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Child Anxiety and Depression During the COVID-19 Pandemic and Unmet Mental Health Care Needs

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Abstract

Child anxiety and depression increased in recent years, while access to health care improved in some ways and worsened in others. The purpose of this study was to understand the prevalence of child anxiety and depression during the COVID-19 pandemic, unmet mental health care need among children with these conditions, and whether disparities exist by race/ethnicity and sex. A cross-sectional secondary data analysis was conducted using the 2021 National Survey of Children’s Health (ages 3–17 years, unweighted n = 42,175). Parent/caregiver-reported child anxiety and depression prevalence was greater among non-Hispanic White children than those of other racial/ethnic groups and females compared to males, after adjusting for covariates. Unmet mental health care need among children with anxiety and depression was greater among Hispanic children than those of other racial/ethnic groups, after adjusting for covariates. In conclusion, this study identified a disparity in unmet need between Hispanic children and those of other races and ethnicities. Implications for policy and practice are discussed.

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Data Availability

The datasets analyzed during the current study are available in the United States Census Bureau repository [45].

References

  1. Merikangas KR, He J, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J (2010) Lifetime prevalence of Mental disorders in U.S. adolescents: results from the National Comorbidity Survey replication–adolescent supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 49(10):980–989. https://doi.org/10.1016/j.jaac.2010.05.017

    Article  PubMed  PubMed Central  Google Scholar 

  2. Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S (2021) Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a Meta-analysis. JAMA Pediatr 175(11):1142–1150. https://doi.org/10.1001/jamapediatrics.2021.2482

    Article  PubMed  Google Scholar 

  3. Ameringen M, Van, Mancini C, Farvolden P (2003) The impact of anxiety disorders on educational achievement. J Anxiety Disord 17(5):561–571. https://doi.org/10.1016/S0887-6185(02)00228-1

    Article  PubMed  Google Scholar 

  4. Glied S, Pine DS (2002) Consequences and correlates of adolescent depression. Arch Pediatr Adolesc Med 156(10):1009–1014. https://doi.org/10.1001/archpedi.156.10.1009

    Article  PubMed  Google Scholar 

  5. GOULD MS, KING R, GREENWALD S, FISHER P, SCHWAB-STONE M, GOODMAN KRAMERRFLISHERAJ, S., CANINO, G., SHAFFER D (1998) Psychopathology Associated with suicidal ideation and attempts among children and adolescents. J Am Acad Child Adolesc Psychiatry 37(9):915–923. https://doi.org/10.1097/00004583-199809000-00011

    Article  CAS  PubMed  Google Scholar 

  6. Lewinsohn PM, Roberts RE, Seeley JR, Rohde P, Gotlib IH, Hops H (1994) Adolescent psychopathology: II. Psychosocial risk factors for depression. J Abnorm Psychol (Vol 103(2):302–315. https://doi.org/10.1037/0021-843X.103.2.302. American Psychological Association

    Article  CAS  Google Scholar 

  7. Lewinsohn PM, Rohde P, Seeley JR (1998) Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications. Clin Psychol Rev 18(7):765–794. https://doi.org/10.1016/S0272-7358(98)00010-5

    Article  CAS  PubMed  Google Scholar 

  8. McDonald B, Lester KJ, Michelson D (2023) She didn’t know how to go back’: School attendance problems in the context of the COVID-19 pandemic—A multiple stakeholder qualitative study with parents and professionals. Br J Educ Psychol 93(1):386–401. https://doi.org/10.1111/bjep.12562

    Article  PubMed  Google Scholar 

  9. Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, Kessler RC (2013) Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication adolescent supplement. JAMA Psychiatry 70(3):300–310. https://doi.org/10.1001/2013.jamapsychiatry.55

    Article  PubMed  Google Scholar 

  10. Quiroga C, Janosz M, Lyons J, Morin A (2012) Grade Retention and Seventh-Grade Depression symptoms in the course of School Dropout among high-risk adolescents. Psychology 3(9A):749–755. https://doi.org/10.4236/psych.2012.329113

    Article  Google Scholar 

  11. REINHERZ HZ, GIACONIA RM, FRIEDMAN SILVERMANAMYB, PAKIZ A, B., FROST, A. K., COHEN E (1995) Early psychosocial risks for adolescent suicidal ideation and attempts. J Am Acad Child Adolesc Psychiatry 34(5):599–611. https://doi.org/10.1097/00004583-199505000-00012

