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The systematic review and meta-analysis of 12 population-based U.S. studies found that within the previous 12 months, 10.06% of youth experienced serious emotional disturbance (SED) with substantial impairment in one of more functional domains and that 6.36% of youth experienced SED with substantial impairment in two or more domains.
“The large numbers of youth and families affected by SED, the significant long-term consequences of these conditions, and the considerable costs and complexity of treating these disorders underscore the need for comprehensive and effective prevention and treatment services,” wrote Nathaniel J. Williams, Ph.D., L.C.S.W., an assistant professor in the School of Social Work at Boise State University, and colleagues.
Previous research found that 4% to 17% of youth in the United States met criteria for SED; however, each of those reviews used a unique sample and method and as a result produced unique prevalence estimates, according to the authors. The goal of this study was to determine pooled prevalence estimates of SED.
Researchers identified studies through electronic searches of the MEDLINE and PsycINFO databases and nine prior reviews. Two raters evaluated 423 full-text, peer-reviewed articles from January 1, 1980, through January 1, 2017. Studies were included if they evaluated psychopathology and functional impairment among community samples of youth aged 18 and younger in the United States using structured interviews or standardized, nationally normed rating scales. Prevalence estimates of SED with domain-specific and global impairment were extracted, along with study characteristics and case definitions. Twelve studies met the inclusion criteria.
These estimates of SED are sufficiently precise to guide clinical decision making, mental health policy, and consideration of child psychiatry workforce needs in this country, according to the investigators. They cited previous research showing that only about 50% of youth with SED receive any mental health treatment within a one-year period.
Given these estimates, an important area of concern is the shortage of child psychiatrists to provide care. “Only about 8,700 child psychiatrists deliver services in the United States, implying an untenable 620:1 ratio of youths with SED per child psychiatrist,” wrote the researchers.
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