Table 1.

Name, website, sponsor	Description	Method of data collection	Topics related to children	Child-related mental health topics and questions	Populations and periodicity
Autism and Developmental Disabilities Monitoring (ADDM) Network https://www.cdc.gov/ncbddd/autism/addm.html CDC, National Center on Birth Defects and Developmental Disabilities	– The ADDM Network is a group of programs funded by CDC to determine the prevalence of ASDs in U.S. communities. – The ADDM sites collect data using the same surveillance methods, which are modeled after CDC’s Metropolitan Atlanta Developmental Disabilities Surveillance Program.	– Screening and abstraction of existing health and education records containing professional assessments of the child's developmental progress at health care or education facilities	– Baseline data on ASD prevalence in participating communities; comparisons between different groups of children and different areas of the country – Characteristics of the population of children with ASDs– Changes in ASD identification over time– Impact of autism and related conditions in selected U.S. communities– Risk factors	– Describes the population of children with ASDs in terms of 1) documented co-occurring conditions and 2) timing of earliest evaluation and diagnosis	– Ongoing since 2000, with data available for even-numbered years through 2016 – Population-based, geographically defined communities in different U.S. states, selected through competitive process– In 2016, monitored ASD among 275,000 children aged 8 yrs and 72,000 aged 4 yrs
National Health and Nutrition Examination Survey (NHANES) https://www.cdc.gov/nchs/nhanes CDC, National Center for Health Statistics	– NHANES is an ongoing cross-sectional survey designed to assess the health and nutritional status of noninstitutionalized persons of all ages in the United States.	– In-person household interviews by trained interviewers using computer-assisted personal interviewing; private interviews in medical examination center – Nutritional assessments– Laboratory tests– Physical examinations	– Nutrition and nutritional disorders – Environmental risk factors– Health care use– Mental, behavioral, and emotional problems of children– Infectious diseases– Weight and physical activity– Dietary supplements and prescription medications– Medical conditions and health indicators, including disability (measured and self-report)– Health insurance status and type	– Alcohol and drug use – Depression (PHQ-9 since 2005)– Use of mental health care services– Psychotropic medication use– Functional limitations caused by long-term physical, mental, and emotional conditions or illness– Mental disorder diagnosis for specific disorders using the Diagnostic Interview Schedule for Children (1999–2004)– Mentally unhealthy days (2001–2014)	– Ongoing since 1999 – Nationally representative sample– 5,000 persons per year, including approximately 1,600 persons aged 3–17 yrs– Oversampling, which changes periodically; in 2013–2014, 2015–2016, and 2017–2018, oversampled persons with low incomes and Hispanic, Black, and Asian persons
National Health Interview Survey (NHIS) https://www.cdc.gov/nchs/nhis CDC, National Center for Health Statistics	– NHIS monitors a broad range of health topics among the U.S. civilian noninstitutionalized population, including children aged 0–17 yrs.	– In-person household interview (of parent or knowledgeable adult who lives in the household and answers on behalf of one randomly selected child in the family) conducted by trained interviewers using computer-assisted personal interviewing, with telephone follow-up when needed	– Health status, selected health conditions and illnesses, disability, selected educational services, health insurance status and type, and health care access	– ASD (ever and current) and ADHD or ADD (ever and current) – Use of mental health care or counseling– Strengths and Difficulties Questionnaire	– Ongoing household survey representative of the U.S. civilian noninstitutionalized population – Has collected data for children annually since 1997
National Survey of Children’s Health (NSCH) https://mchb.hrsa.gov/data-research/national-survey-childrens-health Health Resources and Services Administration, Maternal and Child Health Bureau	– NSCH is a cross-sectional, address-based survey conducted by the Census Bureau that collects information on the health and well-being of children aged 0–17 yrs and related health care, family, and community-level factors that can influence health. – Data from NSCH are the only source of both national- and state-level estimates on specified measures of child health.– NSCH was redesigned for 2016, combining two previously separate Maternal and Child Health Bureau quadrennial surveys, the National Survey of Children with Special Health Care Needs, and NSCH.	– Parent/caregiver-administered questionnaire online and on paper	– Physical and mental health status – Health and functional status, including approximately 20 current or lifelong conditions– Health insurance status, type, and adequacy– Access to and use of health care services– Preventive and specialty care– Medical home– School readiness (3–5 yrs)– Transition to adult health care (12–17 yrs)– Family health and activities– Impact of child’s health on family– Parent/caregiver health status– Parent/caregiver perceptions of neighborhood characteristics– Access to community-based services	– Diagnosis (ever and current) and severity of depression, anxiety problems, behavioral or conduct problems, Tourette syndrome, and ADD or ADHD – Diagnosis (ever and current) and severity of ASD, as well as age at diagnosis and type of provider who made first diagnosis– Current medication treatment for autism, ASD, Asperger’s disorder, PDD, and ADHD– Receipt of behavioral treatment in past year for ASD and ADHD– Receipt of treatment or counseling in past year from a mental health professional– Medication use in past year because of difficulties with emotions, concentration, or behavior– Positive indicators (indicate child is flourishing): affectionate and tender, bounces back quickly, smiles and laughs, interest in and curiosity about learning new things, works to finish tasks, stays calm and in control when faced with a challenge	– Annual survey representative of noninstitutionalized children aged 0–17 yrs at the national and state levels
National Survey on Drug Use and Health (NSDUH) https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health SAMHSA, Center for Behavioral Health Statistics and Quality	– NSDUH provides up-to-date information on tobacco, alcohol, and drug use; mental health; and other health-related issues in the United States. – Information from NSDUH is used to support prevention and treatment programs, monitor substance use trends, estimate the need for treatment, and guide public health policy.	– In-person household interviews by trained interviewers using audio computer-assisted self-interviewing (ACASI)	– Timing and frequency of use of tobacco products, alcohol, marijuana, cocaine, heroin, inhalants, hallucinogens, and prescription drugs – Risk and protective factors– Health care use– Health insurance status and type	– Major depressive episode ever (lifetime) and in past year – Substance use disorder, overall and by substance type (e.g., illicit drug use disorder or alcohol use disorder) and treatment– Level of impairment resulting from major depressive episodes– Treatment for depression– Mental health service use– Parental mental illness, substance use, and substance use disorder	– Began in 1971 and has been administered by SAMHSA since 1992 – Conducted every year in all 50 states and the District of Columbia, with approximately 70,000 people aged ≥12 yrs interviewed each year– National and state representative sample
National Violent Death Reporting System (NVDRS) https://www.cdc.gov/violenceprevention/datasources/nvdrs/index.html CDC, National Center for Injury Prevention and Control	– NVDRS is a state-based active surveillance system that collects data on the characteristics and circumstances associated with violence-related deaths in participating states and territories.	– Death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data)	– Violent deaths: suicides, homicides, deaths from legal intervention (a subtype of homicide), child maltreatment deaths, and intimate partner homicides – Other deaths: deaths from undetermined intent and unintentional firearm deaths	– Numerous precipitating circumstances that are associated with suicide, including history of mental health problems or substance abuse; current diagnosis or treatment for mental health problems; history of suicide, thoughts, plans, or attempts; interpersonal problems; life stressors; and suicide disclosure	– Expanded in 2018 with the addition of 10 new states (Arkansas, Florida, Idaho, Mississippi, Montana, North Dakota, South Dakota, Tennessee, Texas, and Wyoming) that began data collection in 2019; in 2019, all 50 states, the District of Columbia, and Puerto Rico collected data for the system
National Vital Statistics System (NVSS) https://www.cdc.gov/nchs/nvss/deaths.htm CDC, National Center for Health Statistics	– Vital statistics mortality data are a fundamental source of demographic, geographic, and cause-of-death information in the United States. The data are used to present characteristics of those dying in the United States, to understand causes of death, to determine life expectancy, and to compare mortality trends with those in other countries.	– Death certificates, which are completed by funeral directors, attending physicians, medical examiners, and coroners, with causes of death processed in accordance with the International Classification of Diseases, Tenth Revision	– Underlying cause of death – Multiple causes of death– Year, month, and day of week of death– Residence of decedent (state, county, city, population size)– State and county of occurrence– Demographic information about decedent (e.g. age at death, sex, education, race, ethnicity, marital status, and state of birth)	– Information for children who die as a result of suicide or from other causes of death that are related to mental health (e.g., drug overdose)	– Ongoing since 1900 to present – Did not include all states before 1933– Includes information on all deaths occurring in the United States– Final annual data published yearly; provisional data released quarterly, monthly, and weekly for specific cause of death
School-Associated Violent Death Surveillance System (SAVD-SS) https://www.cdc.gov/violenceprevention/youthviolence/schoolviolence/savd.html CDC, National Center for Injury Prevention and Control	– SAVD-SS is an active surveillance system that collects data on the characteristics and circumstances surrounding school-associated violent deaths (homicides, suicides, and legal intervention deaths) that occur in and around school settings throughout the United States.	– Potential SAVD cases are identified through a systematic media scan of newspaper and broadcast media databases via LexisNexis using keywords to capture reports of violent deaths. Cases are then confirmed with local law enforcement or school officials familiar with the incident to ascertain whether they meet SAVD-SS inclusion criteria, and the law enforcement report is obtained when possible. – Demographic and circumstance data are abstracted from law enforcement reports, death certificates, coroner and medical examiner reports (if contained in the law enforcement report), interviews with law enforcement and school officials, or articles published in the media when a reliable source is cited (i.e., a law enforcement or school official or judicial proceedings regarding the incident).	– Circumstances that precipitated incidents (e.g., dating partner problems, other relationship problems, disciplinary issues, bullying or other problems experienced in the school setting, and history of criminal or legal problems) – Potential risk factors for perpetration and victimization– Possible prevention measures– Warning signs	– Whether the victim and perpetrator had a suspected or diagnosed mental health condition, suicidal ideation, or history of suicide attempt – Whether victim and perpetrator were using alcohol or substances at the time of death or regularly used alcohol or substances– Whether victim and perpetrator were victimized or had perpetrated violence in the past	– Since 1994 – Identifies and collect data on all U.S. incidents in which lethal violence occurs 1) on the campus of a functioning public or private primary or secondary school, 2) while the victim was on the way to or from regular sessions at such a school, or 3) while the victim was attending or traveling to or from an official school-sponsored event– Beginning in 2021, will collect data via NVDRS (described in previous row)
National Youth Risk Behavior Survey (YRBS) https://www.cdc.gov/yrbss CDC, National Center for HIV, Viral Hepatitis, STD, and TB Prevention	– The Youth Risk Behavior Surveillance System monitors health behaviors and experiences among U.S. high school students that contribute to the leading causes of mortality, morbidity, and social problems among youths and adults. – The system includes a national YRBS conducted by CDC and separate state, tribal, territorial, and local school district YRBSs.	– Anonymous, school-based survey	– Behaviors that contribute to unintentional injuries and violence – Tobacco use– Alcohol and other drug use– Sexual behaviors that contribute to unintended pregnancy and sexually transmitted infections– Unhealthy dietary behaviors– Inadequate physical activity– Prevalence of obesity and asthma and other health-related behaviors and experiences	– Persistent feelings of sadness or hopelessness – Suicidal ideation and suicide attempts	– Biennial since 1991 (odd years) – Nationally representative samples of public and private high school students (grades 9–12) – State, tribal, territorial, and local school district data also available

