Prevention and treatment strategies for child mental health problems should focus more on the long-lasting effects of mental health problems rather than just relieving current symptoms, according to a new article by Health Administration and Policy Professor Alison Cuellar.
Approximately 13 to 20 percent (up to one in five) of children in the U.S. experience a mental disorder in given year, according to the Centers for Disease Control and Prevention (CDC). Common mental health issues include attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depression, and addiction. Roughly one-half (50.6 percent) of children with mental disorders have sought treatment in the past year, according to the CDC’s National Health and Nutrition Examination Survey.
Mental disorders in children are detected and treated in a variety of settings, including a pediatrician’s or psychologist’s office, school, and within the juvenile justice system. The variety of settings and people that may be involved in diagnosing and/or treating child mental health problems contributes to a lack of coordination and fragmented funding, which hinders the ability to effectively deliver services and prevents effective integration of services, according to Cuellar.
“If we can better track and share how our children are doing, we have a chance to intervene earlier and with more targeted approaches,” Cuellar said. “For example, if pediatricians hear that a patient is having trouble in school, I would encourage them to coordinate with parents, learn more about issues the patient may be having in school, and discuss joint approaches for treating the child, including additional education support or tutoring that might help children who have emotional problems.”
Previous studies have shown that mental health problems can have a significant, long-term, negative impact on children and can lead to lower educational attainment, lower wages, lower likelihood of employment, and increased crime rates. However, most treatment methods focus on how the child appears to be doing medically, for example, by looking at their symptoms. Cuellar asserts that treatment should be focused more on long-term outcomes, such as educational achievement and overall functioning.
“Our medical clinical trials typically have a short horizon, in part because they are expensive, yet we are trying to make long-term investments in children with mental health problems. We are finding that treatments for conditions like ADHD are not having the impact on educational outcomes that we had hoped,” Cuellar said. “Medically, the children appear to be doing better; however, it’s not translating academically, which is an important predictor of future well-being.”
Cuellar suggests that future research on interventions for children with mental health issues should track patients longer and look at more measures of treatment success. In line with Cuellar’s recommendation for more research focused on improving long-term outcomes for children with mental health problems, she is currently collaborating with Professor Dhaval Dave from Bentley University to examine the effect of treating high-risk children with mental health problems. The study has been supported by the Robert Wood Johnson Foundation.
Cuellar’s article, “Preventing and Treating Child Mental Health Problems,” appears in the Spring 2015 issue of the Policies to Promote Child Health journal. This issue focuses on a review of research to determine how effectively U.S. policies promote child health. The Future of Children, a collaboration of the Woodrow Wilson School of Public and International Affairs at Princeton University and the Brookings Institution, is responsible for the journal. Read Cuellar’s research.