Behavioral health providers have increasingly expanded their services, or specifically targeted, children, adolescents and young people to address these populations’ growing need for mental health treatment.
New research has verified that the need for mental health services has only continued to increase.
Rates of depression and anxiety have increased significantly across all demographics, according to a new study published in JAMA Network Open, though some populations are even more vulnerable to these conditions.
“This cohort study … found an increase in clinically diagnosed depression from 2017 to 2021, with a higher increase during the COVID-19 pandemic and higher rates in some subgroups,” researchers wrote. “Equally important, this study identified high rates and an increase in clinical diagnosis of anxiety without a depression diagnosis. These results support the increased need in public health and health care effort to combat the mental health crisis in youths.”
Researchers analyzed rates of depression and anxiety without depression among 1.7 million people ages 5 to 22 using electronic medical record (EMR) data from January 2017 to December 2021.
Rates of anxiety without depression were studied because many people with anxiety also have depression. Anxiety often precedes depression but has not been studied extensively on its own, researchers wrote.
The study concluded that overall rates of depression increased “significantly” over calendar years. In 2017, depression was prevalent in 2.55% of young people. In 2021, prevalence increased by 60% to 2.32%.
The prevalence of anxiety without a depression diagnosis also increased over the studied years, though it dipped slightly in 2020 before reaching the highest point assessed in 2021. In 2017, anxiety was prevalent in 3.13% of young people, and by 2021 was prevalent in 4.22%, an increase of 31%.
Increases in depression and anxiety were highest during 2020 and 2021, following the beginning of the COVID-19 pandemic.
“The unexpected onset of the COVID-19 pandemic in 2020 disrupted many health care systems and their services,” researchers wrote. “It also contributed to an increase in mental health issues for adolescents. Our data showed that the rates of newly diagnosed clinical depression did not decrease because of problems with access to health care in 2020, indicating that patients with depression or anxiety were still receiving care. Instead, the COVID-19 pandemic contributed to the already increasing trends.”
Researchers also analyzed rates of depression and anxiety across demographics in the data set and found that, while rates increased over time for all subgroups, differences existed between demographic groups.
Those identified as female, non-Hispanic white, and belonging to higher-income households were more likely to experience depression. Obesity and a history of comorbidities contributed to an increased likelihood of depression as well. In every year except 2020, American Indian or Alaska Native individuals also showed a higher prevalence of depression.
Age was the most influential factor for depression diagnoses, with the highest rates observed among individuals aged 14 to 22 across all calendar years studied.
Weight status was the most influential factor for rates of anxiety without depression, with underweight individuals having the highest prevalence of anxiety without a depression diagnosis.
“Although underweight was less studied in the literature, previous studies indicated that weight-related teasing for adolescents with underweight (and overweight) may increase the risk of social isolation and mental health problems for youths and adolescents,” the study’s authors wrote. “Other studies have shown that individuals with eating disorders often have comorbid mood or anxiety disorders. The group with underweight may benefit from early interventions to reduce anxiety to prevent future development of depression.”
Several factors limited the study. The population studied consisted of Southern California residents and may not be generalizable to the entire U.S. population.
The major limitation, researchers wrote, was that the study was that the data was limited to clinical diagnosis of depression and anxiety. Barriers including limited access to health care could prevent some young people from obtaining official diagnoses, leading to under-reporting of these mental health conditions.