TABLE 1. Federal surveys and surveillance systems that collect data on children’s mental health — United States

Abbreviations: ADD = attention-deficit disorder; ADHD = attention-deficit/hyperactivity disorder; ASD = autism spectrum disorder; PDD = pervasive developmental disorder; PHQ-9 = nine-item Patient Health Questionnaire; SAMHSA = Substance Abuse and Mental Health Services Administration.

Table 2.

Surveillance system and age group (yrs)
Disorder or indicator	ADDM Network	NHANES	NHIS	NSCH	NSDUH	NVDRS	NVSS	SAVD-SS	National YRBS
Disorder or indicator	8	12‒17	3‒17	0‒17	12‒17	10‒19	10‒19	10–18	~14‒18*
Attention-deficit/ hyperactivity disorder	NA	NA	Parent report of diagnosis by a health care provider (ever, current)	Parent report of diagnosis by a health care provider (ever, current)	NA	NA	NA	NA	NA
Behavior problems	NA	NA	NA	Parent report of diagnosis by a health care provider (ever, current)	NA	NA	NA	Law enforcement or school official report of decedents’ history of behavior problems at home or in school	NA
Depression	NA	Youth self-report of current depression (depression during past 2 wks, score of ≥10 on PHQ-9 depression screener)	NA	Parent report of diagnosis by a health care provider (ever, current)	Youth self-report of major depressive episode (ever, past year)^†	NA	Depression might be inconsistently reported on the death certificate	Law enforcement or school official report of decedents’ history of depressed mood or documented diagnosis of depression	Youth self-report of feeling so sad or hopeless almost every day for ≥2 wks in a row that they stopped doing some usual activities
Anxiety	NA	NA	NA	Parent report of diagnosis by a health care provider (ever, current)	NA	NA	Anxiety might be inconsistently reported on the death certificate	NA	NA
Autism spectrum disorder	Medical record abstraction, surveillance case criteria met^§	NA	Parent report of diagnosis by a health care provider (ever, current)	Parent report of diagnosis by a health care provider (ever, current)	NA	NA	NA	NA	NA
Tourette syndrome	NA	NA	NA	Parent report of diagnosis by a health care provider (ever, current)	NA	NA	NA	NA	NA
Substance use disorder	NA	NA	NA	—^¶	Youth self-report of dependence on or abuse of alcohol or one or more illicit drugs (in past year) based on DSM-IV criteria	NA	Substance use disorder might be inconsistently reported on the death certificate	NA	NA
Suicidality	NA	NA	NA	NA	NA	Death records; deaths per 100,000	Death records; deaths per 100,000	Surveillance of school-associated suicide based on systematic media scan of computerized newspaper and broadcast media databases and confirmation with local law enforcement Law enforcement or school official report of decedents’ history of suicidal thoughts and suicide attempts	Youth self-report of seriously considering attempting suicide, making a suicide plan, attempting suicide ≥1 time, and making a suicide attempt ≥1 time that resulted in injury, poisoning, or overdose that had to be treated by a physician or nurse (during the 12 months before the survey for all four measures)
Treatment	NA	Parent report of child currently using psychotherapeutic agents (in past 30 days)	Parent report of child receiving mental health consultation with professional** or general physician^††	Parent report of child receiving mental health treatment by a professional^§§ and past year medication for mental health problems^¶¶	Youth self-report of child receiving mental health services (specialty or nonspecialty)	NA	NA	Law enforcement or school official report of decedents’ history of mental health treatment provided by a counselor (including a school counselor) or clinician	NA
Positive indicators	NA	NA	NA	Parent report of affection, resilience, and positivity (for children aged 6 mos‒5 yrs); curiosity (6 mos–17 yrs); and persistence and self-control (6–17 yrs)	NA	NA	NA	NA	NA

TABLE 2. Mental disorders and indicators among persons aged 0–19 years, by surveillance system and age group — United States, 2013–2019

Abbreviations: ADDM = Autism and Developmental Disabilities Monitoring; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; MDE = major depressive episode; NA = not applicable; NHANES = National Health and Nutrition Examination Survey; NHIS = National Health Interview Survey; NSCH = National Survey of Children’s Health; NSDUH = National Survey on Drug Use and Health; NVDRS = National Violent Death Reporting System; NVSS = National Vital Statistics System; PHQ-9 = nine-item Patient Health Questionnaire; SAVD-SS = School-Associated Violent Death Surveillance System; YRBS = Youth Risk Behavior Survey.
* Survey participants were public and private high school students in grades 9–12 (i.e., primarily aged 14–18 years).

^† Ever MDE: reported at least five or more of nine symptoms nearly every day in the same 2-week period during their lifetime, in which at least one of the symptoms was depressed mood or loss of interest or pleasure in daily activities; MDE in past year: 1) had ever had an MDE, as well as 2) had a period of time in the past 12 months when they felt depressed or lost interest or pleasure in daily activities for ≥2 weeks and 3) during this period of ≥2 weeks, they had some of the other problems they reported associated with ever having had an MDE.

^§ Case definition based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition criteria for autism spectrum disorder. Clinicians applied the case definition through a review of information systematically collected from developmental evaluations completed by medical and educational service providers in the community.

^¶ NSCH included a question about parent report of a health care provider diagnosis for substance use disorder for children aged 6‒17 years in the 2016–2019 surveys. These data are not included in this report because NSCH removed this item as of 2020 due to small samples and concerns about validity with parental report.

** “During the past 12 months, have you seen or talked to...a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker...about child's health?”

^†† “Did you see or talk to this general doctor because of an emotional or behavioral problem that [child] may have?”

^§§ “During the past 12 months, has this child received any treatment or counseling from a mental health professional?”

^¶¶ “During the past 12 months, has this child taken any medication because of difficulties with his or her emotions, concentration, or behavior?”

Table 3.

