• Holistic care: Integrating physical health, nutrition, and lifestyle factors into the treatment plan.
• Cultural sensitivity: Ensuring treatments are culturally sensitive and relevant to the child’s background and experiences.
• Early intervention: Emphasizing the importance of early diagnosis and intervention to improve long-term outcomes.
• Safety and privacy: Ensuring a safe and confidential environment for children and teens to express themselves freely.

How Parents & Caregivers Can Support Children

Ensuring that children and adolescents receive appropriate mental health care involves proactive and informed actions by parents and caregivers. Here are key steps they can take:

• Educate themselves: Parents and caregivers should learn about mental health issues, common symptoms, and the importance of early intervention. Understanding these aspects can help them recognize when their child might need help.
• Open communication: Establishing a trusting and open line of communication with their children is essential. Encouraging children to express their feelings and thoughts without fear of judgment helps in early detection of potential issues.
• Seek professional help: If a mental health concern is suspected, parents should consult with healthcare professionals, such as pediatricians, child psychologists, or psychiatrists, who specialize in treating children and adolescents.
• Advocate for comprehensive evaluations: Request thorough evaluations that consider the child’s physical health, psychological state, social environment, and educational context to ensure an accurate diagnosis and appropriate treatment plan.
• Involve the school: Collaborate with teachers, school counselors, and administrators to ensure that the child’s educational needs are being met and that any necessary accommodations are made.
• Create a supportive environment: Foster a home environment that is safe, supportive, and free of stigma. Encourage healthy habits, such as regular physical activity, balanced nutrition, and adequate sleep, which contribute to overall well-being.
• Stay informed: Be knowledgeable about different treatment options, including therapy, medication, and alternative treatments. Understand the benefits and potential side effects of each.
• Monitor progress: Regularly check in with the child and their healthcare providers to monitor progress and adjust treatment plans as needed. Being actively involved in the treatment process helps ensure that it remains effective.
• Encourage social connections: Support the child in maintaining healthy social relationships with peers, which can be an important part of their mental health and well-being.
• Participate in therapy: When appropriate, participate in family therapy sessions to address family dynamics and improve communication and support within the family unit.
• Address stigma: Work to reduce the stigma associated with mental health issues by educating themselves and their children about mental health and promoting open discussions about it.
• Plan for emergencies: Be prepared for mental health crises by having a plan in place, including knowing the local mental health crisis hotline, nearest emergency room, and available mental health professionals who can be contacted in urgent situations.

By taking these steps, parents and caregivers can play a crucial role in ensuring that their children and adolescents receive the appropriate mental health care they need.

Mental Health Resources for Children and Teens

Trevor Project Lifeline

• Phone: 1-866-488-7386
• Availability: 24/7
• Description: Offers crisis intervention and suicide prevention services to LGBTQ youth.

Al-Anon and Alateen

• Phone: 1-888-4AL-ANON (425-2666)
• Availability: Various hours
• Description: Offers support for friends and families of problem drinkers. 

988 Suicide & Crisis Lifeline

• Phone: Text HELLO to 741741
• Availability: 24/7
• Description: Offers 24/7 text support for those experiencing emotional distress or crisis.

 National Suicide Prevention Lifeline

• Phone: 1-800-273-8255
• Availability: 24/7
• Description: Offers confidential support for people in crisis, including children and teens.

Teen Line

• Phone: 310-855-4673 or text TEEN to 839863
• Availability: 24/7
• Description: Offers confidential help, from teens for teens.

 National Runaway Safeline

• Phone: 1-800-786-2929 or text 66008
• Availability: 24/7
• Description: Offers support, assistance, and a safe space for young people who have run away from home or are considering doing so