Depression-Related Feelings, by Grade Level

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Learn More About Children's Emotional Health

Measures of Children's Emotional Health on Kidsdata.org
Kidsdata.org provides the following indicators of children's emotional health:
*Levels of school connectedness are based on a scale created from responses to five questions about feeling safe, close to people, and a part of school, being happy at school, and about teachers treating students fairly.
Children's Emotional Health
Bullying and Harassment at School
Childhood Adversity and Resilience
Deaths
Disconnected Youth
Pupil Support Services
School Safety
Hospitalizations
School Climate
Youth Alcohol, Tobacco, and Other Drug Use
Youth Suicide and Self-Inflicted Injury
Injuries
Why This Topic Is Important
Emotional health is an integral part of overall health, as physical and mental health are intricately linked (1, 2). Sound youth mental health—which is more than the absence of disorders—includes effective coping skills and the ability to form positive relationships, to adapt in the face of challenges, and to function well at home, in school, and in life (1, 3). Positive emotional health is critical to equipping young people for the challenges of growing up and living as healthy adults (1, 2).

Mental disorders affect as many as 1 in 5 U.S. children each year and are some of the most costly conditions to treat—mental health problems among young people under age 24 cost the U.S. an estimated $247 billion annually (1, 3). Unfortunately, the majority of young people who need mental health treatment do not receive it, and mental health problems in childhood often have negative effects in adulthood (1, 3, 4).
Depression is one of the most common emotional health problems among youth, with an estimated 11% of U.S. adolescents diagnosed with depression by age 18 (4). One study found that depression accounted for 44% of all pediatric mental health hospital admissions in 2009, costing $1.33 billion (5). In 2015, 30% of high school students nationwide reported persistent feelings of sadness or hopelessness—one indicator of depression (6). Youth with depression are more likely to exhibit suicidal behavior, drop out of school, use alcohol or drugs, and engage in unsafe sexual activity, in addition to having difficulties with school and relationships (4, 6).

For more information on children's emotional health, see kidsdata.org’s Research & Links section.

Sources for this narrative:

1.  Murphey, D., et al. (2014). Are the children well? A model and recommendations for promoting the mental wellness of the nation's young people. Child Trends & Robert Wood Johnson Foundation. Retrieved from: http://www.rwjf.org/en/library/research/2014/07/are-the-children-well-.html

2.  World Health Organization. (2013). Mental health action plan 2013-2020. Retrieved from: http://www.who.int/mental_health/maternal-child/child_adolescent/en

3.  Perou, R., et al. (2013). Mental health surveillance among children—United States, 2005-2011. Morbidity and Mortality Weekly Report, 62(02), 1-35. Retrieved from: https://www.cdc.gov/mmwr/preview/mmwrhtml/su6202a1.htm

4.  Avenevoli, S., et al. (2015). Major depression in the National Comorbidity Survey—Adolescent Supplement: Prevalence, correlates, and treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 54(1), 37-44.e2. Retrieved from: http://www.jaacap.com/article/S0890-8567(14)00732-1/

5.  Bardach, N. S., et al. (2014). Common and costly hospitalizations for pediatric mental health disorders. Pediatrics, 133(4), 602-609. Retrieved from: http://pediatrics.aappublications.org/content/133/4/602

6.  Child Trends Databank. (2016). Adolescents who felt sad or hopeless. Retrieved from: http://www.childtrends.org/?indicators=adolescents-who-felt-sad-or-hopeless
How Children Are Faring
There were 38,578 hospital discharges for mental health issues among California youth ages 5-19 in 2016: 12,806 for children ages 5-14 and 25,772 for teens ages 15-19. Overall, the statewide rate of youth mental health hospitalization was 5 per 1,000 in 2016, up from 4 per 1,000 in 2002.

In 2013-2015, an estimated 25% of 7th graders, 32% of 9th graders, 33% of 11th graders, and 38% of non-traditional students in California experienced depression-related feelings in the previous year (meaning they felt so sad or hopeless almost every day for two weeks or more that they stopped doing some usual activities). Depression-related feelings were more common among female students, those with low levels of school connectedness, and those whose parents did not finish high school. More than 60% of gay, lesbian, and bisexual youth experienced depression-related feelings in 2013-2015, compared to less than 30% of their straight peers. Among racial/ethnic groups with data, estimates of depression-related feelings ranged from less than 27% to more than 40%.

