PODCAST: Children and Mental Health: Part One

May 14, 2021



HOST:  May is Mental Health Month in the United States.  In recent years, mental health awareness has grown as a major public health issue, with suicide being one of the leading causes of death in the country.  The arrival of the COVID-19 pandemic in 2020 placed even more of a spotlight on the subject, and NCHS collects data on topics such as anxiety and depression as well as mental health treatment in the U.S. during the pandemic, all part of the new national Household Pulse Survey.  During the period April 14-26, Pulse data showed that over 27 percent of adults suffered from anxiety in the past week, and that almost 23 percent suffered from depression.  A third, or 32 percent of adults, suffered from both. 

These numbers are the lowest in over a year, but still pose a significant impact on American society and on the American health care system.  21 percent of adults used prescription drugs for mental health problems in the past four weeks, and nearly 10 percent received mental health counseling.  However, the number of suicides and the rate of suicide in the U.S. declined in 2019 and appeared to also decline in 2020, which runs somewhat counter to the fact that 1 in 4 adults either used prescription drugs or received counseling for mental health issues, while another 10 percent needed mental health treatment but did not receive it.

Mental health concerns are also significant among children, and last week the country observed “Children’s Mental Health Awareness Week.”  Suicide is the 2nd leading cause of death among children between ages 10 and 14, and there is a great deal of concern about the impact of the pandemic on children’s mental health.

NCHS has several measures that provide insight into children’s mental health in the U.S.  And joining us today is Benjamin Zablotsky, a health statistician for the Division of Health Interview Statistics at NCHS.

HOST: What did the data tell us about the scope of mental health concerns among children in the U.S.? 

BEN ZABLOTSKY: Sure, I think when we are talking about mental health concerns, we can break that down into two separate things – two different bins if you will.  The first would be the prevalence of mental health disorders in the United States.  And this includes developmental disabilities like autism spectrum disorder and intellectual disabilities, but it also includes behavioral and mental disorders like ADHD, anxiety, and depression.  And when we look at the prevalence of conditions we see about one in five or one in six, depending on what you look at, that seems to be about the prevalence of mental health concerns.  But I think we need to look beyond just the prevalence of these disorders.  The other “bin” I would talk about as it relates to mental health concerns is also what percentage of children are receiving treatment for mental health.  And when we’re talking about mental health treatment, we talk about whether a child is on a pharmaceutical medication or receiving counseling or therapy – and we look at those two things to get a sense of what percentage of the child population is on mental health treatment.  And the report I wrote in 2019 found that about 14% of children have received either a therapy or a mental health-related medication in the past 12 months. 

HOST:  So there’s a lot of information out there.  Now, are teenagers at particular risk of mental health problems compared to adults, given all the changes they’re going through?

BEN ZABLOTSKY: I would say that older children are more likely to be diagnosed with anxiety and depression, and they’re typically along the same lines in terms of prevalence as adults.  And a lot of this just has to do with the stresses of being a teenager – it’s a challenging time.  Teenagers tend to experience a lot of transitions during that time period as it relates to school and their own development. So yeah, I would say certainly teenagers are more likely to experience the mental health conditions than their younger peers, and sometimes comparable to those of adults.

HOST:  Is there any sense that these issues have worsened or become more prevalent over time?

BEN ZABLOTSKY:  You know, people have looked at things like the prevalence of developmental disabilities over time and we have seen an increase in the prevalence of some of those disorders.  As it relates to teenagers and mental health, as it relates to both anxiety and depression, I believe there are some findings that have found higher rates of those two conditions – depression and anxiety – and some of it might be tied to the introduction of social media and the prevalence of bullying generally, including the kind of the more present cyber-bullying that wasn’t something that necessarily existed, you know, a few decades ago.

HOST:  So the social media and the cyber-bullying – is that something you’ve done any research on yourself?

