Contrary to public perception and horrific cases that make headlines, serious mental problems are declining among the nation's youth, and there has been a big rise in how many are getting help, a new study finds.
The study is mostly good news: More children and teens are taking medicines for mental health than ever before, but more also are getting therapy, not just pills. The biggest rise in treatment rates has been among the most troubled kids.
"There's a concern out there that a lot of children and adolescents are receiving mental-health treatments, particularly medications, that they don't need," especially for conditions such as attention deficit hyperactivity disorder, said the study's leader, Dr. Mark Olfson, a psychiatrist at Columbia University Medical Center.
Instead, the results suggest "that at least in some ways, we're moving in the right direction," by getting help to kids who need it most, he said.
The dark cloud: More than half of severely troubled kids get no help at all.
The study used nationwide surveys over three periods from 1996 to 2012, covering more than 53,000 youths ages 6 to 17. Results are in Thursday's New England Journal of Medicine.
The percentage of youths with serious impairments dropped from 13 percent to 11 percent.
Use of any outpatient mental health service rose from 9 percent to 13 percent. The rise was greatest for severely troubled kids, and went from 26 percent to 44 percent — from 1.56 million annually to 2.28 million.
The use of any drug for mental health rose from about 6 percent to 9 percent. Among youths with severe problems, medication use went from 18 percent to 32 percent. Among the rest it went from 4 percent to 6 percent.
Use of stimulants such as methylphenidate, sold as Ritalin and other brands, rose from 4 percent of youths to 6.6 percent. Those drugs are often given for ADHD, which affects more than 1 in 10 children, according to the Centers for Disease Control.
Sleep problems might cause depression
Sleep problems are often a symptom of depression, but a new study raises the possibility that they could cause depression as well.
In a sample of nearly 2,000 Australian men between the ages of 35 and 83, those with excessive daytime sleepiness were 10 percent more likely to be depressed than those without.
None of the men had been diagnosed with severe obstructive sleep apnea when they entered the study, but 857 of them were assessed for the condition after joining. Those who were found to have it were 2.1 times more likely to be depressed than those who didn't have the sleep disorder.
Some of the men had both severe sleep apnea and excessive daytime sleepiness. They were 4.2 times more likely to be depressed compared with men who had no sleep issues. Those with both conditions were also 3.5 times more likely to be depressed than men with only one of them.
All of the men in the study were evaluated for depression twice, with the second test occurring about five years after the first. That allowed the researchers to see whether sleep problems could be linked to a recent diagnosis of depression. The men who had severe sleep apnea that was discovered during the study were 2.9 times more likely to become depressed during those five years.