Outpatient visits for adolescent mental health nearly doubled from 2006-2019

Outpatient visits for adolescent mental health nearly doubled from 2006-2019 | Image Credit: © Rawpixel.com - © Rawpixel.com - stock.adobe.com.

A significant increase in mental health-related outpatient visits and the use of psychotropic medications were observed for adolescents and young adults aged 12 to 24 years from 2006 to 2019, according to a cross-sectional study published in JAMA Network Open.

Especially with the rise in mental health concerns seen during the COVID-19 pandemic, overall concerns have increased in the last 10 years, making the examination of mental health-related trends crucial.

To examine these trends, a retrospective, cross-sectional analysis was developed. Study investigators used nationally representative data from the National Ambulatory Medical Care Survey conducted from 2006 to 2019, including patients aged 12 to 24 years with office-based outpatient visits in the United States.

Mental health-related visits included visits for psychiatric or substance use disorders. According to the study authors, up to 3 diagnoses were recorded for each visit from 2006 to 2013, and up to 5 from 2014 to 2019, though those numbers were limited to the first 3 for consistency. If any 1 of the 3 diagnosis codes was for a mental health condition, visits were included in the analysis.

Psychiatric diagnoses were classified into 6 categories:

• Mood-related (depression, anxiety, bipolar disorder, trauma, and stress-related conditions)
• Behavioral (disruptive, impulse-control, and attention-deficit/hyperactive disorders)
• Psychosis (schizophrenia, schizoaffective, and delusional disorders)
• Suicide-related (suicidal ideation, suicidal attempts, and nonsuicidal self-injury)
• Substance use
• Other (tic disorders, eating disorders, and personality disorders)

Medications associated with visits were grouped and all psychotropic medications were categorized into 7 classes: antidepressants, antipsychotics, central nervous system stimulants, anxiolytics, sedatives, and hypnotics, mood stabilizers, medications for substance use, and antiadrenergic agents.

Results revealed an estimated 1.1 billion outpatient visits by adolescents and young adults, with 145.0 million (13.1%) being associated with a mental health condition, during the study period.

This group had a median age of 18.4 (3.5) years, and there were 74 million females (51.0%).

Diagnoses related to mental health were more prevalent among visits by males compared to female patients (16.8% vs 10.9% [P < .001]). The difference was most pronounced among individuals aged 18 to 24 years, as 20.1% of visits with a psychiatric diagnosis occurring among males compared to 10.1% among females (P < .001).

From 2006 to 2019, the proportion of mental health-related visits increased almost 2-fold, from 8.9% to 16.9% (P < .001). Across all outpatient visits, 17.2% were associated with a prescription of at least 1 psychotropic medication. Significant increases were also observed, from 12.8% to 22.4% by 2019 (P < .001).

With a greater overall burden for male patients, "substantial increases in mental health-related outpatient visits and use of psychotropic medications" were observed from 2006 to 2019 among adolescents and young adults.

"These findings provide a baseline for understanding post-pandemic shifts and suggest that current treatment and prevention strategies will need to address preexisting psychiatric needs in addition to the effects of the COVID-19 pandemic," the study authors concluded.

Reference:

Ahn-Horst RY, Bourgeois FT. Mental Health–Related Outpatient Visits Among Adolescents and Young Adults, 2006-2019. JAMA Netw Open. 2024;7(3):e241468. doi:10.1001/jamanetworkopen.2024.1468