    Article  CAS  PubMed  Google Scholar 

  12. Centers for Disease Control and Prevention. (n.d.). WISQARS Data Visualization: 10 Leading Causes of Death, United States (2020, Both Sexes, All Ages, All Races). Retrieved May 5 (2022) from https://wisqars.cdc.gov/data/lcd/home?lcd=eyJzdGF0ZXMiOlsiMDEiLCIwMiIsIjA

  13. Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, Walkup JT (2018) Epidemiology and impact of health care provider-diagnosed anxiety and depression among US children. J Dev Behav Pediatr 39(5):395–403. https://doi.org/10.1097/DBP.0000000000000571

    Article  PubMed  PubMed Central  Google Scholar 

  14. Whitney DG, Peterson MD (2019) US National and State-Level Prevalence of Mental Health Disorders and Disparities of Mental Health Care Use in Children. JAMA Pediatr 173(4):389–391. https://doi.org/10.1001/jamapediatrics.2018.5399

    Article  PubMed  PubMed Central  Google Scholar 

  15. Samji H, Wu J, Ladak A, Vossen C, Stewart E, Dove N, Long D, Snell G (2022) Review: Mental health impacts of the COVID-19 pandemic on children and youth - a systematic review. Child Adolesc Mental Health 27(2):173–189. https://doi.org/10.1111/camh.12501

    Article  Google Scholar 

  16. Martin R, Rajan S, Shareef F, Xie KC, Allen KA, Zimmerman M, Jay J (2022) Racial disparities in child exposure to Firearm Violence before and during COVID-19. Am J Prev Med 63(2):204–212. https://doi.org/10.1016/j.amepre.2022.02.007

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lebrun-Harris LA, Ghandour RM, Kogan MD, Warren MD (2022) Five-year trends in US children’s Health and Well-being, 2016–2020. JAMA Pediatr 176(7):e220056–e220056. https://doi.org/10.1001/jamapediatrics.2022.0056

    Article  PubMed  PubMed Central  Google Scholar 

  18. Mpofu JJ, Cooper AC, Ashley C, Geda S, Harding RL, Johns MM, Spinks-Franklin A, Njai R, Moyse D, Underwood JM (2022) Perceived racism and demographic, Mental Health, and behavioral characteristics among High School Students during the COVID-19 pandemic - adolescent behaviors and experiences Survey, United States, January-June 2021. MMWR Supplements 71(3):22–27. https://doi.org/10.15585/mmwr.su7103a4

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hawkins D, Davis L, Kriebel D (2021) COVID-19 deaths by occupation, Massachusetts, March 1-July 31, 2020. Am J Ind Med 64(4):238–244. https://doi.org/10.1002/ajim.23227

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Austin AA, Chorpita BF (2004) Temperament, anxiety, and Depression: comparisons across five ethnic groups of children. J Clin Child Adolesc Psychol 33(2):216–226. https://doi.org/10.1207/s15374424jccp3302_2

    Article  PubMed  Google Scholar 

  21. Roberts RE, Chen YW (1995) Depressive symptoms and suicidal ideation among mexican-origin and Anglo adolescents. J Am Acad Child Adolesc Psychiatry 34(1):81–90. https://doi.org/10.1097/00004583-199501000-00018

    Article  CAS  PubMed  Google Scholar 

  22. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ (2019) Prevalence and treatment of Depression, anxiety, and Conduct problems in US children. J Pediatr 206:256–267e3. https://doi.org/10.1016/j.jpeds.2018.09.021

    Article  PubMed  Google Scholar 

  23. Coker TR, Elliott MN, Kataoka S, Schwebel DC, Mrug S, Grunbaum JA, Cuccaro P, Peskin MF, Schuster MA (2009) Racial/Ethnic disparities in the mental health care utilization of fifth grade children. Acad Pediatr 9(2):89–96. https://doi.org/10.1016/j.acap.2008.11.007