Disorder or indicator	Surveillance system and data collection years	Age group	No. of persons surveyed	Weighted prevalence (%)*	Weighted no.^† of children with reported indicator
ADHD
Ever (parent ever told by health care provider child had ADHD)	NSCH 2016‒2019	3‒17 yrs	114,476	9.8	5,964,000
	NHIS 2017‒2018	3‒17 yrs	14,316	9.6	5,952,000
Current (parent reported child currently had ADHD)	NSCH 2016‒2019	3‒17 yrs	114,476	8.7	5,319,000
Current (parent reported child currently had ADHD)	NHIS 2017‒2018	3‒17 yrs	14,292	8.2	5,043,000
Behavioral or conduct problems
Ever (parent ever told by health care provider child had behavioral or conduct problems)	NSCH 2016‒2019	3‒17 yrs	114,476	8.9	5,478,000
Current (parent reported child currently had behavioral or conduct problems)	NSCH 2016‒2019	3‒17 yrs	114,476	7.0	4,265,000
Depression
Ever depression (parent ever told by health care provider child had depression)	NSCH 2016‒2019	3‒17 yrs	114,476	4.4	2,729,000
Current depression (parent reported child currently had depression)	NSCH 2016‒2019	3‒17 yrs	114,476	3.4	2,093,000
Ever had MDE (self-report)^§	NSDUH 2018‒2019	12‒17 yrs	33,678	20.9	5,068,000
Past year MDE (self-report)^§	NSDUH 2018‒2019	12‒17 yrs	33,678	15.1	3,633,000
Current depression (self-reported depression during past 2 wks; score of ≥10 on PHQ-9 depression screener)	NHANES 2013‒2018	12‒17 yrs	2,771	5.8	2,168,000
Sadness or hopelessness (self-reported feeling so sad or hopeless almost every day for ≥2 wks in a row that they stopped doing some usual activities)	National YRBS 2019	~14‒18 yrs^¶	13,677	36.7	6,145,000
Anxiety
Ever (parent ever told by health care provider child had anxiety problems)	NSCH 2016‒2019	3‒17 yrs	114,476	9.4	5,769,000
Current (parent reported child currently had anxiety)	NSCH 2016‒2019	3‒17 yrs	114,476	7.8	4,768,000
Autism spectrum disorder
Ever (parent ever told by health care provider child had ASD)	NSCH 2016‒2019	3‒17 yrs	114,476	3.1	1,881,000
	NHIS 2017‒2018	3‒17 yrs	14,324	2.4	1,468,000
Current (parent reported child currently had ASD)	NSCH 2016‒2019	3‒17 yrs	114,476	2.9	1,766,000
Current (parent reported child currently had ASD)	NHIS 2017‒2018	3‒17 yrs	14,320	2.0	1,266,000
Met ASD surveillance case definition**	ADDM Network 2016	8 yrs	275,419^††	1.9	NA^§§
Tourette syndrome
Ever (parent ever told by health care provider child had Tourette syndrome)	NSCH 2016‒2019	3‒17 yrs	114,476	0.3	174,000
Current (parent reported child currently had Tourette syndrome)	NSCH 2016‒2019	3‒17 yrs	114,476	0.2	136,000
Substance use disorder ^¶¶
Past year substance use disorder	NSDUH 2018‒2019	12‒17 yrs	33,678	4.1	1,017,000
Past year alcohol use disorder	NSDUH 2018‒2019	12‒17 yrs	33,678	1.6	407,000
Past year illicit drug use disorder	NSDUH 2018‒2019	12‒17 yrs	33,678	3.2	788,000
Suicidality
Seriously considered attempting suicide (during 12 mos before survey)	YRBS 2019	~14‒18 yrs^¶	13,677	18.8	3,148,000
Made a suicide plan (during 12 mos before survey)	YRBS 2019	~14‒18 yrs^¶	13,677	15.7	2,629,000
Attempted suicide ≥1 time (during 12 mos before survey)	YRBS 2019	~14‒18 yrs^¶	13,677	8.9	1,490,000
Made a suicide attempt ≥1 time (during 12 mos before survey) that resulted in injury, poisoning, or overdose that had to be treated by physician or nurse	YRBS 2019	~14‒18 yrs^¶	13,677	2.5	419,000
No. of suicides	NVSS 2018‒2019	10‒19 yrs	5,744 deaths	6.9/100,000	NA
No. of suicides	NVDRS*** 2014‒2018	10‒19 yrs	4,903 deaths	7.0/100,000	NA
Mental health services
Mental health treatment, professional^†††	NSCH 2016‒2019	3‒17 yrs	114,476	10.1	6,197,000
Mental health consultation, professional^§§§	NHIS 2017‒2018	3‒17 yrs	14,287	9.6	5,939,000
Mental health consultation, general physician^¶¶¶	NHIS 2017‒2018	3‒17 yrs	14,253	5.2	3,222,000
Mental health services received (specialty and nonspecialty)	NSDUH 2018‒2019	12‒17 yrs	33,678	25.9	6,358,000
Mental health consultation, professional****	NHANES 2013–2018	4‒17 yrs	8,071	9.8	5,664,000
Past year medication for mental health problems^††††	NSCH 2016‒2019	3‒17 yrs	114,476	7.8	4,724,000
Current use of psychotherapeutic agents in past 30 days for mental health problems	NHANES 2013–2018	3‒17 yrs	8,637	6.6	4,082,000
Positive indicators of child mental health
Affectionate (usually or always affectionate and tender with parent)	NSCH 2018‒2019	6 mos‒5 yrs	15,844	97.3	21,055,000
Resilient (usually or always bounces back quickly when things do not go their way)	NSCH 2018‒2019	6 mos‒5 yrs	15,844	89.8	19,457,000
Positivity (usually or always smiles and laughs a lot)	NSCH 2018‒2019	6 mos‒5 yrs	15,844	99.0	21,451,000
Curious (usually or always shows interest and curiosity in learning new things)	NSCH 2018‒2019	6 mos‒17 yrs	59,057	91.3	64,912,000
Persistent (usually or always works to finish tasks)	NSCH 2018‒2019	6‒17 yrs	43,213	84.5	40,457,000
Self-control (usually or always stays calm and in control when faced with a challenge)	NSCH 2018‒2019	6‒17 yrs	43,213	76.8	37,757,000

TABLE 3. Estimated number and prevalence of persons aged 0–19 years with certain mental disorders and indicators of mental health, by surveillance system, year of data collection, and age group — United States, 2013–2019

Abbreviations: ADDM = Autism and Developmental Disabilities Monitoring; ADHD = attention-deficit hyperactivity disorder; ASD = autism spectrum disorder; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, MDE = major depressive episode; NA = not applicable; NHANES = National Health and Nutrition Examination Survey; NHIS = National Health Interview Survey; NSCH = National Survey of Children’s Health; NSDUH = National Survey on Drug Use and Health; NVDRS = National Violent Death Reporting System; NVSS = National Vital Statistics System; PHQ-9 = nine-item Patient Health Questionnaire; YRBS = Youth Risk Behavior Survey.

* All estimates are weighted, except for 1) the prevalence of ASD from ADDM, calculated as number of cases identified divided by number of children living in catchment area and 2) suicide rates for NVSS and NVDRS, calculated as number of suicides per 100,000 persons aged 10‒19 years

^† NSCH: weighted using sample child weights that adjust for sampling probability, nonresponse, and raking adjustments. Raking adjustments used population controls from the 2015–2018 Census Bureau’s American Community Survey. NHIS: weighted using sample child weights that adjust for the probability of selection, nonresponse, and poststratification. Poststratification adjustments for this report use population estimates derived from the 2010 Census by the Census Bureau. NHANES: weighted using interview and examination sample weights, adjusted for the probability of selection, non-response, and calibration. Calibration adjustments and population estimates are based on age-specific Census Bureau American Community Surveys from 2013, 2015, and 2017. NSDUH: individual observations weighted so that the weighted sample represents the civilian, noninstitutionalized population in the United States. The person-level weights in NSDUH are calibrated by adjusting for nonresponse and poststratifying to known population estimates (or control totals) obtained from the Census Bureau. YRBS: estimates multiplied by 16,745,000, the number of public and private high school students in the United States in 2019.

^§ Ever MDE: reported at least five or more of nine symptoms nearly every day in the same 2-week period during their lifetime, in which at least one of the symptoms was depressed mood or loss of interest or pleasure in daily activities; MDE in past year: 1) had ever had an MDE, as well as 2) had a period of time in the past 12 months when they felt depressed or lost interest or pleasure in daily activities for ≥2 weeks and 3) during this period of ≥2 weeks, they had some of the other problems they reported associated with ever having had an MDE.

^¶ Survey participants were public and private high school students in grades 9–12 (i.e., primarily aged 14–18 years).

** Case definition based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition criteria for autism spectrum disorder. Clinicians applied the case definition through a review information systematically collected from developmental evaluations completed by medical and educational service providers in the community.

^†† Population denominator for ADDM catchment areas.

^§§ ADDM estimates are not weighted or intended to be extrapolated to the entire U.S. population.

^¶¶ Substance use disorder: meets DSM-IV criteria for either dependence or abuse for one or more illicit drugs or alcohol; alcohol use disorder: meets criteria for either alcohol dependence or abuse; illicit drug use disorder: meets criteria for either dependence or abuse for one or more illicit drugs.

*** States (n = 18) included Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin.

^††† “During the past 12 months, has this child received any treatment or counseling from a mental health professional?”

^§§§ “During the past 12 months, have you seen or talked to...a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker...about child's health?”

^¶¶¶ “Did you see or talk to this general doctor because of an emotional or behavioral problem that [child] may have?”

**** “During the past 12 months, have you seen or talked to...a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker...about child's health?”

^†††† “During the past 12 months, has this child taken any medication because of difficulties with his or her emotions, concentration, or behavior?”

Table 4.

