Childhood mental illness diagnoses up 31%: study

There is a direct correlation between the increasing rate of childhood mental illness and healthcare costs, according to a new study by IBM Watson Health.

New research, which was presented at the ISPOR 2019 conference, finds that mental illness diagnoses among U.S. children increased 30.5% between 2011 and 2017. Additionally, the study finds that overall healthcare costs for children with mental illness are two-and-a-half times higher than children with no mental illness diagnosis.

In total, the Centers for Disease Control and Prevention estimates that 20% of children in the U.S. have a mental, emotional or behavioral disorder. And the number is on the rise. From 2012 to 2016, there was a 55% increase in mental health emergency department visits by children.

And in 2014, suicide surpassed homicide as the second leading cause of death in teenagers.

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Between 2011 and 2017, the incidence of mental illness increased by 19.2 %. More than half of the patients with prevalent mental illnesses were adolescents. Early childhood-aged kids made up the other half.

Children with a mental illness incurred significantly greater healthcare costs compared to controls in all years assessed. In 2017, the mean total cost was $7,087 versus $2,026 in 2011.

Rates of those children diagnosed with substance abuse and alcohol abuse decreased, as did rates of bipolar disorder and depression, between 2011 and 2017. However, anxiety rates got significantly higher. And there was also a small increase in the number of children with developmental disorders and eating disorders.

The most prevalent disorders in the study were attention disorders, anxiety, depression and developmental disorders. All other disorders were diagnosed less than 5% of the time. Depression accounted for more than half of the sample, attention disorders for 25.5%, and developmental disorders for 66.8%. The highest prevalence found in the data was for anxiety, 85.3%.

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“Overall, the number of males with a mental or behavioral disorder actually outnumbered females, a trend that was driven by the higher rate of boys with attention/conduct disorders in early and middle childhood. That’s surprising because mental illness is often viewed as an issue that disproportionately affects females.” Joseph Tkacz, IBM Watson Health researcher and co-investigator, told FierceHealthcare. “While we are certainly seeing that there are specific conditions that support this notion—for instance, anxiety and depression are more common in females— when all conditions are considered, males outnumber females in mental health diagnoses in the pediatric population.”

Research suggests increases in divorce, electronic media, and focus on acquiring money and/or fame, are likely causes for the increases in mental illness among children.

So what can payers and providers do to help reverse this trend?

"Early identification of any disease state is critical to minimizing both costs and complications of a disease. An estimated 50% of youths experiencing a mental health problem go undiagnosed, so even though we’ve seen an increase in diagnoses, providers need to stay vigilant," Brenna Brady, IBM Watson Health researcher and co-investigator, told FierceHealthcare. "The primary care setting is the first healthcare encounter for youths, so integrating a mental health screening process into routine checkups would be a meaningful step.

"On the payer side, health plans, employers and government agencies will need to continue to address coverage and access to enable this critical population to obtain the care they need as early as possible in order to avoid potential increased costs that can come along with delayed treatment," Brady added.