    Article  PubMed  PubMed Central  Google Scholar 

  24. Fox DJ, Hanes D (2023) Prevalence and Correlates of Unmet Mental Health Services Need in adolescents with Major Depressive Episode in 2019: an analysis of National Survey on Drug Use and Health data. J Adolesc Health 72(2):182–188. https://doi.org/10.1016/j.jadohealth.2022.10.001

    Article  PubMed  Google Scholar 

  25. Merikangas KR, He J, Burstein M, Swendsen J, Avenevoli S, Case B, Georgiades K, Heaton L, Swanson S, Olfson M (2011) Service utilization for Lifetime Mental disorders in U.S. adolescents: results of the National Comorbidity Survey–Adolescent supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 50(1):32–45. https://doi.org/10.1016/j.jaac.2010.10.006

    Article  PubMed  Google Scholar 

  26. Curfman AL, Hackell JM, Herendeen NE, Alexander JJ, Marcin JP, Moskowitz WB, Bodnar CEF, Simon HK, McSwain SD, SECTION ON TELEHEALTH CARE (2021) Telehealth: improving Access to and Quality of Pediatric Health Care. Pediatrics 148(3):e2021053129 & AMBULATORY MEDICINE, C. O. N. P. W. https://doi.org/10.1542/peds.2021-053129

    Article  PubMed  Google Scholar 

  27. Chang JE, Lai AY, Gupta A, Nguyen AM, Berry CA, Shelley DR (2021) Rapid Transition to Telehealth and the Digital divide: implications for primary Care Access and Equity in a Post-COVID era. Milbank Q 99(2):340–368. https://doi.org/10.1111/1468-0009.12509

    Article  PubMed  PubMed Central  Google Scholar 

  28. Anderson KE, McGinty EE, Presskreischer R, Barry CL (2021) Reports of Forgone Medical Care among US adults during the initial phase of the COVID-19 pandemic. JAMA Netw Open 4(1):e2034882–e2034882. https://doi.org/10.1001/jamanetworkopen.2020.34882

    Article  PubMed  PubMed Central  Google Scholar 

  29. U.S. Census Bureau (2022) 2021 National Survey of Children’s Health: Methodology Report. https://www2.census.gov/programs-surveys/nsch/technical-documentation/methodology/2021-NSCH-Methodology-Report.pdf

  30. Levesque J-F, Harris MF, Russell G (2013) Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 12(1):18. https://doi.org/10.1186/1475-9276-12-18

    Article  PubMed  PubMed Central  Google Scholar 

  31. Werlen L, Gjukaj D, Mohler-Kuo M, Puhan MA (2020) Interventions to improve children’s access to mental health care: a systematic review and meta-analysis. Epidemiol Psychiatric Sci 29:e58. https://doi.org/10.1017/S2045796019000544

    Article  Google Scholar 

  32. Liu Y, Finch BK, Brenneke SG, Thomas K, Le PD (2020) Perceived discrimination and Mental Distress amid the COVID-19 pandemic: evidence from the understanding America Study. Am J Prev Med 59(4):481–492. https://doi.org/10.1016/j.amepre.2020.06.007

    Article  PubMed  PubMed Central  Google Scholar 

  33. Vanderminden J, Esala JJ (2018) Beyond symptoms: race and gender predict anxiety disorder diagnosis. Soc Mental Health 9(1):111–125. https://doi.org/10.1177/2156869318811435

    Article  Google Scholar 

  34. Hawes MT, Szenczy AK, Klein DN, Hajcak G, Nelson BD (2022) Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic. Psychol Med 52(14):3222–3230. https://doi.org/10.1017/S0033291720005358

    Article  PubMed  Google Scholar 

  35. Artiga S, Hill L, Damico A (2022) Health Coverage by Race and Ethnicity, 2010–2021. https://www.kff.org/racial-equity-and-health-policy/issue-brief/health-coverage-by-race-and-ethnicity/

  36. Hill L, Artiga S (2022) COVID-19 Cases and Deaths by Race/Ethnicity: Current Data and Changes Over Time. https://www.kff.org/coronavirus-covid-19/issue-brief/covid-19-cases-and-deaths-by-race-ethnicity-current-data-and-changes-over-time/