An estimated 21% of California youth ages 12-17 needed help for emotional or mental health problems (such as feeling sad, anxious, or nervous) in 2013-2014, up from 17% in 2005. Among those who needed help, approximately one-third (35%) received counseling. According to 2011-2012 parent reports, an estimated 63% of California children ages 2-17 who needed mental health treatment or counseling received services in the previous year, with county-level estimates ranging from 53% to 67%.
When asked whether their school emphasizes helping students with emotional and behavioral problems, 28% of responses by middle school staff, 24% of responses by high school staff, and 43% of responses by staff at non-traditional schools reported strong agreement in 2013-2015.
Policy Implications
The vast majority of emotional health problems begin in adolescence and young adulthood, with half of all disorders starting by age 14 (1, 2). Screening, early identification, and treatment are critical, as untreated mental illness can disrupt children's development, academic achievement, and their ability to lead healthy, productive lives (1, 2, 3). Health care and school settings are natural places to identify early warning signs, though many primary care providers do not routinely screen youth for mental health issues, and teachers may lack the training or time to identify such issues and refer students for services (1, 3, 4). Even if mental health problems are identified, children often face challenges with stigma and access to services; in fact, most children who need mental health treatment do not receive it (1, 3).

Experts recommend promoting mental wellness in addition to preventing and treating mental illness (1, 5). Mental wellness is influenced by socioeconomic, biological, and environmental factors, and promoting positive emotional health requires coordinated, cross-sector strategies that address influences at both the individual and community levels (1, 5).

Policy options that could promote children's emotional health include:
  • Ensuring that mental health funding is aligned with what is known about the age of onset of disorders, populations at higher risk (e.g., children in poverty, LGBT youth, and children in foster care, among others), and effective services and strategies, which include increased integration and coordination among mental health services and other systems, such as health care, education, child welfare, and juvenile justice (1, 2, 3, 5)
  • Setting school policies that foster a positive, supportive environment and promote student engagement in school; also supporting comprehensive K-12 education for social-emotional learning, including communication skills, problem-solving, and stress management (1, 5, 6)
  • Ensuring adequate funding and training for a range of school staff to recognize signs of mental distress and refer students to services; such training also should focus on how to promote a safe and supportive environment for all students, including LGBT youth (1, 4, 7)
  • Promoting efforts in communities to provide youth with positive experiences, relationships, and opportunities, such as quality after-school programs and safe places to play and exercise (1, 8)
  • Promoting mental health training for medical residents and pediatricians, and expanding the workforce of qualified mental health professionals serving youth, including school counselors, psychiatrists, and primary care physicians (1, 3, 9)
  • Supporting efforts to promote parents' mental health and positive parenting skills, including increased screening for parental depression (1)
  • Increasing access to high-quality early childhood education, especially for low-income children, and ensuring that early education staff are trained on social-emotional learning (1)
  • Supporting training and media campaigns to reduce the stigma associated with mental health problems and increase knowledge of warning signs; trainings could include "mental health first aid" for wide-ranging audiences, focusing on how to recognize early warning signs, provide non-professional support, and help youth access community resources (1, 9)
For more policy ideas and information on this topic, see kidsdata.org’s Research & Links section or the report, Are the Children Well? Also see Policy Implications under the following kidsdata.org topics: Youth Suicide and Self-Inflicted Injury, Bullying and Harassment at School, and School Connectedness.

Sources for this narrative:

1.  Murphey, D., et al. (2014). Are the children well? A model and recommendations for promoting the mental wellness of the nation’s young people. Child Trends & Robert Wood Johnson Foundation. Retrieved from: http://www.rwjf.org/en/library/research/2014/07/are-the-children-well-.html

2.  World Health Organization. (n.d.). Child and adolescent mental health. Retrieved from: http://www.who.int/mental_health/maternal-child/child_adolescent/en

3.  Padilla-Frausto, D. I., et al. (2014). Three out of four children with mental health needs in California do not receive treatment despite having health care coverage. UCLA Center for Health Policy Research. Retrieved from: http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1307

4.  Dowdy, E., et al. (2010). School-based screening: A population-based approach to inform and monitor children’s mental health needs. School Mental Health, 2(4), 166-176. Retrieved from: https://link.springer.com/article/10.1007%2Fs12310-010-9036-3

5.  World Health Organization. (2016). Mental health: Strengthening our response. Retrieved from: http://www.who.int/mediacentre/factsheets/fs220/en

6.  Patel, V. (2013). Reducing the burden of depression in youth: What are the implications of neuroscience and genetics on policies and programs? Journal of Adolescent Health, 52(2, Suppl. 2), S36-S38. Retrieved from: http://www.jahonline.org/article/S1054-139X(12)00178-4/

7.  Centers for Disease Control and Prevention. (2017). Lesbian, gay, bisexual, and transgender health: LGBT Youth. Retrieved from: http://www.cdc.gov/lgbthealth/youth.htm

8.  Afterschool Alliance. (2014). Taking a deeper dive into afterschool: Positive outcomes and promising practices. Retrieved from: http://www.afterschoolalliance.org/documents/Deeper_Dive_into_Afterschool.pdf

9.  Goodell, S. (2014). Mental health parity. Health Affairs. Retrieved from: http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=112
Websites with Related Information
Key Reports and Research
County/Regional Reports
More Data Sources For Children's Emotional Health