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Depression

What Factors Keep Young Adults From Depression Treatment?

National survey research highlights key factors keeping younger folks from care.

Key points

  • Children, adolescents, and young adults face increasing rates of depression and anxiety.
  • Research shows that cost, not knowing where to go, and fear of being committed are among the top reasons for not seeking mental health care.
  • Measures focused on addressing young people’s concerns and barriers to care are urgently needed.

By Grant H. Brenner

Rates of anxiety and depression have been dramatically rising in the U.S., and globally. This is especially true among younger people, a concerning omen for the future if unchecked.

Mental Health Challenges Facing Young Adults

In JAMA Pediatrics (Journal of the American Medical Association), Racine and colleagues (2021) report that among children and adolescents, rates of depression and anxiety are 25.2% and 20.5%, respectively, and have been on the rise during the pandemic.

For young adults, the picture is similarly concerning. In the Journal of Psychiatric Research, Goodwin and colleagues (2020) found that between the years of 2008 and 2018, anxiety rates nearly doubled, going from 7.97% to 14.66% among those aged 18-25. Anxiety also increased the most in this group compared with older age ranges. Likewise, the National Institute of Mental Health (NIMH) reports that adults aged 18-25 suffer from the highest rates of depression, clocking in at 17%.

While suicide rates declined overall during the pandemic, suicidality rose among young adults. Per NIMH, serious suicidal thinking was higher than in all other age groups, reported by 11.3%. Suicide is currently the second most common cause of death for children, adolescents, and adults up to age 34.

What Keeps Young Adults Away From Proper Care?

Understanding what keeps people in this high-risk younger population from getting treatment for depression is critical to allow better access to mental health care. Researchers Lu, Bessaha, and Muñoz-Laboy (2022) in JAMA Network identified the top reasons adults aged 18-25 report why they don’t seek treatment.

Researchers drew upon data from the 2011-2019 National Survey on Drug Use and Health for relevant statistical trends in care-seeking as a function of age and other variables within a sample of over 21,000 participants.

They found that within a given 12-month period, over 53% did not get treatment for depression. Women made up 61.1% of this group who needed, but did not receive, care. Almost 57% reported that depression had caused severe impairment in function.

The most common reasons for not receiving treatment were as follows:

  1. Cost (54.7%).
  2. Not knowing where to go for services (37.8%).
  3. Thinking they can handle problems without treatment (30.9%).
  4. Fear of being committed / Having to take medication (22.8%).

Between 2011 and 2019, the deterrent effect of these and other factors reportedly increased. Other barriers to depression treatment included lacking insurance coverage, fear of negatively affecting employment, and worry about information confidentiality. Latinx and Asian respondents were less likely to know where to go for services compared with white participants, and Native Americans were more likely to report not having insurance.

Latinx participants were more likely to worry about people finding out about depression treatment, and women were less concerned than men about negative opinions by people in their social circles or having others find out they were in treatment for depression.

Moving Toward Mental Health

These findings highlight that, while there has been progress in making treatment and insurance available to more people, there are considerable hurdles to proper care. Stigma and fear of consequences, lack of adequate insurance coverage, and availability of appealing treatment options make it even harder for young adults with depression to get effective treatment.

Measures focusing on the broad concerns shared, as well as targeted approaches to address barriers to care among specific groups, are urgently needed given the expanding scope and awareness of the problem.

References

Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis. JAMA Pediatr. 2021;175(11):1142–1150. doi:10.1001/jamapediatrics.2021.2482

Goodwin, R. D., Weinberger, A. H., Kim, J. H., Wu, M., & Galea, S. (2020). Trends in anxiety among adults in the United States, 2008-2018: Rapid increases among young adults. Journal of psychiatric research, 130, 441–446. https://doi.org/10.1016/j.jpsychires.2020.08.014

Lu W, Bessaha M, Muñoz-Laboy M. Examination of Young US Adults’ Reasons for Not Seeking Mental Health Care for Depression, 2011-2019. JAMA Netw Open. 2022;5(5):e2211393. doi:10.1001/jamanetworkopen.2022.11393

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