  37. Adepoju OE, Chae M, Ojinnaka CO, Shetty S, Angelocci T (2022) Utilization gaps during the COVID-19 pandemic: racial and ethnic disparities in Telemedicine Uptake in federally qualified Health Center Clinics. J Gen Intern Med 37(5):1191–1197. https://doi.org/10.1007/s11606-021-07304-4

    Article  PubMed  PubMed Central  Google Scholar 

  38. Atske S, Perrin A (2021) Home broadband adoption, computer ownership vary by race, ethnicity in the U.S Pew Research Center. https://pewresearch-org-preprod.go-vip.co/fact-tank/2021/07/16/home-broadband-adoption-computer-ownership-vary-by-race-ethnicity-in-the-u-s/

  39. Govier DJ, Cohen-Cline H, Marsi K, Roth SE (2022) Differences in access to virtual and in-person primary care by race/ethnicity and community social vulnerability among adults diagnosed with COVID-19 in a large, multi-state health system. BMC Health Serv Res 22(1):511. https://doi.org/10.1186/s12913-022-07858-x

    Article  PubMed  PubMed Central  Google Scholar 

  40. White-Williams C, Liu X, Shang D, Santiago J (2023) Use of Telehealth among racial and Ethnic Minority Groups in the United States before and during the COVID-19 pandemic. Public Health Reports (Washington D C : 1974) 138(1):149–156. https://doi.org/10.1177/00333549221123575

    Article  PubMed  Google Scholar 

  41. Elmore AL, Crouch E (2020) The Association of Adverse Childhood experiences with anxiety and depression for children and Youth, 8 to 17 years of age. Acad Pediatr 20(5):600–608. https://doi.org/10.1016/j.acap.2020.02.012

    Article  PubMed  PubMed Central  Google Scholar 

  42. Lee H, Singh GK (2021) Monthly trends in Access to Care and Mental Health Services by Household Income Level during the COVID-19 pandemic, United States, April: December 2020. Health Equity 5(1):770–779. https://doi.org/10.1089/heq.2021.0036

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Lu W, Todhunter-Reid A, Mitsdarffer ML, Muñoz-Laboy M, Yoon AS, Xu L (2021) Barriers and Facilitators for Mental Health Service Use Among Racial/Ethnic Minority Adolescents: A Systematic Review of Literature. Front Public Health. https://doi.org/10.3389/fpubh.2021.641605

    Article  PubMed  PubMed Central  Google Scholar 

  44. Owens PL, Hoagwood K, Horwitz SM, Leaf PJ, Poduska JM, Kellam SG, Ialongo NS (2002) Barriers to children’s mental health services. J Am Acad Child Adolesc Psychiatry 41(6):731–738. https://doi.org/10.1097/00004583-200206000-00013

    Article  PubMed  Google Scholar 

  45. United States Census Bureau. (n.d.). NSCH Datasets. Retrieved January 5 (2023) from https://www.census.gov/programs-surveys/nsch/data/datasets.html

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Acknowledgements

We thank the National Survey of Children’s Health for their thorough documentation and for making the data publicly available. We also thank Pat Walsh, instructor of the Medical College of Wisconsin Clinical & Translational Science Institute of Southeast Wisconsin Manuscript Writing Intensive Course, for assistance with reviewing and editing this manuscript.

Funding

Funding for the National Survey of Children’s Health is primarily provided by the Health Resources and Services Administration’s Maternal and Child Health Bureau. No funding was received for conducting this study.

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Authors and Affiliations

  1. Institute for Health & Equity, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, USA

    Lora Daskalska, Sergey Tarima & John Meurer

  2. Department of Family and Community Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, USA

    Staci Young

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  1. Lora Daskalska
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  2. Sergey Tarima
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Contributions

LD conceptualized the study, conducted the data analysis, and wrote the original draft. LD and ST developed the methodology. All authors read, reviewed, and edited the manuscript and approved the final manuscript.

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Correspondence to Lora Daskalska.

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The National Survey of Children’s Health is a publicly available and de-identified dataset, so Institutional Review Board approval was exempted for this study by the Medical College of Wisconsin.

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Daskalska, L., Tarima, S., Meurer, J. et al. Child Anxiety and Depression During the COVID-19 Pandemic and Unmet Mental Health Care Needs. Child Psychiatry Hum Dev (2024). https://doi.org/10.1007/s10578-024-01668-4

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