2017 Children’s Mental Health Report

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The Adolescent Treatment Gap

Many youth with mental disorders, even severe and impairing disorders, have never received treatment for their conditions. Among those who have received care, treatment is often quite limited. – Kathleen Merikangas et al

Most adolescents with mental health disorders never even begin treatment:¹ ²

  • 40% of youth with ADHD go untreated
  • 60% of youth with depression go untreated
  • 80% of youth with an anxiety disorder go untreated

When they do begin mental health treatment, many adolescents do not complete their course of treatment (whether medication, psychotherapy, or both):

  • Individuals diagnosed with major mood disorders have a non-adherence range near 50%³
  • In one large longitudinal study of ADHD, among the 87% of children who were medicated at some time in their lives, 27.9% had stopped taking medication by the age of 11 years and 67.9% had stopped by age 15. 
  • Between 33 and 44% of patients with psychosis adhere poorly to their medications and clinical treatment and, consequently, are 6 times more likely to be readmitted to hospital.

These statistics are unfortunate given that effective, evidence-supported treatments work well when the full course is followed, as described in the following section.

[1] Merikangas, K. R., He, J., Burstein, M. E., Swendsen, J., Avenevoli, S., Case, B., … Olfson, M. (2011). Service Utilization for Lifetime Mental Disorders in U.S. Adolescents: Results of the National Comorbidity Survey Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 50(1), 32–45. doi:10.1016/j.jaac.2010.10.006

[2] SAMHSA. (2014). Results from the 2013 National Survey on Drug Use and Health. Retrieved from: http://www.samhsa.gov/data/sites/default/files/NSDUHre- sultsPDFWHTML2013/Web/NSDUHresults2013.pdf

[3] Scott, J., & Pope, M. (2002). Self-Reported Adherence to Treatment With Mood Stabilizers, Plasma Levels, and Psychiatric Hospitalization. American Journal of Psychiatry, 159(11), 1927-1929. doi:10.1176/appi.ajp.159.11.1927

[4] Charach,A., Ickowicz, A., & Schachar, R. (2004). Stimulant treatment over five

years: adherence, effectiveness, and adverse effects. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 559-567. http://dx.doi.org/10.1097/00004583-200405000-00009

[5] Wolraich, M.L., Wibbelsman, C.J., Brown, T.E., Evans, S.W., Gotlieb, E.M., Knight, J.R., Ross, E.C., Shubiner, H.H., Wender, E.H., & Wilens, T. (2005). ADHD Among Adolescents: A Review of the Diagnosis, Treatment, and Clinical Implications. Pediatrics. 115 (6) 1734-1746; doi:10.1542/peds.2004-1959

[6] Verdoux, H., & Liraud, F. (2000). Neuropsychological function and duration of illness in psychotic and mood disorders. Schizophrenia Research, 41(1), 273. doi:10.1016/s0920-9964(00)90988-5