Characteristic	Ever had ADHD		Current ADHD
	NSCH 2016–2019	NHIS 2017–2018	NSCH 2016–2019	NHIS 2017–2018
	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)
Age group (yrs)	3–17	3–17	3–17	3–17
Sample size (no.)	114,476	14,316	114,476	14,292
Total	9.8 (9.4‒10.1)	9.6 (9.0‒10.2)	8.7 (8.4‒9.1)	8.2 (7.6‒8.7)
Age group (yrs)
3–5	2.2 (1.8‒2.8)	1.8 (1.2‒2.6)	2.0 (1.6‒2.5)	1.6 (1.1‒2.3)
6–11	10.0 (9.4‒10.6)	9.7 (8.8‒10.7)	9.3 (8.7‒9.8)	8.7 (7.8‒9.6)
12–17	13.2 (12.6‒13.8)	13.4 (12.4‒14.4)	11.5 (10.9‒12.0)	10.8 (10.0‒11.8)
Sex
Male	13.3 (12.8‒13.9)	12.9 (12.0‒13.8)	11.9 (11.3‒12.4)	11.0 (10.2‒12.0)
Female	6.1 (5.7‒6.5)	6.2 (5.6‒6.9)	5.5 (5.1‒5.9)	5.2 (4.6‒5.8)
Race/Ethnicity*
Hispanic	7.5 (6.7‒8.5)	7.0 (5.9‒8.2)	6.6 (5.9‒7.5)	5.4 (4.5‒6.5)
Black, non-Hispanic	12.0 (10.8‒13.4)	11.4 (9.7‒13.5)	10.5 (9.4‒11.8)	9.9 (8.1‒11.9)
White, non-Hispanic	10.9 (10.6‒11.3)	10.9 (10.1‒11.7)	9.9 (9.5‒10.3)	9.4 (8.7‒10.2)
Asian, non-Hispanic	2.6 (2.0‒3.3)	2.1 (1.3‒3.3)	2.2 (1.7‒2.9)	1.6 (0.9‒2.6)
FPL ^†
≤100% FPL	11.2 (10.3‒12.2)	11.5 (10.0‒13.2)	10.2 (9.3‒11.1)	10.0 (8.6‒11.6)
>100% to ≤ 200% FPL	10.5 (9.6‒11.5)	11.2 (9.9‒12.7)	9.3 (8.4‒10.1)	9.6 (8.4‒11.0)
>200% FPL	9.0 (8.6‒9.4)	8.5 (7.8‒9.2)	8.0 (7.7‒8.4)	7.1 (6.4‒7.8)
Highest level of parent education^§
Less than high school	9.2 (7.6‒11.2)	8.2 (6.6‒10.2)	8.0 (6.5‒9.9)	7.1 (5.7‒9.0)
High school graduate	11.0 (10.1‒12.0)	10.8 (9.3‒12.4)	10.0 (9.1‒11.0)	8.9 (7.6‒10.4)
More than high school	9.5 (9.2‒9.8)	9.2 (8.5‒9.9)	8.5 (8.2‒8.8)	7.8 (7.1‒8.5)
Health insurance^¶
Yes
Any public	13.2 (12.4‒14.0)	12.4 (11.4‒13.5)	12.1 (11.4‒12.8)	10.7 (9.7‒11.7)
Any private	8.7 (8.3‒9.1)	8.3 (7.3‒9.3)	7.7 (7.4‒8.1)	7.2 (6.3‒8.2)
No insurance	7.1 (5.9‒8.7)	6.1 (4.3‒8.6)	5.8 (4.8‒7.1)	4.7 (3.2‒7.0)
Geographic classification**
Urban/Suburban	9.5 (9.0‒9.9)	9.3 (8.7‒10.0)	8.4 (8.0‒8.8)	7.9 (7.3‒8.5)
Rural	12.0 (11.1‒12.9)	12.0 (10.4‒13.7)	10.7 (9.9‒11.6)	10.0 (8.6‒11.6)

TABLE 4. Weighted prevalence estimates of attention-deficit/hyperactivity disorder among children and adolescents aged 3–17 years, by sociodemographic characteristics and surveillance system — United States, 2016–2019

Abbreviations: ADHD = attention-deficit/hyperactivity disorder; FPL = federal poverty level; NHIS = National Health Interview Survey; NSCH = National Survey of Children’s Health.
* Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates.
^† FPL is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. Imputed income files were used to impute family income when it was not provided, and for NSCH, family size was imputed using other information about the household when the number of family members was not provided (https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html).

^§ The highest level of parent education is based on the highest education level among up to two adults who were identified as primary caregivers in the survey.

^¶ Private included any insurance from an employer or union, directly purchased, TRICARE or other military health care, or the Affordable Care Act; coverage from any government assistance plan was considered public, including Medicaid or other state-sponsored health plans including the Children’s Health Insurance Program. Respondents who indicated both public and private insurance coverage were represented in both subcategories.

** Methods for determining geographic classification differed by survey. NSCH: 2010 Office of Management and Budget metropolitan and micropolitan statistical areas standards (https://www.govinfo.gov/content/pkg/FR-2010-06-28/pdf/2010-15605.pdf); urban/suburban includes metropolitan statistical areas associated with at least one urbanized area of at least 50,000 population; rural was defined as counties that were not part of a metropolitan statistical area. NHIS: 2013 National Center for Health Statistics urban/rural classification (https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf); urban/suburban includes large metropolitan, medium metropolitan, and small metropolitan areas, whereas rural includes nonmetropolitan areas with <50,000 population.

Table 5.

Characteristic	Ever had behavioral or conduct problems	Current behavioral or conduct problems
Characteristic	% (95% CI)	% (95% CI)
Age group (yrs)	3–17	3–17
Sample size (no.)	114,476	114,476
Total	8.9 (8.6‒9.3)	7.0 (6.6‒7.3)
Age group (yrs)
3–5	5.0 (4.4–5.6)	3.8 (3.4–4.4)
6–11	10.4 (9.8–11.1)	8.6 (8.1–9.2)
12–17	9.3 (8.8–9.8)	6.8 (6.3–7.3)
Sex
Male	12.2 (11.6–12.8)	9.4 (8.9–9.9)
Female	5.5 (5.1–5.9)	4.4 (4.1–4.8)
Race/Ethnicity*
Hispanic	7.2 (6.4–8.1)	5.6 (4.9–6.4)
Black, non-Hispanic	13.1 (11.8–14.5)	10.1 (9.0–11.4)
White, non-Hispanic	8.9 (8.6–9.3)	7.0 (6.7–7.4)
Asian, non-Hispanic	3.4 (2.6‒4.3)	2.5 (1.9‒3.3)
FPL^†
≤100% FPL	12.4 (11.4‒13.6)	10.3 (9.4‒11.4)
>100% to ≤200% FPL	9.5 (8.8‒10.4)	7.6 (7.0‒8.3)
>200% FPL	7.4 (7.1‒7.8)	5.5 (5.2‒5.8)
Highest level of parent education^§
Less than high school	8.9 (7.3‒10.7)	7.1 (5.7‒8.8)
High school graduate	10.5 (9.6‒11.5)	8.7 (7.9‒9.6)
More than high school	8.4 (8.1‒8.8)	6.4 (6.1‒6.7)
Health insurance^¶
Yes
Any public	13.9 (13.1‒14.7)	11.6 (10.9‒12.4)
Any private	7.0 (6.7‒7.4)	5.2 (4.9‒5.5)
No insurance	6.3 (5.2‒7.7)	4.8 (3.9‒5.9)
Geographic classification**
Urban/Suburban	8.5 (8.2‒9.0)	6.6 (6.2‒7.0)
Rural	10.5 (9.7‒11.4)	8.6 (7.9‒9.4)

TABLE 5. Weighted prevalence estimates of behavioral or conduct problems among children and adolescents aged 3–17 years, by sociodemographic characteristics — National Survey of Children's Health, United States, 2016–2019

Abbreviations: FPL = federal poverty level; NSCH = National Survey of Children’s Health.
* Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates.

^† FPL is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. Imputed income files were used to impute family income when it was not provided, and for NSCH family size was imputed using other information about the household when the number of family members was not provided (https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html).

^§ The highest level of parent education is based on the highest education level among up to two adults who were identified as primary caregivers in the survey.

^¶ Private included any insurance from an employer or union, directly purchased, TRICARE or other military health care, or the Affordable Care Act; coverage from any government assistance plan was considered public, including Medicaid or other state-sponsored health plans including the Children’s Health Insurance Program. Respondents who indicated both public and private insurance coverage were represented in both subcategories.

** Method for determining geographic classification for NSCH was based on the 2010 Office of Management and Budget metropolitan and micropolitan statistical areas standards (https://www.govinfo.gov/content/pkg/FR-2010-06-28/pdf/2010-15605.pdf). Urban/suburban includes metropolitan statistical areas associated with at least one urbanized area of at least 50,000 population; rural was defined as counties that were not part of a metropolitan statistical area.

Table 6.

Characteristic	Ever had depression (parent reported diagnosis)	Current depression (parent report)	Ever had major depressive episode (self-report)	Past year major depressive episode (self-report)	Current depression (self-report)*	Past year persistent feelings of sadness or hopelessness (self-report)†
	NSCH 2016–2019	NSCH 2016–2019	NSDUH 2018–2019	NSDUH 2018–2019	NHANES 2013–2018	YRBS 2019

