The news
Increasingly, adolescents’ and young adults’ doctor visits involve mental health evaluations, along with the prescription of psychiatric medications.
That’s the conclusion of a new study that found that in 2019, 17 percent of outpatient doctor visits for patients ages 13 to 24 in the United States involved a behavioral or mental health condition. , including anxiety, depression, suicidal ideation, self-harm or other issues. That number has increased dramatically since 2006, when only 9 percent of doctor visits involved mental illnesses.
The study, published Thursday in JAMA Network Open, also found a sharp increase in the proportion of visits involving psychiatric medications. In 2019, 22.4 percent of outpatient visits by the 13-24 age group involved the prescription of at least one psychiatric drug, up from 13 percent in 2006.
The big picture
The study is the latest evidence on changes in the types of disorders affecting children, adolescents and young adults. For decades, their health care visits involved more physical ailments, such as broken bones, viruses and drunk driving injuries. Increasingly, however, doctors are seeing a wide variety of behavioral and mental health issues.
The reasons are not entirely clear. Some experts say that modern life presents a new kind of mental pressure, even as society limits the risks of physical illness.
The latest study does not posit a reason for the shift. But the pandemic alone is not to blame, it said. “These findings suggest the increase in mental health conditions seen in youth during the pandemic occurred in the setting of already increasing rates of mental illness,” wrote the authors, a pediatrician and psychiatrist at Harvard Medical School. “Treatment and prevention strategies need to consider factors beyond the direct and indirect effects of the pandemic.”
The numbers
The analysis was drawn from the National Ambulatory Care Survey, which asks a sample of clinicians from across the country about reasons for patient visits. Between 2006 and 2019, patients aged 13 to 24 made 1.1 billion healthcare visits, of which 145 million were related to mental health issues. But the share of mental health-related visits increased each year, the study found, as did the prescription of psychiatric drugs, including stimulants, antipsychotics, mood stabilizers and anti-anxiety drugs.
The study found that antidepressants had the largest increase, but it did not specify the exact level, said Dr. Florence T. Bourgeois, a pediatrician at Boston Children’s Hospital, an associate professor of pediatrics at Harvard Medical School and a co-author of the paper.
Prescription patterns leave an open question, he said.
“We cannot determine whether this speaks to the severity of conditions or changes in prescribing attitudes and trends,” he said. Either way, he added, “We treat these conditions aggressively.”
