8th Graders with 2+ Mental Health or Substance Use Experiences

by Scott Richter and Dr. Patrick Jones

Other than increasing, it’s hard to know for sure how much mental health issues in U.S. children have grown over the last 30, 40, or 50-years. Kids disrupting class in the 1950’s might have been “diagnosed” as a class clown or a troublemaker and that student had to deal with the consequences of their actions as society understood them at the time. The same child today is more likely be diagnosed and treated for one of many common mental health conditions.

The American Psychological Association reports how typical school age children in the 1980’s had more anxiety than child psychiatric patients did in the 1950’s. Nationally, the direction of this trend continued as anxiety disorders in children increased by 20% from 2007 to 2012.

Diagnosis of a disorder is the first step. Seeking and following through with treatment is the second step. However, estimates are 20/20 American youth are getting the care they need.

According to the U.S. Centers for Disease Control and Prevention (CDC): roughly 20% of American youth between the ages of 3 and 17 “have a diagnosable mental, emotional or behavioral disorder in a given year” while only 20% of these children are ever diagnosed or treated. 

For anxiety, gender doesn’t make a difference before puberty. After, prevalence of anxiety in girls becomes 2:1 to boys.

Pew Research surveyed 920 teens September through November 2018 asking about the problems they see among their peers. 96% of respondents said depression and anxiety were a problem. Of the 96%, 70% said these were a major problem and 26% said a minor problem. Only 4% of respondents said depression and anxiety in their peers was not a problem.  

Looking at the Share of 8th Graders Reporting Two or More Mental Health or Substance Use Experiences on Spokane Trends, we also see prevalence increasing in both the state and county. 

During 2018, nearly one- quarter (23.8%) of 8th grade students in Spokane County reported two or more mental health or substance use experiences 30-days prior to taking the HYS questionnaire, increasing from 18.7% in 2010. In Washington State, 22.4% 8th grade students reported affirmatively in 2018, up from 18.2% in 2010. 

What mental health disorders are included in this Trend? The (CDC) reports during 2016, the most commonly diagnosed mental health disorders in children were:

  • Attention Deficit-Hyperactivity Disorder (ADHD), 9.4% of U.S. children ages 2-17.
  • Behavior Disorders, 7.4% of U.S. children ages 3-17.
  • Anxiety Disorders, 7.1% of U.S. children ages 3-17.
  • Depression, 3.2% of U.S. children ages 3-17.

More specifically, 

  • Children with ADHD have problems with “sustaining attention, hyperactivity and impulsive behavior… low self-esteem, troubled relationships and poor performance in school.”
  • Behavior Disorders (include, but are not limited to) oppositional defiant disorder, learning disorders, bipolar disorder, and conduct disorders.
  • Anxiety Disorders (include, but are not limited to) generalized anxiety disorder, post-traumatic stress disorder, social anxiety disorder, obsessive-compulsive disorder, eating disorders, panic disorder, and phobias.
  • Depression disorders (include, but are not limited to) disruptive mood dysregulation disorder, major depressive disorder, and persistent depressive disorder (dysthymia).

Compared to the general population, both children and adults with mental health disorder are much more likely to develop a substance use disorder. Referred to as a co-occurring disorder (also as a dual-diagnosis or co-morbidity), which in general means two or more disorders increasing the negative effects of each other.

Substance use includes tobacco, alcohol, marijuana, prescription pain medication (non-prescribed), and all other illegal drugs. 

While 19% of U.S. adults with a mental health disorder also have a co-occurring substance use disorder, the share of U.S. adolescents is estimated to be as high as 60-75%.

The source for this Trend is the Washington Office of Superintendent of Public Instruction (OSPI), Healthy Youth Survey (HYS). According to OSPI, the HYS “measures health risk behaviors that contribute to morbidity, mortality, and social problems among youth in Washington State. These behaviors include alcohol, tobacco, and other drug use, behaviors that result in unintentional and intentional injuries (e.g., violence), dietary behaviors, physical activity, and related risk and protective factors.”