	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)
Age group (yrs)	3–17	3–17	12–17	12–17	12–17	~14–18^§
Sample size (no.)	114,476	114,316	33,678	33,678	2,771	13,677
Total	4.4 (4.2–4.7)	3.4 (3.2‒3.6)	20.9 (20.4‒21.6)	15.1 (14.6‒15.6)	5.8 (4.6‒7.4)	36.7 (35.1‒38.3)
Age group (yrs)
3–5	0.1 (0.1–0.3)	0.1 (0.1‒0.3)	NA	NA	NA	NA
6–11	2.3 (2.0–2.6)	1.9 (1.6‒2.2)	NA	NA	NA	NA
12–17	8.6 (8.1–9.1)	6.5 (6.1‒6.9)	20.9 (20.4‒21.6)	15.1 (14.6‒15.6)	5.8 (4.6‒7.4)	36.4 (34.8–38.0)
Sex
Male	4.0 (3.7–4.4)	3.0 (2.8‒3.3)	11.8 (11.2‒12.5)	8.2 (7.7 ‒8.8)	3.3 (2.3‒4.6)	26.8 (25.2‒28.4)
Female	4.8 (4.5–5.2)	3.8 (3.5‒4.1)	30.4 (29.5‒31.4)	22.3 (21.4‒23.1)	8.4 (6.3‒11.1)	46.6 (44.4‒48.9)
Race/Ethnicity ^¶
Hispanic	4.0 (3.4–4.8)	2.7 (2.2‒3.2)	22.4 (21.1‒23.7)	16.2 (15.1‒17.4)	5.3 (3.7‒7.2)	40.0 (38.0‒42.1)
Black, non-Hispanic	4.5 (3.8–5.3)	3.7 (3.1‒4.4)	15.9 (14.6‒17.4)	10.8 (9.7‒12.0)	6.0 (4.1‒8.4)	31.5 (28.8‒34.3)
White, non-Hispanic	4.8 (4.6–5.1)	3.8 (3.6‒4.1)	21.4 (20.6‒22.2)	15.5 (14.8‒16.2)	6.0 (4.0‒8.6)	36.0 (34.1‒38.0)
Asian	1.6 (1.1–2.3)	1.3 (0.8‒2.0)	20.3 (17.4‒23.5)	14.3 (11.8‒17.2)	3.6 (1.5‒7.3)**	31.6 (27.4‒36.1)
American Indian or Alaska Native, non-Hispanic	NA	NA	18.2 (13.5–23.9)	13.6 (9.3–19.6)	NA	45.5 (32.7-58.9)
Native Hawaiian or other Pacific Islander, non-Hispanic	NA	NA	NA	NA	NA	36.8 (22.6‒53.7)
FPL^††
≤100% FPL	5.8 (5.1–6.6)	4.7 (4.1‒5.4)	18.6 (17.4‒19.8)	13.2 (12.3‒14.3)	8.5 (6.4‒11.0)	NA
>100% to ≤200% FPL	4.6 (4.1–5.2)	3.6 (3.2‒4.1)	21.8 (20.5‒23.1)	15.4 (14.3‒16.6)	6.3 (4.3‒8.9)	NA
>200% FPL	3.9 (3.6–4.2)	2.9 (2.7‒3.1)	21.5 (20.7‒22.3)	15.6 (15.0‒16.3)	4.9 (3.2‒7.2)	NA
Highest level of parent education^§§
Less than high school	5.3 (4.1–6.8)	3.8 (2.9‒5.0)	NA	NA	5.1 (3.0‒8.2)	NA
High school graduate	5.0 (4.4–5.7)	3.8 (3.4‒4.4)	NA	NA	12.4 (8.1‒18.0)	NA
More than high school	4.2 (3.9–4.4)	3.2 (3.0‒3.5)	NA	NA	4.4 (3.2‒7.0)	NA
Health insurance^¶¶
Yes
Any public	6.3 (5.8–6.9)	5.0 (4.6‒5.5)	20.5 (19.5‒21.4)	14.5 (13.7 ‒15.3)	7.3 (5.6‒9.4)	NA
Any private	3.6 (3.4–3.9)	2.8 (2.6‒3.0)	21.3 (20.6‒22.2)	15.4 (14.7‒16.1)	4.8 (3.1‒7.0)	NA
No insurance	4.3 (3.1–6.0)	2.8 (2.0‒4.0)	20.2 (17.5‒23.2)	15.4 (13.1‒18.0)	3.8 (1.7‒7.0)	NA
Geographic classification***
Urban/Suburban	4.3 (4.0–4.6)	3.2 (3.0‒3.5)	21.0 (20.3‒21.7)	15.2 (14.6‒15.8)	NA	36.6 (34.8‒38.5)
Rural	5.6 (5.0–6.4)	4.4 (3.8‒5.0)	20.7 (19.4‒22.1)	14.6 (13.5‒15.8)	NA	36.6 (33.5‒39.9)

TABLE 6. Weighted prevalence estimates of surveillance indicators of depression among children and adolescents aged 3–17 years, by sociodemographic characteristics and year — four surveillance systems, United States, 2013–2019

Abbreviations: FPL = federal poverty level; NA = not available; NHANES = National Health and Nutrition Examination Survey; NSCH = National Survey of Children’s Health; NSDUH = National Survey on Drug Use and Health; YRBS = National Youth Risk Behavior Survey.

* Depression during past 2 weeks (score of ≥10 on the nine-item Patient Health Questionnaire depression module; adolescent report).

^† During the past 12 months before the survey, felt so sad or hopeless almost every day for 2 or more weeks in a row that they stopped doing some usual activities.

^§ For YRBS, survey participants were public and private high school students in grades 9–12 (i.e., primarily aged 14–18 years).

^¶ Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates.

** Estimate did not meet all NCHS data presentation standards (CI width >5, relative CI width >130) and should be interpreted with caution.

^†† For NSCH, NHIS, and NSDUH, FPL is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. Imputed income files were used to impute family income when it was not provided, and for NSCH, family size was imputed using other information about the household when the number of family members was not provided (https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html). NHANES uses the US Department of Health and Human Services poverty guidelines (https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines) to calculate FPLs (also known as the family income to poverty ratio) and does not impute missing incomes. NSDUH only imputes family size when exact counts cannot be determined from the household roster.

^§§ The highest level of parent education is based on the highest education level among up to two adults who were identified as primary caregivers in the survey. For NHANES, education of household reference person and spouse of household reference person (most often primary caregiver of youth).

^¶¶ Private included any insurance from an employer or union, directly purchased, TRICARE or other military health care, or the Affordable Care Act; coverage from any government assistance plan was considered public, including Medicaid or other state-sponsored health plans including the Children’s Health Insurance Program. Respondents who indicated both public and private insurance coverage were represented in both subcategories.

*** Methods for determining geographic classification differed by survey. NSCH: 2010 Office of Management and Budget metropolitan and micropolitan statistical areas standards (https://www.govinfo.gov/content/pkg/FR-2010-06-28/pdf/2010-15605.pdf). Urban/suburban includes metropolitan statistical areas associated with at least one urbanized area of at least 50,000 population; rural was defined as counties that were not part of a metropolitan statistical area; NHIS: 2013 NCHS urban/rural classification (https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf). Urban/suburban includes large metropolitan, medium metropolitan, and small metropolitan areas, whereas rural includes nonmetropolitan areas with >50,000 population; NSDUH: Rural-Urban Continuum Codes (https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/). Urban/suburban includes large metropolitan, medium metropolitan, and small metropolitan areas; rural includes nonmetropolitan counties. YRBS: MDR (formerly Market Data Retrieval) propriety information, determined by an MDR formula based on the National Center for Education Statistics Locale Code classification and zip code. The urban category includes the urban, suburban, and town groups, and the rural category includes the rural/nonmetropolitan group.

Table 7.

Characteristic	Ever had anxiety problems	Current anxiety problems
Characteristic	% (95% CI)	% (95% CI)
Age group (yrs)	3–17	3–17
Sample size (no.)	114,476	114,476
Total	9.4 (9.0‒9.7)	7.8 (7.5‒8.1)
Age group (yrs)
3–5	2.0 (1.7–2.4)	1.6 (1.4–2.0)
6–11	8.6 (8.1–9.2)	7.1 (6.6–7.6)
12–17	13.7 (13.1–14.3)	11.4 (10.9–12.0)
Sex
Male	9.1 (8.6–9.6)	7.5 (7.1–7.9)
Female	9.7 (9.2–10.2)	8.1 (7.6–8.5)
Race/Ethnicity*
Hispanic	8.0 (7.1‒9.0)	6.1 (5.3‒6.9)
Black, non-Hispanic	6.4 (5.6‒7.3)	5.3 (4.6‒6.1)
White, non-Hispanic	11.4 (11.0‒11.8)	9.7 (9.4‒10.1)
Asian, non-Hispanic	3.0 (2.3‒3.8)	2.2 (1.7‒2.9)
FPL^†
≤100% FPL	9.7 (8.8‒10.6)	8.0 (7.2‒8.8)
>100% to ≤ 200% FPL	9.4 (8.6‒10.3)	7.5 (6.9‒8.3)
>200% FPL	9.3 (8.9‒9.7)	7.8 (7.4‒8.2)
Highest level of parent education^§
Less than high school	8.9 (7.3‒10.8)	6.3 (5.1‒7.6)
High school graduate	9.1 (8.3‒10.0)	7.4 (6.7‒8.2)
More than high school	9.6 (9.2‒9.9)	8.1 (7.8‒8.5)
Health insurance^¶
Yes
Any public	11.3 (10.6‒12.1)	9.4 (8.8‒10.0)
Any private	9.2 (8.8‒9.6)	7.6 (7.3‒8.0)
No insurance	6.9 (5.6‒8.6)	5.6 (4.5‒6.9)
Geographic classification**
Urban/Suburban	9.0 (8.6‒9.5)	7.4 (7.1‒7.8)
Rural	10.2 (9.4‒11.1)	8.7 (7.9‒9.4)

TABLE 7. Weighted prevalence estimates of anxiety problems among children and adolescents aged 3–17 years, by sociodemographic characteristics — National Survey of Children's Health, United States, 2016–2019

Abbreviations: FPL = federal poverty level; NSCH = National Survey of Children’s Health.

* Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates

^† FPL is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. Imputed income files were used to impute family income when it was not provided and family size was imputed using other information about the household when the number of family members was not provided (https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html)

^§ The highest level of parent education is based on the highest education level among up to two adults who were identified as primary caregivers in the survey.

^¶ Private included any insurance from an employer or union, directly purchased, TRICARE or other military health care, or the Affordable Care Act; coverage from any government assistance plan was considered public, including Medicaid or other state-sponsored health plans including the Children’s Health Insurance Program. Respondents who indicated both public and private insurance coverage were represented in both subcategories.

