Even as the number of youth in California experiencing mental illness and substance use disorders has grown over the last five years, mental health and treatment services have failed to keep pace, a report from the California Health Care Foundation finds.
According to the report, Mental Health and Substance Use: A Crisis for California's Youth (HTML or 27 pages, PDF), 7.6 percent of children under the age of 17 in California suffered a "serious emotional disturbance" in the past year, with higher rates among African-American (8.1 percent), Latinx (8.1 percent), and Native American (7.9 percent) youth as well as those from low-income families earning below the federal poverty level (10 percent) or up to 199 percent of the FPL (8 percent). The report also found that the prevalence of "major depressive episodes" of more than two weeks among Californians between the ages of 12 and 17 rose steadily, from 9.2 percent in 2011-12 to 12.3 percent in 2014-15 — well above the national rate, which increased from 8.7 percent to 11.9 percent over the same period — but that two-thirds of those adolescents did not receive treatment. In addition, 8.2 percent of the state's high school students reported that they had attempted suicide in 2015, with rates among females (11.9 percent) more than twice as high as for males (5.5 percent), while only 1.9 percent — 1 percent of females and 2.8 percent of males — of high school students both attempted suicide and were treated by a nurse or doctor.
The study found that nearly 10 percent of California youth under the age of 17 who received county mental health services for serious emotional disturbances had a co-occurring substance use disorder. Indeed, between 60 percent and 75 percent of adolescents with substance abuse disorders are thought to have a co-occurring mental illness, with substance use often the end result of an individual's attempt to manage his or her symptoms via self-medication. Among adolescents age 12 to 17 in California, 5.1 percent were identified as having a substance use disorder, including excessive consumption of alcohol (2.3 percent), illicit drug use (3.9 percent), and use of pain medication (0.6 percent). The report also found that by eleventh grade, 33 percent of the state's high school students had used alcohol "at least four times to get high," while 31.2 percent had used cough medicine and 25.1 percent had used marijuana at least four times.
While mental health conditions and substance use disorders are often chronic and recurring, the report notes that, with early identification and intervention, there are treatments that work. According to the report, however, fewer than half of adolescents with psychiatric disorders received any treatment in the past year, with adolescents who are homeless, in the child welfare and juvenile justice systems, living in rural areas, or who are lesbian, gay, bisexual, and/or transgender least likely to receive services. Similarly, fewer than 10 percent of youth who need substance use disorder services receive them, for reasons that include lack of access, lack of a workforce trained to work with youth, stigma, and family and cultural barriers.