What’s at stake and who’s likely to be at risk when it comes to mental health

The diagnosis

Thirty years ago, researchers didn’t believe that children possessed the ego structure to become depressed. Now they know that children at 3 or even younger can exhibit the same mental and emotional problems as adults. The most common or severe childhood mental disorders include:

Attention-Deficit/Hyperactivity Disorder (ADHD): One of the most common mental disorders among children. Symptoms include inattention, hyperactivity and impulsivity over a period of time.

Bipolar disorder: Formerly called manic-depressive illness, characterized by cycles of mood changes: severe highs followed by severe lows.

Conduct disorder: Persistent misbehavior, such as frequent temper tantrums and lying, violating the rights of others, being actively aggressive toward people and/or animals, amorality.

Depression (major affective disorder): a combination of symptoms that interfere with the ability to work, study, sleep, eat and enjoy once-pleasurable activities.

Generalized Anxiety Disorder: constant, worrisome thoughts, unwarranted and exaggerated tension about routine life.

Obsessive-Compulsive Disorder (OCD): Patterns of repetitive thoughts and behaviors that are distressing but extremely difficult to overcome.

Oppositional Defiant Disorder (ODD): Extreme levels of argumentativeness, disobedience, stubbornness, negativity and provocation of others that persist over months or years and occur across many situations.

Post-traumatic Stress Disorder (PTSD): Persistent symptoms that occur after a traumatic event such as nightmares, flashbacks, emotional numbness, depression, anger, irritability, distractedness and being easily startled.

Reactive Attachment Disorder: A disorder related to gross deprivation of care or successive multiple caregivers, leading to a lack of attachment.

Schizophrenia: A chronic, severe brain disease. Youths with schizophrenia often suffer terrifying symptoms such as hearing internal voices, or believing that other people are controlling their thoughts, or plotting to harm them.

Separation anxiety: Unreasonable fears about leaving home and parents. Serious education or social problems can develop if away from school and friends for an extended time.

Children at risk

How do children enter the mental-health system?

Typically by one of four routes:

Overwhelmed loved ones contact their own doctors, psychologists or a community mental-health center.

Juvenile justice system : refer troubled kids..

Schools: identify kids acting out.

Child welfare agencies look into cases of child abuse and neglect.

What does childhood mental health cost the nation?

Between $5 billion and $50 billion a year, although it could be much more. No one knows for sure because parsing the numbers has proved nearly impossible.

The U.S. Department of Health and Human Services estimated that state mental-health departments alone spend $30 billion a year on mental health — $5 billion a year to children. But these numbers do not include the billions spent by other local, state and federal organizations such as school districts, juvenile justice programs, non-profits, insurers, private individuals and child welfare agencies.

Although children make up 30 percent of the population, children generally get significantly less in mental-health money. The most generous states, such as Vermont, Alaska and Montana, spent between 40 and 49 percent of their state mental-health money on children. Most spend between 15 and 25 percent.

In 2006, the Missouri Department of Mental Health will spend about 16 percent of its $366 million on children’s services. In 2006, Kansas will have spent 32 percent of its $216 million.