** Method for determining geographic classification for NSCH was based on the 2010 Office of Management and Budget metropolitan and micropolitan statistical areas standards (https://www.govinfo.gov/content/pkg/FR-2010-06-28/pdf/2010-15605.pdf). Urban/suburban includes metropolitan statistical areas associated with at least one urbanized area of at least 50,000 population; rural was defined as counties that were not part of a metropolitan statistical area.

Table 8.

Characteristic	Ever had ASD		Current ASD		Met ASD surveillance case definition*
	NSCH 2016–2019	NHIS 2017–2018	NSCH 2016–2019	NHIS 2017–2018	ADDM Network 2016
	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)
Age group (yrs)	3–17	3–17	3–17	3–17	8
Sample size (no.)	114,476	14,316	114,476	14,292	275,419
Total	3.1 (2.8‒3.3)	2.4 (2.1‒2.7)	2.9 (2.6‒3.1)	2.0 (1.8‒2.4)	1.9 (1.8‒1.9)
Age group (yrs)
3–5	2.1 (1.7‒2.5)	1.8 (1.3‒2.6)	1.9 (1.6‒2.2)	1.6 (1.1‒2.3)	NA
6–11	3.2 (2.8‒3.6)	2.3 (1.8‒3.0)	3.0 (2.6‒3.4)	2.0 (1.5‒2.5)	1.9 (1.8‒1.9)^†
12–17	3.5 (3.1‒3.9)	2.7 (2.2‒3.2)	3.3 (2.9‒3.7)	2.3 (1.9‒2.8)	NA
Sex
Male	4.8 (4.3‒5.2)	3.6 (3.1‒4.2)	4.4 (4.0‒4.9)	3.1 (2.7‒3.7)	3.0 (2.9‒3.1)
Female	1.3 (1.1‒1.5)	1.1 (0.8‒1.5)	1.2 (1.0‒1.5)	0.9 (0.7‒1.3)	0.7 (0.7‒0.7)
Race/Ethnicity^§
Hispanic	3.5 (2.8‒4.4)	2.1 (1.6‒2.7)	3.4 (2.7‒4.3)	1.8 (1.3‒2.4)	1.5 (1.4‒1.6)
Black, non-Hispanic	3.4 (2.7‒4.1)	2.8 (1.7‒4.6)	3.1 (2.6‒3.8)	2.2 (1.4‒3.4)	1.8 (1.7‒1.9)
White, non-Hispanic	2.9 (2.7‒3.1)	2.5 (2.1‒2.9)	2.7 (2.5‒2.9)	2.3 (1.9‒2.7)	1.9 (1.8‒1.9)
Asian, non-Hispanic	2.1 (1.6‒2.8)	1.3 (0.7‒2.5)	1.9 (1.4‒2.6)	0.8 (0.4‒1.7)	1.8 (1.6‒2.0)
FPL^¶
≤100% FPL	4.0 (3.3‒4.9)	2.3 (1.6‒3.1)	3.9 (3.2‒4.8)	2.1 (1.5‒3.0)	NA
>100% to ≤200% FPL	3.8 (3.2‒4.6)	2.8 (2.2‒3.5)	3.5 (2.9‒4.3)	2.3 (1.8‒3.0)	NA
>200% FPL	2.4 (2.3‒2.6)	2.3 (1.8‒2.8)	2.3 (2.1‒2.5)	1.9 (1.6‒2.3)	NA
Highest level of parent education**
Less than high school	3.1 (2.1‒4.8)	1.6 (1.0‒2.6)	3.1 (2.0‒4.7)	1.4 (0.8‒2.3)	NA
High school graduate	3.6 (3.0‒4.4)	2.2 (1.6‒2.9)	3.4 (2.7‒4.2)	2.0 (1.5‒2.8)	NA
More than high school	2.9 (2.7‒3.2)	2.5 (2.1‒3.0)	2.7 (2.5‒2.9)	2.1 (1.8‒2.5)	NA
Health insurance^††
Yes
Any public	4.8 (4.3‒5.5)	3.1 (2.6‒3.7)	4.6 (4.0‒5.2)	2.8 (2.3‒3.4)	NA
Any private	2.6 (2.4‒2.9)	2.2 (1.8‒2.8)	2.4 (2.2‒2.7)	1.8 (1.4‒2.3)	NA
No insurance	1.8 (1.1‒3.0)	2.4 (1.0‒5.3)	1.8 (1.1‒3.0)	1.7 (0.7‒4.2)	NA
Geographic classification^§§
Urban/Suburban	3.0 (2.7‒3.4)	2.3 (2.0‒2.7)	2.9 (2.6‒3.2)	2.0 (1.7‒2.3)	NA
Rural	2.8 (2.4‒3.2)	2.8 (2.0‒3.9)	2.6 (2.2‒3.0)	2.7 (1.9‒3.8)	NA

TABLE 8. Weighted prevalence estimates of autism spectrum disorder among children and adolescents aged 3–17 years, by sociodemographic characteristics — three surveillance systems, United States, 2016–2019

Abbreviations: ADDM = Autism and Developmental Disabilities Monitoring; ASD = autism spectrum disorder; FPL = federal poverty level; NA = not available; NHIS = National Health Interview Survey; NSCH = National Survey of Children’s Health.

* Case definition based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition criteria for autism spectrum disorder. Clinicians applied the case definition through a review of information systematically collected from developmental evaluations completed by medical and educational service providers in the community.

^† Estimate is for children aged 8 years only.

^§ Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates

^¶ FPL is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. Imputed income files were used to impute family income when it was not provided, and for NSCH, family size was imputed using other information about the household when the number of family members was not provided (https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html)

** The highest level of parent education is based on the highest education level among up to two adults who were identified as primary caregivers in the survey.

^†† Private included any insurance from an employer or union, directly purchased, TRICARE or other military health care, or the Affordable Care Act; coverage from any government assistance plan was considered public, including Medicaid or other state-sponsored health plans including the Children’s Health Insurance Program. Respondents who indicated both public and private insurance coverage were represented in both subcategories.

^§§ Method for determining geographic classification differed by survey. NSCH: 2010 Office of Management and Budget metropolitan and micropolitan statistical areas standards (https://www.govinfo.gov/content/pkg/FR-2010-06-28/pdf/2010-15605.pdf). Urban/suburban includes metropolitan statistical areas associated with at least one urbanized area of at least 50,000 population; rural was defined as counties that were not part of a metropolitan statistical area; NHIS: 2013 NCHS urban/rural classification (https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf). Urban/suburban includes large metropolitan, medium metropolitan, and small metropolitan areas, whereas rural includes nonmetropolitan areas with >50,000 population.

Table 9.

Characteristic	Ever had Tourette syndrome	Current Tourette syndrome
Characteristic	% (95% CI)	% (95% CI)
Age group (yrs)	3–17	3–17
Sample size (no.)	114,476	114,476
Total	0.3 (0.2‒0.4)	0.2 (0.2‒0.3)
Characteristic
Age group (yrs)
3–5	—*	—*
6–11	0.3 (0.2‒0.5)	0.2 (0.1‒0.4)
12–17	0.4 (0.3‒0.5)	0.3 (0.2‒0.4)
Sex
Male	0.5 (0.3‒0.6)	0.4 (0.3‒0.5)
Female	0.1 (0.1‒0.2)	0.1 (0.0‒0.1)
Race/Ethnicity^†
Hispanic	0.3 (0.1‒0.6)	0.2 (0.1‒0.6)
Black, non-Hispanic	—*	—*
White, non-Hispanic	0.3 (0.3‒0.4)	0.3 (0.2‒0.4)
Asian, non-Hispanic	—*	—*
FPL^§
≤100% FPL	0.2 (0.2‒0.4)	0.2 (0.1‒0.3)
>100% to ≤200% FPL	0.2 (0.1‒0.3)	0.2 (0.1‒0.3)
>200% FPL	0.3 (0.2‒0.4)	0.2 (0.2‒0.4)
Highest level of parent education^¶
Less than high school	—*	—*
High school graduate	0.3 (0.2‒0.4)	0.2 (0.1‒0.3)
More than high school	0.3 (0.2‒0.4)	0.2 (0.2‒0.3)
Health insurance**
Yes
Any public	0.2 (0.2‒0.3)	0.2 (0.1‒0.3)
Any private	0.3 (0.2‒0.4)	0.2 (0.2‒0.4)
No insurance	0.4 (0.2‒0.8)	—*
Geographic classification^††
Urban/Suburban	0.3 (0.2‒0.4)	0.2 (0.2‒0.3)
Rural	0.4 (0.3‒0.6)	0.3 (0.2‒0.5)

TABLE 9. Weighted prevalence estimates of Tourette syndrome among children and adolescents aged 3–17 years, by sociodemographic characteristics — National Survey of Children's Health, United States, 2016–2019

Abbreviations: FPL = federal poverty level; NSCH = National Survey of Children’s Health.

* Estimates based on cell sizes <20 have been suppressed due to instability of estimates.

^† Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates.

^§ FPL is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. Imputed income files were used to impute family income when it was not provided and family size was imputed using other information about the household when the number of family members was not provided (https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html).

^¶ The highest level of parent education is based on the highest education level among up to two adults who were identified as primary caregivers in the survey.

** Private included any insurance from an employer or union, directly purchased, TRICARE or other military health care, or the Affordable Care Act; coverage from any government assistance plan was considered public, including Medicaid or other state-sponsored health plans including the Children’s Health Insurance Program. Respondents who indicated both public and private insurance coverage were represented in both subcategories.

