Kentucky Partnership for Families and Children

To those reading this newsletter, it’s probably a “no-brainer” as to why anyone should care about mental health issues. Mental health affects everyone, whether it’s in the form of a loved one, or if we’re questioning our own. However, stigma related to mental issues still exists, especially in children.
Mental health diagnoses are more prevalent than most people realize. Based on the 2005 American Community Survey (ACS) of civilians who were not currently in an institution, seven percent of the U.S. population between the ages of 5 to 20 described themselves as having a diagnosis. In Kentucky the percentage was much higher at almost 10 percent.

MENTAL HEALTH IN THE U.S.
The 2000 U.S. census breaks the category of disability down into four separate categories: sensory, physical, self-care, and mental. The mental category includes any disability that affects learning, remembering, and/or concentration. To match the terms used in the census, mental health issues will be called mental disabilities for this portion of the newsletter.
The census found that, of the over two million people between the ages of five to fifteen, almost five percent had a mental disability. This was the highest percentage of all the disability categories. The incident of a mental disability occurred more frequently in boys than in girls, occurring in about six percent of boys, and only about three percent of girls. About 70 percent of youth reported having two or more disabilities.
The census also found that most of the people with mental disabilities live in the south, which includes Kentucky. The data found that two of every five people in the U.S. with a disability lives in the South. This includes about thirty-nine percent of the population with a mental disability. However, there are more people in this region, which can at least partially explain the high percentage rates.

MENTAL HEALTH IN KENTUCKY
Unfortunately, Kentucky was listed as one of the states with the highest occurrence of mental disabilities. Of those aged five and older, nearly seven percent had a disability (nearly 3.7 million children) in Kentucky. For those youth 16 and older, nearly 10 percent had a problem with going outside of their homes (over 3 million youth) in Kentucky. Of those aged 16 to 64, almost 14 percent had a disability that affected their ability to be employed.
The census also found that the counties with “very high” disability rates were clustered around the coal mining areas of Kentucky, West Virginia, and Virginia. The counties in Kentucky included Bell, Breathitt, Clay, Harlan, Leslie, Martin, and Owsley.
Some slightly updated information reported by the ACS in 2005 found that about nine percent of males aged five to fifteen had a disability compared to about seven percent of males between 16 to 20. For females, the population of those with a disability was about five percent for both five to 15 year olds and 16 to 20 year olds.
This same survey found that only seven percent of males with a disability were employed, compared to about 23 percent of females. On the positive side, the 2005 survey also found that about 57 percent of males were enrolled in college or graduate school, and 65 percent of females were doing the same.

Resources
U.S. Census www.census.gov

MENTAL HEALTH AND FAMILIES
In 2000, two of every seven families in the U.S. reported having at least one person with a diagnosed mental disability. Of those families, almost four percent reported having one or more children between the ages of five to 17 with a disability. Families who reported having a member with a disability were more likely to report being in poverty and reported being on Supplemental Security Income (SSI). Nearly six percent of U.S. families who had no member with a disability reported being in poverty compared to nine percent of families who had a member with a disability. Most of these families were in the South in rural areas.

ECONOMIC COST OF MENTAL HEALTH
According to research presented to the National Institute of Mental Health (NIMH), there has been very little research done to estimate the cost of mental illness in children & adolescents. In 1998 the direct costs for the treatment of a young person with an emotional and/or behavioral health issue was approximately $11.75 billion, which breaks down to about $173 per child.
A research brief entitled “Brief Overview: Estimating the Economic Burden of Mental Illness for Children and Adolescents” (www.nimh.org) found further complications with attempting to find the true economic cost of adolescent mental health. The authors of the brief explain that the reason this is difficult is because mental health services for adolescents is not always provided by mental health professionals. Many children and adolescents receive treatment and other services from their pediatrician, and also through the education, child welfare, and juvenile justice systems.
Since so many groups of professionals provide what can be considered mental health services, no across-the-board data exists for this area. The article did mention that this data could be compiled; it would just take a multidisciplinary team to do the research and crunch the numbers.

CHILD AND ADOLESCENT MENTAL HEALTH

While it is difficult to know the true impact mental health has on Kentucky’s youth, Mental Health America (formerly the Mental Health Association) has compiled a list of “fast facts” regarding mental health and America’s youth:
 Only about 21 percent of children in the U.S. who need mental health services actually receive them,
 Five to 9 percent of children in the U.S. have a serious emotional disturbance,
 About 13 percent of children between 9 and 17 years old have an anxiety disorder,
 About 4 percent of school-age children have attention deficit-hyperactivity disorder
 Early childhood trauma can lead to memory problems and mental and cognitive declines later in life because early emotional stress
can lead to a slow decline in how neurons fire within the brain, especially near the region of the brain that is associated with
memory recall and learning,
 Nearly 4 percent of boys and 6 percent of girls have symptoms of post-traumatic stress disorder caused by violence they have
endured or witnessed,
 Nearly two-thirds of boys and three-fourths of girls in juvenile detention centers have a psychiatric disorder.
www.mentalhealthamerica.net
According to the World Health Organization (WHO), mental health affects and is affected by all other aspects of adolescent health; it is an important part of normal adolescent development in the areas of ability to cope with emotions, personality style and way of relating to others, and healthy expression of one’s feelings. Sadly, accidents, violence, and suicide are among the three most common causes of death in adolescents. An adolescents’ mental health can sometimes act as a sign or consequence of many risky behaviors, which can directly and indirectly affect the above three causes of death. Mental health issues that may have been already diagnosed may worsen as the adolescent struggles through their physical and emotional development. Unfortunately, adolescence is also a peak age for onset of a serious mental illness. Mood disorders such as depression and bipolar and psychotic disorders, such as schizophrenia are two types of mental illnesses that early recognition and treatment is critical for long-term benefits.
www.who.int Prevention and Care of Illness: Adolescents
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that about one in five children and adolescents have a mental health disorder. Their Children and Adolescent Mental Health website lists warning signs that may signal a mental health disorder or an emotional disturbance. Some changes to look for are:
 Sad and hopeless for no reason, and the feelings don’t go away,
 Feeling worthless or guilty often
 Feeling anxious or worried often,
 Frightened that his or her mind is either controlled or out of control,
 Constantly concerned about physical problems or physical appearance
 Using drugs or alcohol,
 Eating large amounts of food, then purging or abusing laxatives to avoid weight gain,
 Dieting or exercising excessively,
 Setting fires,
 Killing animals,
 Doing things that can be life threatening,