In a new article published last week in JAMA Pediatrics, researchers from the Health Resources and Services Administration find that anxiety and depression among children ages 3-17 have increased over the last five years. The researchers use data from the National Survey of Children’s Health to look at trends in children’s health, care utilization, and family circumstances from 2016-2020. The study also provides some insight into the early effects of the pandemic, as the researchers note that data collection for this survey was not unduly affected by the pandemic. Some key takeaways are below:

• Even before the pandemic, anxiety and depression were becoming more common among children and adolescents, increasing 27 percent and 24 percent respectively from 2016 to 2019. By 2020, 5.6 million kids (9.2%) had been diagnosed with anxiety problems and 2.4 million (4.0%) had been diagnosed with depression.
• About 5 million kids also experienced behavior and conduct problems in 2020, a 21 percent increase from the previous year.
• Despite these increases in need, use of mental health care among children and adolescents did not increase over the five-year period. In 2020, only 80 percent of kids who needed counseling or other mental health services received mental health care services in the past year, a slight (but not statistically significant) decrease from the 82 percent who had gotten care in 2016.
• Other health care use also declined, partially due to the pandemic. For example, the share of kids with a usual source of sick care and the share who had had a preventive visit in the past year both declined by more than 6 percent over the five-year period, with unmet need for care spiking 32 percent from 2019 to 2020.
• Parents and caregivers also experienced greater mental health needs. In 2020, just two-thirds of caregivers reported being in “excellent or very good” mental health, and just 6 in 10 reported coping “very well” with the demands of childrearing, both down significantly compared to 2016. On the other hand, 1 in 12 kids lived with someone with a mental illness in 2020, a 5.5 percent increase compared to 2016.

As federal policymakers look to address the growing pediatric mental health crisis, this research offers new evidence that children’s mental health is trending in the wrong direction. Though the pandemic likely exacerbated growing mental health needs among children, rising anxiety and depression, stalled access to care, and declines in caregiver wellbeing have been a troublesome trend for years. Policies like those included in the House-passed Build Back Better reconciliation bill to provide states with a permanent increase in their federal match rate to support children’s mental health through home- and community-based services could help make progress on longstanding concerns about children’s mental health.