According to the latest research, more children, adolescents and young adults suffer from anxiety, but fewer receive the appropriate treatment.
A new study looked at data from the National Ambulatory Medical Care Survey from 2006 to 2018 and evaluated in-office doctor visits to see how many included an anxiety disorder diagnosis and what treatment, if any, was administered. The observed patients ranged in age from 4 to 24 years.
While visits for anxiety increased from 1.4 percent in 2006 to 2009 to 4.2 percent in 2014 to 2018, the percentage of visits with therapy decreased, according to the study published Monday in the journal Pediatrics of the. American Academy of Pediatrics.
The likelihood of a patient receiving medication on their own to treat anxiety without any therapy has increased significantly in recent years of data analyzed in this survey, which continues to be administered by the US National Center for Health Statistics.
The research showed what mental health providers reported: Anxiety in young people is getting worse in the United States, said the study’s lead author, Dr. Laura Chavez, principal investigator at the Center for Child Health. Equity and Outcomes Research at Nationwide Childrens Hospital Colombo, Ohio.
The burden of treating mental health conditions among children is growing, Chavez said. Even when patients are able to navigate the healthcare system and have attended visits with a doctor, they can still walk away without (the patient) getting the care they need.
A weakness of the study is that it likely covers only part of the problem, said Dr. Lata McGinn, a psychology professor at Yeshiva University in New York City who was not involved in the study.
While the study includes people who come for treatment, there are many people who never come to the doctor’s office, said McGinn, who is also a cofounder of Cognitive & Behavioral Consultants in White Plains, New York. There are a lot of people who don’t even get anything.
The treatment data is concerning, because existing evidence has shown that for most people, therapy is the best way to treat anxiety, McGinn said.
But most of the young people were not receiving any type of therapy, even though treatment such as cognitive behavioral therapy, or CBT, is a frontline defense against anxiety, he added.
For serious conditions that benefit from medications, best practices state that those patients should undergo both pharmaceutical and psychotherapeutic interventions, McGinn said.
Taking drugs as the only form of treatment could mean being on them for a long time, she said.
The fact that they aren’t receiving therapy suggests that they fundamentally aren’t learning the tools to deal with anxiety on their own, McGinn said, adding that it’s especially concerning for young people who are still biologically and socially developing.
Living with conditions like anxiety and depression can feel like being in an ocean, said Dr. Ariana Hoet, executive clinical director of On Our Sleeves, an initiative created by Nationwide Children’s Hospital which supports children’s mental health. Hoet was not involved in the research.
Therapy is meant to teach you how to swim, but sometimes you’re sinking from exhaustion from navigating currents and need buoys to help you, she added.
Here’s what the drug may be, Hoet said. You can have these life preservers and it gives you that breath. It takes away from the intensity of the symptoms, but then you still want to go to therapy to learn the tools to still learn how to deal with it and live with it and survive it.
More effective treatment, including therapy, could help with growing mental health challenges in young people, Chavez said.
Hopefully patients will have access to both and then we wouldn’t see these changes over time that we’ve been looking at where more patients are actually just getting medications, he added.
While there is a broader issue of resources and availability when it comes to mental health care, there are things families can do to get help.
Unfortunately, the way our system is designed, it’s very taxing on defense and navigating that is up to the patient and the family, Chavez said.
One of the first steps is learning to recognize anxiety in children early, McGinn added. This type of behavior usually manifests itself in avoidance, such as a fear of sleeping alone or trying to stay home from school.
While the drive to nurture and protect may prompt adults to allow avoidance to relieve anxiety in the short term, McGinn advised against giving in to anxiety while continuing to support your child.
This approach might mean not letting your child stay home when they’re feeling anxious. Don’t dismiss chronically anxious behavior as shyness and instead seek a mental health professional for an evaluation, he said she.
And although drug companies have more money to market their solutions, be sure to find providers who can work with your family through evidence-based therapy programs like CBT, she said.
There can be hurdles to navigating insurance and finding available providers, so Hoet advises families to contact their child’s school or place of work to see if help is available there.
Families can also find help getting care and resources in the meantime at onoursleeves.org, she added.
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