McLEAN, Va. – The nation's medical system falls far short of meeting the demand for teen mental health services because cases of suicide and psychiatric disorders are skyrocketing, underscoring a public health crisis that is already costing Americans billions to combat.
Research from federal regulators and medical groups shows the suicide rate for young people ages 10 to 19 rose by 56% from 2007 to 2016, the latest year for which figures are available. Only 40% of young people with major depression got treatment, according to the National Institute for Mental Health.
Severe depression is a common precursor to suicide, which kills thousands of children and teenagers a year in the USA. Suicides and suicide attempts cost the nation about $70 billion a year in lifetime costs for medical care and lost work hours.
The staggering price tag doesn't end there. Serious mental illness costs nearly $195 billion in lost earnings every year, and prescription opioid misuse – not including heroin, other drugs and alcohol – costs nearly $80 billion a year.
"The lack of access to psychiatric care has been a problem for a long time, and it's not improving because of the increasing demand for care of our nation's youth," says Dr. Wun Jung Kim, a child psychiatrist and professor at the Robert Wood Johnson Medical School at Rutgers University. "We have a lousy system of care."
Experts say the key is addressing the crisis before it drives the opioid epidemic's mounting cost to unprecedented levels, according to USA TODAY research.
Nearly half of people who suffer from substance abuse disorder have a mental health disorder, federal data show. The American Academy of Child and Adolescent Psychiatry says children often languish for up to 10 years after mental health symptoms emerge.
“Many of the serious mental health issues begin in childhood, and we need to address them sooner,” says Dr. Christine Moutier, a psychiatrist and chief medical officer of the American Foundation for Suicide Prevention.
Children and teens regularly wait days in emergency rooms before a bed opens up in hospital psychiatric units. There, doctors can decide whether it’s safe to release young patients to some form of outpatient treatment, or possibly residential rehabilitation if other efforts have failed.
Parents in Fairfax County, Virginia, often have to travel three to four hours south when inpatient beds open late at night, says Rick Leichtweis, senior director of Inova Health System's Kellar Center, which treats children and teens for mental health, addiction and special education.
Washington, D.C., is the only place in the U.S. that the psychiatric academy says has the right ratio of child psychiatrists for the population.
Adult and child psychiatrists alike are in short supply, Kim says, because the field is one of the lowest-paying medical specialties, and psychiatric wings of hospitals can hardly compete with, say, a new orthopedic unit.
Rising rates of youth suicide and psychiatric disorders come as the health care system has started to focus on the effect of loneliness on mental and physical health. Young people, seemingly the most connected of all through social media, are being hit hard, San Diego State University psychology professor Jean Twenge reported in a study in March.
Teens whose face time with friends is mostly on their phones are the loneliest of all, but even those who mix real-world socializing with social media still are increasingly isolated, Twenge found. The share of high school seniors who said they often felt lonely increased from 26% in 2012 to 39% in 2017.
An NBC News/Survey Monkey poll out today places much of the blame for teen mental health challenges on social media. Nearly a third of about 1,300 parents of 5- to 17-year-olds blamed social media for mental and emotional health problems in children. Bullying and stress were the next most frequently cited problems in the poll, part of the network's Kids Under Pressure series this week.
Jamison Monroe, founder and CEO of the teen mental health treatment company Newport Academy, says he self-medicated his severe depression and anxiety with alcohol and marijuana in high school. It's a story he told last month as he tried to convince angry neighbors of the need for four group homes he's trying to open in upscale McLean neighborhoods.
Such group homes “might actually be a wonderful thing from a suicide prevention standpoint if it offers something that's not the clinical environment but teaches them skills (and) allows them to get treatment and then integrate back into their their normal life,” Moutier says.
•Training pediatricians.The American Academy of Pediatrics last year called on members to screen for depression in children as young as 10. Psychiatrist Justine Larson, a senior medical adviser for mental health at the federal Substance Abuse Mental Health Services Administration, says education of primary care doctors is a top priority.
• Remote psychiatric consultations. Johns Hopkins University’s Center for Mental Health Services in Pediatric Primary Care is studying ways to integrate mental health care into primary care. It also tracks programs that connect psychiatrists with pediatricians during appointments and provides a list on its website.
• Nonprofit programs. Nonprofits are stepping in to address government funding shortfalls. In the Washington, D.C., area, Strength In Our Voices trains high school students, teachers and others in suicide prevention in schools. In Florida's Collier County, agencies collaborate to reach at-risk children before they are in crisis through the Naples Children & Education Foundation's Beautiful Minds initiative. At Cincinnati Children's Hospital, Adapting for Life, Surviving the Teens teaches coping and language skills to navigate into adulthood, especially how to ask for help when teens need it.
Whether they get that care often depends on their parents. Rutgers' Dr. Kim says psychiatry is made more challenging by the stigma many parents and grandparents attach to the field.
Milwaukee-area teen TJ Esser told his family he was transgender when he was 13 and found them very supportive. He was one of four students who spoke publicly in a new Milwaukee PBS/Milwaukee Journal Sentinel documentary about youth mental health.
Transgender students "suffer from so much mental health because it's not always an open place in schools to be who you are," says Esser, who is now 16..
Genevieve Mulligan, who grew up blocks from the proposed group homes in McLean, says she knows at least seven former high school classmates who died from an overdose or suicide.
"I truly hope that the adults opposing these homes understand that the youth of McLean are listening and the message they are receiving is loud and clear: if you are struggling with mental health or substance use conditions, you are not the kind of person I want in my backyard," Mulligan says.
The Harvard University graduate begins medical school at the University of Michigan this fall. She may specialize in child and adolescent psychiatry.
If you or your children are struggling with issues mentioned in this story and you would like to connect with others online, join USA TODAY’s "I Survived It" Facebook support group.
Contributing; Frank Gluck and Janine Zeitlin of the Fort Myers News Press, Rory Linnane of the Milwaukee Journal-Sentinel and Anne Saker of the Cincinnati Enquirer.
This article originally appeared on USA TODAY: Teen suicide and mental health: America's deadly, costly problems that have no end in sight