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Majority of Youth with Mental Disorders May Not Be Receiving Sufficient Services

Science Update

Teens talking in group session.

A substantial proportion of youth with severe mental disorders do not receive mental health care, according to data from an NIMH-funded survey published in the January 2011 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.


Kathleen Merikangas, Ph.D., of NIMH and colleagues analyzed data from the National Comorbidity Study-Adolescent Supplement (NCS-A), a nationally representative, face-to-face survey of more than 10,000 teens ages 13 to 18. Previously published results found that about 20 percent of youth are affected by a severe mental disorder. For the most recent study, Merikangas and colleagues tracked the rate at which these youth reported having ever received services specifically to treat their disorder. They also were asked to specify what types of services they received and how often they received them.


About 36 percent of youth with any lifetime mental disorder received services, and only half of these youth who were severely impaired by their mental disorder received professional mental health treatment. The majority (68 percent) of the children who did receive services had fewer than six visits with a provider over their lifetime.

Service use was highest among those with ADHD (60 percent), and behavior disorders like conduct disorder or oppositional defiant disorder (45 percent). Among those with mood disorders such as depression or bipolar disorder, 38 percent received services, and 18 percent of those with an anxiety disorder received services. In addition, 15 percent of those with a substance use disorder received services, and 13 percent of those with an eating disorder received services.

Girls were more likely to receive services for anxiety disorders, and boys were more likely to receive services for ADHD. Racial and ethnic minorities were less likely than non-Hispanic whites to receive treatment for any mood or anxiety disorder, and less likely to receive mental health treatment in general than their white counterparts.


The researchers conclude that despite recent programs designed to improve mental health services for youth, such as the State Children’s Health Insurance Program and the federal Children’s Mental Health Initiative, many children in need of mental health care still do not receive it. In addition, the relatively low number of treatment visits suggests that the few who are getting treatment may not have sufficient professional follow-up. Finally, ethnic disparities in mental health care, especially of mood and anxiety disorders, are still widespread.

What’s Next

More efforts are needed to increase awareness of mood and anxiety disorders among ethnic minority communities, improve access to services, and improve the assessment skills of clinicians and pediatricians who are often the “front line” treatment providers of youth with mental disorders.


Merikangas KR, He J, Burstein ME, Swendsen J, Avenevoli S, Case B, Georgiades K, Heaton L, Swanson S, Olfson M. Service utilization for lifetime mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry. Jan 2011.50(1):32-45.