^†† Method for determining geographic classification for NSCH was based on the 2010 Office of Management and Budget metropolitan and micropolitan statistical areas standards (https://www.govinfo.gov/content/pkg/FR-2010-06-28/pdf/2010-15605.pdf). Urban/suburban includes metropolitan statistical areas associated with at least one urbanized area of at least 50,000 population; rural was defined as counties that were not part of a metropolitan statistical area.

Table 10.

Characteristic	Past year substance use disorder*	Past year alcohol use disorder	Past year illicit drug use disorder
Characteristic	% (95% CI)	% (95% CI)	% (95% CI)
Age group (yrs)	12–17	12–17	12–17
Sample size (no.)	33,678	33,678	33,678
Total	4.1 (3.8–4.4)	1.6 (1.5‒1.8)	3.2 (2.9‒3.4)
Characteristic
Sex
Male	3.8 (3.4–4.2)	1.3 (1.1‒1.6)	3.1 (2.7‒3.4)
Female	4.4 (4.0–4.8)	2.0 (1.7‒2.2)	3.3 (2.9‒3.6)
Race/Ethnicity^†
Hispanic	4.5 (3.8–5.2)	1.7 (1.3‒2.2)	3.5 (2.9‒4.2)
Black, non-Hispanic	3.3 (2.7–4.0)	0.5 (0.3‒0.7)	3.0 (2.4‒3.7)
White, non-Hispanic	4.2 (3.9–4.6)	2.0 (1.8‒2.3)	3.1 (2.8‒3.4)
Asian, non-Hispanic	2.0 (1.1–3.4)	0.5 (0.2‒1.6)	1.7 (1.0‒3.0)
FPL^§
≤100% FPL	3.9 (3.4–4.6)	1.4 (1.1‒1.8)	3.2 (2.7‒3.8)
>100% to ≤200% FPL	4.3 (3.8–5.0)	1.5 (1.2‒1.9)	3.5 (3.0‒4.1)
>200% FPL	4.0 (3.7–4.4)	1.8 (1.5‒2.0)	3.0 (2.7‒3.4)
Health insurance^¶
Yes
Any public	4.3 (3.9–4.8)	1.5 (1.2‒1.8)	3.6 (3.2‒4.1)
Any private	3.9 (3.5–4.3)	1.7 (1.5‒2.0)	2.8 (2.5‒3.1)
No insurance	4.8 (3.6–6.4)	1.6 (1.0‒2.4)	4.1 (3.0‒5.6)
Geographic classification**
Urban/Suburban	4.1 (3.8–4.5)	1.6 (1.4‒1.8)	3.3 (3.0‒3.6)
Rural	3.8 (3.3–4.4)	2.1 (1.7‒2.5)	2.5 (2.1‒3.0)

TABLE 10. Weighted prevalence estimates of past year substance use disorder, alcohol use disorder, and/or illicit drug use disorder among adolescents aged 12–17 years, by sociodemographic characteristics — National Survey on Drug Use and Health, United States, 2018–2019

Abbreviations: FPL = federal poverty level; NSDUH = National Survey on Drug Use and Health.

* Includes either past year alcohol use disorder or past year illicit drug use disorder.

^† Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates.

^§ FPL is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. Imputed income files were used to impute family income when it was not provided (https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html). NSDUH only imputes family size when exact counts cannot be determined from the household roster.

^¶ Private included any insurance from an employer or union, directly purchased, TRICARE or other military health care, or the Affordable Care Act; coverage from any government assistance plan was considered public, including Medicaid or other state-sponsored health plans including the Children’s Health Insurance Program. Respondents who indicated both public and private insurance coverage were represented in both subcategories.

** Geographic classification for NSDUH used Rural-Urban Continuum Codes (https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/). Urban/suburban includes large metropolitan, medium metropolitan, and small metropolitan areas; rural includes nonmetropolitan counties.

Table 11.

Characteristic	Seriously considered attempting suicide^†	Made suicide plan^†	Attempted suicide^§	Made suicide attempt requiring medical treatment^¶	Suicide		Current mental disorder among those who died by suicide	Current mental disorder treatment among those who died by suicide
	YRBS 2019 (N = 13,677)				NVSS 2018–2019**		NVDRS 2014–2018^††		NVDRS 2014–2018^††
	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)	No.	Rate per 100,000 (95% CI)	No.	Rate per 100,000 (95% CI)	No. (%)^§§	No. (%)^§§
Age group (yrs)	14–18^¶¶	14–18^¶¶	14–18^¶¶	14–18^¶¶	10–19	10–19	10–19	10–19	10–19	10–19
Total	18.8 (17.6–20.0)	15.7 (14.6–16.9)	8.9 (7.9–10.0)	2.5 (2.1–3.0)	5,744	6.9 (6.7‒7.0)	4,903	7.0 (4.7‒9.3)	2,100 (46.9)	1,325 (29.6)
Age group (yrs)***
10‒14	18.1 (15.1‒21.5)	14.8 (12.4‒17.6)	8.4 (7.0‒10.0)	1.9 (1.0‒3.4)	1,130	2.7 (2.6‒2.9)	928	2.7 (1.7‒3.7)	359 (8.0)	242 (5.4)
15‒19	18.8 (17.7‒19.9)	15.7 (14.7‒16.8)	8.9 (7.8‒10.1)	2.6 (2.1‒3.1)	4,614	10.9 (10.6‒11.3)	3,975	11.2 (9.1‒13.2)	1,741 (38.9)	1,083 (24.2)
Sex
Male	13.3 (12.2‒14.5)	11.3 (10.3‒12.4)	6.6 (5.5‒8.1)	1.7 (1.3‒2.3)	4,286	10.0 (9.7‒10.3)	3,633	10.1 (8.2‒12.1)	1,404 (31.4)	848 (19.0)
Female	24.1 (22.3‒26.0)	19.9 (18.4‒21.6)	11.0 (9.7‒12.5)	3.3 (2.6‒4.2)	1,458	3.6 (3.4‒3.7)	1,270	3.7 (2.4‒4.9)	696 (15.6)	477 (10.7)
Race/Ethnicity^†††
Hispanic	17.2 (15.2‒19.4)	14.7 (13.0‒16.7)	8.9 (7.1‒11.1)	3.0 (2.3‒3.8)	978	4.7 (4.4‒5.0)	555	5.5 (4.7‒6.3)	203 (4.5)	111 (2.5)
Black, non-Hispanic	16.9 (15.3‒18.7)	15.0 (12.9‒17.5)	11.8 (8.7‒15.9)	3.3 (2.2‒4.9)	632	5.0 (4.6‒5.4)	543	4.3 (3.6‒5.1)	161 (3.6)	99 (2.2)
White, non-Hispanic	19.1 (17.6‒20.8)	15.7 (14.1‒17.4)	7.9 (6.9‒9.1)	2.1 (1.5‒2.8)	3,652	8.1 (7.9‒8.4)	3,395	7.8 (5.9‒9.7)	1,591 (35.6)	1,020 (22.8)
Asian, non-Hispanic	19.7 (15.8‒24.3)	16.1 (13.1‒19.7)	7.7 (4.8‒12.3)	1.7 (0.6‒4.6)	272	5.5 (4.8‒6.1)	144	4.5 (4.1‒4.9)	45 (1.0)	32 (0.72)
American Indian or Alaska Native, non-Hispanic	34.7 (23.8‒47.6)	24.2 (13.5‒39.6)	25.5 (12.6‒44.6)	11.5 (3.7‒30.3)	198	24.0 (20.7‒27.4)	NA	13.4 (13.1‒13.8)	NA	NA
Native Hawaiian or other Pacific Islander, non-Hispanic	15.4 (8.2‒27.0)	13.5 (6.2‒26.8)	8.8 (2.4‒27.2)	NA	NA	NA	NA	NA	NA	NA
Geographic classification^§§§
Urban/Suburban	19.0 (17.6‒20.5)	15.8 (14.5‒17.1)	8.9 (7.7‒10.2)	2.5 (2.0‒3.0)	4,559	6.3 (6.1‒6.5)	NA	NA	NA	NA
Rural	17.6 (16.0‒19.3)	15.0 (13.6‒16.6)	9.1 (7.3‒11.3)	2.8 (1.9‒4.1)	1,185	10.2 (9.6‒10.7)	NA	NA	NA	NA

TABLE 11. Prevalence estimates ^* of suicidal ideation and suicide attempts and number and rate of suicides among persons aged 10–19 years, by sociodemographic characteristics and known circumstances — three surveillance systems, 2014‒2019

Abbreviations: FPL = federal poverty level; NA = not available; NVDRS = National Violent Death Reporting System; NVSS = National Vital Statistics System; YRBS = National Youth Risk Behavior Survey.

* Estimates for YRBS are weighted; numbers, rates, and unweighted percentages are presented for NVSS and NVDRS.

^† During the 12 months before the survey.

^§ During the 12 months before the survey, actually attempted suicide ≥1 time.

^¶ During the 12 months before the survey, made a suicide attempt ≥1 time that resulted in injury, poisoning, or overdose that had to be treated by a physician or nurse.

** Suicides are identified using International Classification of Diseases, 10th Revision underlying cause-of-death codes U03, X60–X84, and Y87.0.

^†† States (n = 18) included Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin.

^§§ The overall denominator for percent of suicides associated with a current mental disorder and current mental disorder treatment is 4,471.

^¶¶ Survey participants were public and private high school students in grades 9–12 (i.e., primarily aged 14–18 years).