BEN ZABLOTSKY: I haven’t looked at that personally but we actually are now including some questions on the National Health Interview Survey on bullying to get a sense of that from the parent perspective, and interestingly enough later this year as part of a CDC data modernization initiative, the Division of Health Interview Statistics is going to be launching a survey of adolescents.  These are actually people who were the subjects at the National Health Interview Survey, and we are going to be including some questions on cyber-bullying and bullying in general. This should be really great to look at to get a sense of that from the adolescent perspective.

HOST: You mentioned some of your research – could you talk a little bit more about some of the studies you’ve been involved in and what you found?

BEN ZABLOTSKY: Sure.  So as I was mentioning I kind of think of two different domains that my research lies in.  The first part is looking at the prevalence of mental health conditions generally, and most of that work has been focused around developmental disabilities.  And using the NHIS we explored how there might have been changes in the prevalence over time in children in the United States between (ages) 3 and 17.  And we actually did find a significant increase in the prevalence of developmental disabilities over time, with the current prevalence being about one in six children in the United States.  And then some of the other work that I do which focuses on the treatment side of things – which I think is really important just to make the point that even though we’re talking about the prevalence of these disorders, we’re really only talking for the most part about the prevalence “diagnosed” disorders.  And so it’s quite possible that children could be receiving treatment for their mental health that’s not affiliated or to a specific disorder.  So that mental health treatment side, we are finding in a report that used data from 2019 that about 14% of children are receiving mental health treatment, either in the form of taking a medication for their mental health or receiving counseling or therapy from a mental health professional in the past 12 months.

HOST:  So often times mental health is something that’s viewed as kind of a silent problem, and therefore it’s assumed that people who need treatment aren’t getting it.  Would you say that your data support that or does it show that on contrary kids are actually getting treatment for some of these problems?

BEN ZABLOTSKY: Right.  So there are situations where if you were to kind of do a crosstab of children who have a diagnosed condition and a child who has received mental health treatment, it’s not a one-to-one match.  So there are certainly situations where children who don’t have a diagnosis are still receiving mental health treatment, and a lot of times it might be a situation where the child doesn’t have access to services to get a diagnosis but they certainly can find resources in the community to get treatment of some sort to help in the treatment of the diagnosis that just might be not actually diagnosed by a professional.

HOST:  Next week we will continue our discussion with Ben Zablotsky about his research on mental health issues facing children in the U.S.

This week, NCHS released the latest quarterly data on infant mortality in the U.S., showing a rate of an estimated 5.50 infant deaths per 1,000 live births in the one-year period ending in mid-year 2020, the lowest rate on record. 

NCHS also released the latest monthly data on drug overdose deaths in the country, for the one-year period ending in October 2020.  Over 91,000 Americans died from drug overdoses during this period, a 30% increase from the same period a year ago.

Finally, NCHS released an analysis of total fertility rates by educational attainment, which showed that women with no high school diploma are giving birth at above-replacement levels whereas women with the highest educational attainment are giving birth at levels considerably below replacement. 

Latest Pulse Survey on Anxiety and Depression during Pandemic

May 6, 2021

The latest Household Pulse Survey shows 1 out of 3 U.S. adults (32.1%) had symptoms of an anxiety or a depressive disorder in the past week.  This is the lowest percentage since the start of the survey a year ago.  Also, more than half of 18-29 year olds experienced the same symptoms.

More Findings:

  • Almost 10% of U.S. adults say they needed counseling or therapy, but did not get it the past month.  This is a 1.2 percentage decrease from more than a year ago.
  • Almost 1 out of 4 U.S. adults (24%)  delayed or did not get needed medical care in the past month due to the pandemic. This estimate is almost 5 percentage points lower than the estimate from March 17-29, 2021.
  • 25% of U.S. adults had an appointment with a health professional over video or phone in the past month.  
  • 2 out of 5 U.S. adults with a disability (40.5%) had an appointment with a health professional over video or phone in the past month.

