In February of this year, the American Academy of Pediatrics (AAP) announced its intentions to initiate change by calling for every child to receive an annual screening for depression beginning at the age of 12. This is a big step forward, but is it enough?
Depression is the leading cause of disability in the United States among people aged 15 to 44, according to the World Health Organization.
Eighty percent of patients who receive mental health treatment for depression show an improvement in their symptoms after a month of treatment.
However, an estimated two-thirds of people suffering from depression do not end up getting diagnosed or receiving treatment at all.
Unfortunately, the fact that depression is underdiagnosed and undertreated has dire consequences. Depression is the primary cause of suicide, and up to two-thirds of cases of older adult suicide are attributable to misdiagnosed or untreated depression.
With depression affecting one in eight adolescents and suicide being the third-leading cause of death among young adults, it is not difficult to conclude that America needs a better mental healthcare system and that the flaws in the current one is a disservice to not only patients of all ages, but particularly to the new generation of youth.
Screening kids regularly may be able to diagnose more of those who exhibit depression symptoms earlier. But what happens after the diagnosis — getting the treatment — may be the real problem.
There are a multitude of barriers between a young patient getting diagnosed with depression and their options for help and treatment.
The concerned parents of these patients often discover that finding the right provider for their child is a near impossible task.
Only a small number of therapists and an even smaller number of psychiatrists accept private insurance.
Out of these options, most are already full and not accepting new patients or have waiting lists of many months to a year.
On top of that, the provider must be close enough in proximity to make weekly trips to the office. And of course, they need to connect well with the teenage patient for truly effective treatment, which in itself is a challenge.
In a 2017 study conducted by Harvard, researchers pretending to be parents of a young adolescent with depression called 601 pediatricians and 312 child psychiatrists across five different cities. The results were discouraging.
They were able to schedule appointments with only less than half of the pediatricians and only 17 percent of the child psychiatrists, and of these, wait times of several months were considered rather favorable results.
President and CEO of Mental Health America, Paul Gionfriddo, explains that this is not due to a large number of patients but instead due to the lack of mental healthcare professionals.
Psychiatrists, although required to attend medical school and train in residency like all physicians, are paid significantly less than doctors in many other specialties.
Because mental health is dismissed as less important than physical health, providers are not valued and not paid enough, and thus there are less of them than there needs to be.
However, the reason why finding treatment for depression is so difficult is not limited to the lack of availability of mental healthcare providers.
Mental health issues have always carried a stigma. Many parents will refuse to take their children to see a mental healthcare provider because they do not want to accept that their child has clinical depression. Many youth themselves feel ashamed for needing to seek help.
According to Gionfriddo, the key to closing the gap between depression diagnosis and treatment is opening up the conversation about mental health and its importance.
He said that physicians in fields other than psychiatry should take mental health just as seriously as physical health and should offer referrals to specialists. Additionally, he said physicians should help patients and their families find information about depression and the different options for treatment.
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