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Articles   |    
Services for Adolescents With Psychiatric Disorders: 12-Month Data From the National Comorbidity Survey–Adolescent
E. Jane Costello, Ph.D.; Jian-ping He, M.S.; Nancy A. Sampson, B.A.; Ronald C. Kessler, Ph.D.; Kathleen Ries Merikangas, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201100518
View Author and Article Information

Dr. Costello is with the Department of Psychiatry, Duke University, Durham, North Carolina (e-mail: elizabeth.costello@duke.edu). Ms. He is with the Division of Intramural Research Programs and Dr. Merikangas is with the Mood and Anxiety Disorders Program, Section on Developmental Genetic Epidemiology, both at the National Institute of Mental Health, Bethesda, Maryland. Ms. Sampson and Dr. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  This study examined 12-month rates of service use for mental, emotional, and behavioral disorders among adolescents.

Methods  Data were from the National Comorbidity Survey Adolescent Supplement (NCS-A), a survey of DSM-IV mental, emotional, and behavioral disorders and service use.

Results  In the past 12 months, 45.0% of adolescents with psychiatric disorders received some form of service. The most likely were those with ADHD (73.8%), conduct disorder (73.4%), or oppositional defiant disorder (71.0%). Least likely were those with specific phobias (40.7%) and any anxiety disorder (41.4%). Among those with any disorder, services were more likely to be received in a school setting (23.6%) or in a specialty mental health setting (22.8%) than in a general medical setting (10.1%). Youths with any disorder also received services in juvenile justice settings (4.5%), complementary and alternative medicine (5.3%), and human services settings (7.9%). Although general medical providers treated a larger proportion of youths with mood disorders than with behavior disorders, they were more likely to treat youths with behavior disorders because of the larger number of the latter (11.5% of 1,465 versus 13.9% of 820). Black youths were significantly less likely than white youths to receive specialty mental health or general medical services for mental disorders.

Conclusions  Findings from this analysis of NCS-A data confirm those of earlier, smaller studies, that only a minority of youths with psychiatric disorders receive treatment of any sort. Much of this treatment was provided in service settings in which few providers were likely to have specialist mental health training.

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Anchor for Jump
Table 1Data on 12-month service use from the National Comorbidity Survey Adolescent Supplement among youths with a DSM-IV disorder, by diagnosis and service setting
Table Footer Note

a Complementary and alternative medicine

Anchor for Jump
Table 2Demographic correlates of service receipt for a DSM-IV disorder among 1,725 youths in the National Comorbidity Survey Adolescent Supplement, by service settinga
Table Footer Note

a Analyses were adjusted for all demographic variables in the table and number of disorders.

Table Footer Note

b Complementary and alternative medicine

Table Footer Note

c Ratio of family income to the family’s poverty threshold level based on family size

Table Footer Note

*p<.05, **p<.01, ***p<.001

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