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- Definition: Number of hospital discharges for mental health issues among children and youth ages 5-19, by age group (e.g., in 2018, there were 26,959 hospital discharges for mental health issues among California youth ages 15-19).Number of hospital discharges for mental health issues per 1,000 children and youth ages 5-19, by age group (e.g., in 2018, there were 9.7 hospital discharges for mental health issues per 1,000 California youth ages 15-19).
- Data Source: California Office of Statewide Health Planning and Development special tabulation; California Dept. of Finance, Population Estimates and Projections, 2000-2009, 2010-2060 (May 2019).
- Footnote: Data are based on the number of hospitalizations, not the number of children hospitalized. Data are limited to hospital admissions; emergency room visits that do not result in admission are excluded. A full list of diseases and disorders included in these data can be found here. Mental disorders related to substance abuse are excluded. County-level data reflect the patient's county of residence, not the county in which the hospitalization occurred. Cases with unknown county of residence are included in California totals. Data are excluded for cases of patients with erroneous birth dates. The notation S refers to rates that have been suppressed because there were fewer than 20 cases, and to data that have been suppressed by the California Office of Statewide Health Planning and Development. N/A means that data are not available.
Learn More About Children's Emotional Health
- Measures of Children's Emotional Health on Kidsdata.org
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Kidsdata.org provides the following indicators of children's emotional health:
- The number and rate of children and youth ages 5-19 hospitalized for mental health issues, by age group
- The percentage of students with depression-related feelings (i.e., being so sad or hopeless every day for two weeks or more that they stop doing some usual activities) in the previous year, by grade level (7, 9, 11, and non-traditional), gender, level of school connectedness,* parent education level, race/ethnicity, and sexual orientation
- The percentage of youth ages 12-17 needing help in the previous year for emotional or mental health problems, and, in California and Los Angeles County, the percentage of those who receive counseling
- The percentage of school staff reports on the share of students who are well-behaved, the extent to which student depression or other mental health issues are a problem, and their level of agreement that helping students with emotional and behavioral problems is emphasized at their school, by type of school (elementary, middle, high, and non-traditional)
Data on student depression-related feelings come from the California Healthy Kids Survey (CHKS). State-level CHKS estimates, although derived from the Biennial State CHKS, may differ from data published in Biennial State CHKS reports due to differences in grade-level classification of students in continuation high schools.
*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
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- Hospitalizations for Mental Health Issues, by Age Group
- Depression-Related Feelings, by Grade Level
- Youth Needing Help for Emotional or Mental Health Problems
- Students Who Are Well-Behaved (Staff Reported)
- Student Depression or Mental Health Is a Problem at School (Staff Reported)
- School Emphasizes Helping Students with Emotional and Behavioral Problems (Staff Reported)
- Bullying and Harassment at School
- Pupil Support Services
- Childhood Adversity and Resilience
- School Climate
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- School Connectedness (Student Reported), by Grade Level
- School Supports (Student Reported), by Grade Level
- Caring Relationships with Adults at School (Student Reported), by Grade Level
- High Expectations from Adults at School (Student Reported), by Grade Level
- Meaningful Participation at School (Student Reported), by Grade Level
- Adults at School Care About Students (Staff Reported)
- Adults at School Believe in Student Success (Staff Reported)
- School Welcomes and Facilitates Parent Involvement (Staff Reported)
- School Gives Students Opportunities to Make a Difference (Staff Reported)
- School Fosters Youth Resilience or Asset Promotion (Staff Reported)
- Students Respect Each Other’s Differences (Staff Reported)
- Cultural or Racial/Ethnic Tension at School (Staff Reported)
- Deaths
- Hospital Use
- School Safety
- Youth Suicide and Self-Inflicted Injury
- Injuries
- Why This Topic Is Important
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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 one in five 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 2017, 32% of high school students nationwide had experienced persistent feelings of sadness or hopelessness in the previous year—one indicator of depression (6, 7). 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, 7).
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: https://www.childtrends.org/publications/are-the-children-well-a-model-and-recommendations-for-promoting-the-mental-wellness-of-the-nations-young-people
2. World Health Organization. (2013). Mental health action plan 2013-2020. Retrieved from: https://www.who.int/mental_health/publications/action_plan/en
3. Perou, R., et al. (2013). Mental health surveillance among children – United States, 2005-2011. Morbidity and Mortality Weekly Report, 62(2), 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: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408277
5. Bardach, N. S., et al. (2014). Common and costly hospitalizations for pediatric mental health disorders. Pediatrics, 133(4), 602-609. Retrieved from: https://pediatrics.aappublications.org/content/133/4/602
6. Centers for Disease Control and Prevention. (2018). Youth Risk Behavior Survey: Data summary and trends report 2007-2017. Retrieved from: https://npin.cdc.gov/publication/youth-risk-behavior-survey-data-summary-trends-report-2007-2017
7. Mental Health America. (n.d.). Depression in teens. Retrieved from: https://www.mhanational.org/depression-teens-0 - How Children Are Faring
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There were 41,087 hospital discharges for mental health issues among California youth ages 5-19 in 2018: 14,128 for children ages 5-14 and 26,959 for teens ages 15-19. Overall, the statewide rate of youth mental health hospitalization was 5.2 per 1,000 in 2018, up from 3.4 per 1,000 in 2007.
In 2015-2017, an estimated 24% of 7th graders, 30% of 9th graders, 32% of 11th graders, and 33% 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 and those with low levels of school connectedness. More than 60% of gay, lesbian, and bisexual youth had experienced depression-related feelings in 2015-2017, compared with less than 30% of their straight peers.