To rapidly monitor recent changes in mental health, NCHS partnered with the Census Bureau on an experimental data system called the Household Pulse Survey. This 20-minute online survey was designed to complement the ability of the federal statistical system to rapidly respond and provide relevant information about the impact of the coronavirus pandemic in the U.S. The data collection period for Phase 1 of the Household Pulse Survey occurred between April 23, 2020 and July 21, 2020. Phase 2 data collection occurred between August 19, 2020 and October 26, 2020. Phase 3 data collection occurred between October 28, 2020 and March 29, 2021. Data collection for Phase 3.1 of the survey began on April 14, 2021 and will continue through July 5, 2021.

Prevalence of Depression Among Adults Aged 20 and Over: United States, 2013–2016

February 13, 2018

Questions for Debra J. Brody, M.P.H., and Laura Pratt, Ph.D., Epidemiologists and Lead Authors of “Prevalence of Depression Among Adults Aged 20 and Over: United States, 2013–2016

Q: What made you decide to focus on the prevalence of depression for the subject of your new report?

DB/LP: Our intent in conducting this study was to provide up-to-date prevalence estimates for depression—a common and serious medical condition that can result in both emotional and physical problems. We focused on U.S. adults 20 and older to determine if there have been any changes in the proportion of adults with depression over the past 10 years. The estimates are based on responses to a series of depression symptom questions asked during the examination portion of the 2013-2016 National Health and Nutrition Examination Survey (NHANES), a nationally representative study.

Q: Was there a result in your study that you hadn’t expected and that really surprised you?

DB/LP: The finding that most surprised us was that among adults who are depressed, four out of five, or 80%, have at least some difficulty going to work, doing their regular activities at home, or getting along with people. What was perhaps most striking was to see that impairment due to depression affected both men and women equally—given that the prevalence of depression among men (5.5%) was almost half of what it is among women (10.4%).

Q:  What differences or similarities did you see among race and ethnic groups, and various demographics, in this analysis?

DB/LP:  We found one notable difference in depression among race and ethnic groups in the 2013-2016 NHANES data. The prevalence of depression in the non-Hispanic Asian subgroup (3.1%) of adults was significantly lower than depression among adults from the three other race-ethnic groups that we examined (non-Hispanic white, non-Hispanic black, and Hispanic.) We would like to acknowledge that the estimate for non-Hispanic Asian adults is for persons self-identified as belonging to any Asian origin subgroup. In our study, adults of Chinese, Indian, Filipino, and every other Asian-origin are all grouped together because we do not have the sample sizes to show the prevalence for separate Asian origin groups. Other studies have found lower and more moderate estimates of depression among Asian adults compared with those from other race and ethnic groups.

Q: How has the prevalence of depression changed in the past 10 years?

DB/LP: Our data show that over the past 10 years, the percentage of adults who have depression has stayed relatively stable. A point to consider is that the NHANES surveys do not include persons in the military, or those living in institutions like hospitals or nursing homes where adults may be at higher risk for depression. In addition, we did not include in our analysis persons currently being treated for depression or taking medications, unless they screened positively for depression in our survey.

Q: What is the take-home message of this report?

DB/LP: We think the real take-home message of this study is the seriousness of depression, a common mental disorder—and how emotional and physical problems that are symptoms of depression impact the everyday life of those affected by depression. We found that overall, about one out of every 12 U.S. adults have depression in any given 2-week period. Depression rates are higher in some population subgroups—like among women as compared to men—and among adults from low income families as compared to those from higher incomes. Among U.S adults who have depression, managing daily activities—at work and at home—poses at least some difficulty.

Stat of the Day – June 8, 2017

June 8, 2017

Depression in the U.S. Household Population, 2009–2012

December 4, 2014

Depression is a serious medical illness with mood, cognitive, and physical symptoms. Depression is associated with higher rates of chronic disease, increased health care utilization, and impaired functioning. Rates of treatment remain low, and the treatment received is often inadequate.

