If children and teenagers receive any help for an anxiety disorder, it’s usually medication — not counseling — according to a study published Wednesday in Pediatrics.
In fact, there was an inverse relationship between the need for therapy and what has been given over more than a decade. As the number of youth with anxiety disorders has risen continually since 2006, the number of children receiving psychotherapy has decreased.
“This really shows that the burden of treating mental health conditions among patients is growing,” said study author Laura Chavez, a senior research scientist at the Center for Child Health Equity and Outcomes Research at Nationwide Children’s Hospital in Columbus, Ohio.
“Even when they’re able to navigate the health care system and visit with a physician in an office setting, they may not receive the treatment that they need,” she said.
There are several possible reasons, including stigma and a lack of access to pediatric therapists, according to the Child Mind Institute.
Chavez and her research team looked at data representing 46.4 million pediatric office visits from 2006 through 2018. They broke down those office visits in chunks of time: 2006-2009, 2010-2013 and 2014-2018.
The term “office visits” included pediatrician’s offices, family medicine providers and a variety of different ambulatory care settings.
Such visits for anxiety disorders tripled, from 1.4% during the earliest time period studied, to 4.2% during the last time period.
This finding echoes multiple other studies showing dramatic increases in youth mental health conditions.
Overall, approximately 5.8 million children in the U.S. had a diagnosed anxiety disorder in 2019, according to the Centers for Disease Control and Prevention.
Last year, the influential U.S. Preventive Services Task Force recommended that children as young as 8 be screened for anxiety. While the new report ends in 2018, it’s possible a rise in screening could result in even more children being prescribed medication.
But as the need for treatment has risen, Chavez’s study indicates, the need isn’t being met, at least with therapy.
The proportion of doctor’s office visits for anxiety that included therapy decreased from 48.8% during the first study period to 32.6% during the last.
But the proportion of anxiety medications prescribed during these visits held steady over time, at about 60%.
This means that the number of children whose doctors only prescribed a medication, without therapy, has increased.
That’s a real problem, said Janine Domingues, a psychologist in the Anxiety Disorders Center at the Child Mind Institute.
“The reason we don’t recommend just medication alone, particularly with children and adolescents,” she said, “is because we know that the skills gained through therapy are an important addition.”
Lessons learned through therapy, she said, can help youth find ways to cope with or overcome their anxiety.
“Not only do we want to see kids not suffering with anxiety symptoms, we also want to see them functioning, going to school, having friends,” Domingues said.
Symptoms of anxiety in children:
According to the CDC, signs of anxiety disorder in children include:
- Being very afraid away from parents or regular caregivers.
- Being overly worried about something bad happening in the future.
- Having extreme fears about a specific thing or situation, such as dogs, spiders or going to school.
These fears can be felt physically, as well as manifest in trouble sleeping, headaches, stomachaches, rapid heart beat, dizziness and feeling shaky or sweaty.
More on teen mental health struggles
But with the availability of mental health services declining in many areas, Chavez said, the research highlights the need to get more support to pediatricians and other doctors caring for children in need.
“We need to really think carefully about how we can provide tools to office-based physicians so that they can better care for their patients,” she said. “We don’t want to see as many missed opportunities for these patients to get the care they need.”
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