According to 2015-2016 estimates, 19% of California youth ages 12-17 needed help for emotional or mental health problems (such as feeling sad, anxious, or nervous) in the previous year, up from 13% in 2009. Among those who needed help, fewer than two in five (38%) received counseling.
When asked whether their school emphasizes helping students with emotional and behavioral problems, 31% of responses by middle school staff, 27% of responses by high school staff, and 46% of responses by staff at non-traditional schools reported strong agreement in 2015-2017. - Policy Implications
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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 high 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 Climate.
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: https://www.childtrends.org/publications/are-the-children-well-a-model-and-recommendations-for-promoting-the-mental-wellness-of-the-nations-young-people
2. World Health Organization. (n.d.). Child and adolescent mental health. Retrieved from: https://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: https://www.who.int/en/news-room/fact-sheets/detail/mental-health-strengthening-our-response
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: https://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: https://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: https://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=112 - Research & Links
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- Websites with Related Information
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- American Academy of Pediatrics: Mental Health Initiatives
- Blueprints for Healthy Youth Development. University of Colorado Boulder.
- California Children’s Trust
- Center on the Developing Child. Harvard University.
- Centers for Disease Control and Prevention: Children's Mental Health
- Child Mind Institute
- Child Trends: Youth Development
- Children and Adolescents with Emotional, Behavioral, and Mental Health Challenges: Professional Resource Guide. Maternal and Child Health Digital Library.
- Evidence-Based Practices Resource Center. Substance Abuse and Mental Health Services Administration.
- HEARD Alliance (Health Care Alliance for Response to Adolescent Depression)
- MentalHealth.gov. U.S. Dept. of Health and Human Services.
- National Institute of Mental Health: Child and Adolescent Mental Health
- National Training and Technical Assistance Center for Child, Youth, and Family Mental Health. Substance Abuse and Mental Health Services Administration.
- Social and Emotional Development in Children and Adolescents: Professional Resource Guide. Maternal and Child Health Digital Library.
- Stanford Center for Youth Mental Health and Wellbeing. Stanford Medicine.
- Youth.gov. Interagency Working Group on Youth Programs.
- Key Reports and Research
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- 2020 California Children's Report Card. Children Now.
- Are the Children Well? A Model and Recommendations for Promoting the Mental Wellness of the Nation's Young People. (2014). Child Trends & Robert Wood Johnson Foundation. Murphey D., et al.
- Behavioral Health Barometer (Vol. 5) (2019). Substance Abuse and Mental Health Services Administration.
- California Reducing Disparities Project: Strategic Plan to Reduce Mental Health Disparities. (2018). California Pan-Ethnic Health Network.
- Children's Mental Health Report. Child Mind Institute.
- Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda. (2019). National Academies Press. National Academies of Sciences, Engineering, and Medicine.
- Improving Behavioral Health Care for Children in California: A Call to Action. (2019). California Children’s Hospital Association.
- Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. (2019). Substance Abuse and Mental Health Services Administration.
- Mental and Behavioral Health: NSCH Data Brief. (2020). Health Resources and Services Administration, Maternal and Child Health Bureau.
- Mental Health and Suicidality Among Racially/Ethnically Diverse Sexual Minority Youths. (2014). American Journal of Public Health. Bostwick, W. B., et al.
- Mental Health Parity. (2014). Health Affairs. Goodell, S.
- Policies to Promote Child Health. (2015). The Future of Children.
- Portrait of Promise: The California Statewide Plan to Promote Health and Mental Health Equity. (2015). California Dept. of Public Health, Office of Health Equity.
- Reducing the Burden of Depression in Youth: What Are the Implications of Neuroscience and Genetics on Policies and Programs? (2013). Journal of Adolescent Health. Patel, V.
- Supportive Relationships and Active Skill-Building Strengthen the Foundations of Resilience. (2015). National Scientific Council on the Developing Child.
- The State of Mental Health in America. Mental Health America.
- County/Regional Reports
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- 2018-19 California County Scorecard of Children's Well-Being. Children Now.
- Annual Report on the Conditions of Children in Orange County. Orange County Children's Partnership.
- Community Health Improvement Plan for Los Angeles County 2015-2020. Los Angeles County Dept. of Public Health.
- Key Indicators of Health by Service Planning Area. (2017). Los Angeles County Dept. of Public Health.
- Live Well San Diego Report Card on Children, Families, and Community, 2019. (2020). San Diego Children’s Initiative. McBrayer, S. L., et al.
- Orange County Community Indicators Report. Orange County Community Indicators Project.
- San Mateo County All Together Better. San Mateo County Health.
- Santa Clara County Children's Data Book. Santa Clara County Office of Education, et al.
- Santa Monica Youth Wellbeing Report Card. Santa Monica Cradle to Career.
- Youth Need Data. Get Healthy San Mateo County.
- More Data Sources For Children's Emotional Health
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- California Health Interview Survey. UCLA Center for Health Policy Research.
- California School Climate, Health, and Learning Surveys Public Dashboards. WestEd & California Dept. of Education.
- Health, United States, 2018 – Data Finder. National Center for Health Statistics.
- Mental Health Data and Publications. Centers for Disease Control and Prevention.
- National Longitudinal Study of Adolescent to Adult Health (Add Health) UNC Carolina Population Center.
- Substance Abuse and Mental Health Services Administration (SAMHSA): Data. U.S. Dept. of Health and Human Services.
- Youth Risk Behavior Surveillance System (YRBSS) Centers for Disease Control and Prevention.
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