A new NCHS report examines both depression and depressive symptom severity in the past 2 weeks from a symptom-based questionnaire, by demographic characteristics, functioning difficulties, and recent contact with a mental health professional. Severity is categorized as severe, moderate, mild, or no depressive symptoms. Current depression is defined as severe or moderate symptoms; no depression is defined as mild or no symptoms.

Key Findings from the Report:

  • During 2009–2012, 7.6% of Americans aged 12 and over had depression (moderate or severe depressive symptoms in the past 2 weeks). Depression was more prevalent among females and persons aged 40–59.
  • About 3% of Americans aged 12 and over had severe depressive symptoms, while almost 78% had no symptoms.
  • Persons living below the poverty level were nearly 2½ times more likely to have depression than those at or above the poverty level.
  • Almost 43% of persons with severe depressive symptoms reported serious difficulties in work, home, and social activities.
  • Of those with severe symptoms, 35% reported having contact with a mental health professional in the past year.


Antidepressant Use in Americans 12 and Older

October 24, 2011

Surprisingly, only a third of the people with severe psychological symptoms actually take antidepressant medication. Despite this fact, antidepressants are still the third most commonly prescribed drug taken by Americans of all ages. From 2005-2008, cholesterol-lowering drugs and analgesics, also known as painkillers, were the top two most prescribed drugs, with antidepressants following closely behind. A recent report on Antidepressant use in persons 12 and older: United States, 2005-2008 found that 11% of Americans 12 and over take antidepressants, of these people, over half have taken them for two or more years.

Non-Hispanic whites are more likely to take antidepressant medication than people of other races, although there was no difference in the usage of these types of medication based on income. Women were also more likely to take medication for severe depressive symptoms, about 40%. Many people take more than one antidepressant, although this study did not provide any data on how many medications taken per person.

Seeing a mental health professional is critical in tracking depression; the more drugs prescribed to a person, the more likely it is that they have seen a mental health professional in the past year. However, less than one third of persons taking just one antidepressant have seen a mental health professional in the past year. The data found in this study brings about many questions. How many people out there are in need of medication, yet refuse, or are unable, to get help? What are the long term effects of taking antidepressants in teenagers? And perhaps most importantly, why are there so many people taking antidepressants?

To view the full report please visit:


Related articles:

Medical News Today uses data from survey-


ABC Action News Report-


Cigarette smoking linked to depression in adults

April 21, 2010

Data from the National Health and Nutrition Examination Surveys (2005-2008) has found that adults ages 20 and over with depression were more likely to be cigarette smokers than those without depression.  This key finding is the focus of a new report from NCHS, “Depression and Smoking in the U.S. Household Population Aged 20 and Over, 2005-2008.” This report also found the following:                        

  • Women with depression had smoking rates similar to men with depression, while women without depression smoked less than men.
  • Over one-half of men with depression ages 40–54 were current smokers compared with 26 percent of men without depression of the same age.
  • Among women ages 40–54, of those with depression, 43 percent were smokers compared with 22 percent of those without depression.
  • Among adult smokers, those with depression smoked more heavily than those without depression. They were more likely to smoke their first cigarette within 5 minutes of awakening and to smoke more than one pack of cigarettes per day.
  • Adults with depression were less likely to quit smoking than those without depression.

The graph below shows the percentage of adult smokers with depression from 2005-2008:

 For more, visit: http://www.cdc.gov/nchs/data/databriefs/db34.pdf

Depression in the United States

January 20, 2010

Depression is a common and debilitating illness. According to the American Psychiatric Association, depression is characterized by changes in mood, self-attitude, cognitive functioning, sleep, appetite, and energy level. Here’s some facts about depression in the U.S. you may not know:

  • More than 1 in 20 Americans age 12 and over have depression.
  • More than 1 in 7 poor Americans have depression.
  • Rates of depression were higher in 40-59 year olds, women, and non-Hispanic black persons than in other demographic groups (see the chart below).

For more information, please visit the NCHS FastStats page on depression at http://www.cdc.gov/nchs/fastats/depression.htm, or visit http://www.cdc.gov/nchs/data/databriefs/db07.pdf.