*** For YRBS, only age 14 years is included for the 10–14 years age group, and 15 to ≥18 years is included in 15–19 years age group.

^††† Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates.

^§§§ Geographic classification for YRBS was determined using MDR (formerly Market Data Retrieval) propriety information, determined by an MDR formula based on the National Center for Education Statistics Locale Code classification and zip code. The urban category includes the urban, suburban, and town groups, and the rural category includes the rural/nonmetropolitan group. Geographic classification for NVSS was determined by the decedent’s county of residence and was categorized using the 2013 NCHS Urban–Rural Classification Scheme for Counties. Counties were classified into six urbanization levels based on metropolitan–nonmetropolitan status, population distribution, and other factors. The four metropolitan categories (i.e., large central metro, large fringe metro, medium metro, and small metro) were grouped as urban counties. The two nonmetropolitan categories (i.e., micropolitan and noncore) were grouped as rural counties.

Table 12.

Characteristic	Mental health treatment, professional*	Mental health consultation, professional^†		Mental health consultation, general physician^§	Mental health services^¶	Past year medication for mental health problems**	Current medication for mental health problems^††
	NSCH 2016–2019	NHIS 2017–2018	NHANES 2013–2018	NHIS 2017–2018	NSDUH 2018–2019	NSCH 2016–2019	NHANES 2013–2018
	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)	% (95% CI)
Age group (yrs)	3–17	3–17	4–17	3–17	12‒17	3–17	3–17
Sample size (no.)	114,476	14,287	8,071	13,440	33,678	114,476	8,637
Total	10.1 (9.8‒10.5)	9.6 (9.0‒10.2)	9.8 (8.6‒11.2)	5.2 (4.8‒5.7)	25.9 (25.3–26.5)	7.8 (7.5‒8.1)	6.6 (5.7‒7.7)
Characteristic
Age group (yrs)
3–5	2.6 (2.2‒3.1)	4.0 (3.1‒5.2)	4.7 (3.2‒6.5)	3.8 (3.0‒4.9)	NA	1.0 (0.7‒1.4)	1.2 (0.6‒2.0)
6–11	9.5 (9.0‒10.0)	9.5 (8.6‒10.5)	9.8 (8.3‒11.4)	5.5 (4.9‒6.3)	NA	7.2 (6.7‒7.6)	7.1 (5.9‒8.5)
12–17	14.3 (13.7‒15.0)	12.4 (11.5‒13.4)	11.5 (9.8‒13.5)	5.6 (5.0‒6.3)	25.9 (25.3–26.5)	11.6 (11.1‒12.2)	8.7 (7.0‒10.7)
Sex
Male	10.6 (10.1‒11.1)	10.6 (9.8‒11.5)	10.9 (9.5‒12.5)	6.0 (5.3‒6.7)	21.3 (20.5–22.1)	9.5 (9.0‒9.9)	8.5 (7.3‒9.8)
Female	9.6 (9.1‒10.1)	8.6 (7.8‒9.4)	8.7 (7.3‒10.3)	4.5 (3.9‒5.0)	30.6 (29.7–31.5)	6.0 (5.6‒6.4)	4.7 (3.6‒6.0)
Race/Ethnicity^§§
Hispanic	8.7 (7.8‒9.6)	6.7 (5.8‒7.8)	7.4 (5.6‒9.6)	4.2 (3.5‒5.1)	24.6 (23.3–26.0)	5.3 (4.6‒6.0)	2.9 (1.9‒4.1)
Black, non-Hispanic	9.8 (8.8‒10.9)	7.6 (6.2‒9.2)	8.8 (7.4‒10.4)	4.8 (3.7‒6.2)	25.6 (24.0–27.2)	8.7 (7.7‒9.8)	4.1 (3.0‒5.5)
White, non-Hispanic	11.4 (11.0‒11.8)	11.9 (11.1‒12.8)	11.4 (9.5‒13.5)	6.2 (5.6‒6.9)	27.1 (26.3–27.9)	9.2 (8.9‒9.6)	9.1 (7.6‒10.8)
Asian, non-Hispanic	4.3 (3.5‒5.4)	3.9 (2.7‒5.6)	4.5 (2.8‒6.8)	1.9 (1.1‒3.3)	18.5 (15.8–21.4)	1.9 (1.4‒2.5)	1.3 (0.5‒2.8)
FPL^¶¶
≤100% FPL	11.0 (10.1‒12.1)	9.6 (8.2‒11.2)	11.3 (9.3‒13.6)	6.3 (5.2‒7.7)	26.8 (25.4–28.2)	8.8 (8.0‒9.7)	7.2 (5.6‒9.2)
>100% to ≤200% FPL	9.8 (9.0‒10.7)	9.7 (8.5‒11.0)	11.0 (8.9‒13.5)	5.8 (4.9‒6.8)	25.1 (23.9–26.4)	8.0 (7.3‒8.8)	6.3 (4.9‒8.1)
>200% FPL	9.9 (9.5‒10.3)	9.6 (8.9‒10.3)	9.4 (7.8‒11.3)	4.7 (4.2‒5.3)	25.8 (25.0–26.7)	7.3 (7.0‒7.6)	7.0 (6.6‒10.0)
Highest level of parent education***
Less than high school	8.7 (7.3‒10.4)	6.5 (5.1‒8.4)	6.2 (4.5‒8.3)	4.6 (3.4‒6.1)	NA	7.7 (6.2‒9.4)	3.4 (1.8‒5.8)
High school graduate	9.8 (9.0‒10.8)	8.1 (6.8‒9.5)	12.5 (9.9‒15.6)	4.4 (3.5‒5.5)	NA	8.6 (7.8‒9.4)	8.2 (5.9‒11.0)
More than high school	10.4 (10.0‒10.7)	10.0 (9.4‒10.8)	10.0 (8.5‒11.7)	5.3 (4.8‒5.9)	NA	7.6 (7.3‒7.8)	7.0 (5.9‒8.3)
Health insurance^†††
Yes
Any public	13.1 (12.4‒13.9)	11.4 (10.4‒12.4)	13.0 (11.2‒15.1)	6.6 (5.9‒7.5)	27.6 (26.5–28.6)	10.4 (9.8‒11.1)	8.6 (7.0‒10.4)
Any private	9.4 (9.0‒9.7)	8.5 (7.6‒9.5)	7.7 (6.2‒9.4)	4.5 (3.8‒5.3)	25.5 (24.7–26.3)	7.1 (6.8‒7.5)	5.6 (4.4‒7.1)
No insurance	5.8 (4.7‒7.1)	5.5 (3.8‒8.0)	4.1 (1.9‒7.6)^§§§	3.0 (2.0‒4.5)	19.8 (17.1–22.9)	4.9 (3.9‒6.3)	0.9 (0.2‒2.4)
Geographic classification^¶¶¶
Urban/Suburban	9.9 (9.5‒10.4)	9.5 (8.9‒10.2)	NA	5.1 (4.7‒5.6)	26.1 (25.4–26.8)	7.4 (7.1‒7.8)	NA
Rural	10.2 (9.4‒11.1)	10.3 (8.9‒12.0)	NA	6.0 (4.9‒7.3)	24.5 (23.2–25.9)	10.3 (9.4‒11.1)	NA

TABLE 12. Weighted prevalence estimates of receipt of mental health treatment, services, and medication among children and adolescents aged 3‒17 years, by sociodemographic characteristics — four surveillance systems, United States, 2013–2019

Abbreviations: FPL = federal poverty level; NA = not available; NHANES = National Health and Nutrition Examination Survey; NHIS = National Health Interview Survey; NSCH = National Survey of Children’s Health; NSDUH = National Survey on Drug Use and Health.

* “During the past 12 months, has this child received any treatment or counseling from a mental health professional?“

^† NHIS: “During the past 12 months, have you seen or talked to...a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker...about child's health?“ NHANES: “During the past 12 months, has the child seen or talked to a mental health professional such as a psychologist, psychiatrist, psychiatric nurse or clinical social worker about their health?“

^§ “Did you see or talk to this general doctor because of an emotional or behavioral problem that [child] may have?“

^¶ Receipt of specialty and nonspecialty mental health services.

** “During the past 12 months, has this child taken any medication because of difficulties with his or her emotions, concentration, or behavior?“

^†† Use of psychotherapeutic agents in past 30 days.

^§§ Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates.

^¶¶ For NSCH and NHIS, FPL is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. Imputed income files were used to impute family income when it was not provided, and for NSCH, family size was imputed using other information about the household when the number of family members was not provided (https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html). NSDUH only imputes family size when exact counts cannot be determined from the household roster. NHANES uses the US Department of Health and Human Services poverty guidelines in calculating the FPLs (also known as the family income to poverty ratio) and does not impute missing incomes.

*** The highest level of parent education is based on the highest education level among up to two adults who were identified as primary caregivers in the survey. For NHANES, education of household reference person and spouse of household reference person (most often primary caregiver of youth).

^††† Private included any insurance from an employer or union, directly purchased, TRICARE or other military health care, or the Affordable Care Act; coverage from any government assistance plan was considered public, including Medicaid or other state-sponsored health plans including the Children’s Health Insurance Program. Respondents who indicated both public and private insurance coverage were represented in both subcategories.

^§§§ Estimate did not meet all NCHS data presentation standards (CI width >5, relative CI width >130) and should be interpreted with caution.

^¶¶¶ Method for determining geographic classification differed by survey. NSCH: 2010 Office of Management and Budget metropolitan and micropolitan statistical areas standards (https://www.govinfo.gov/content/pkg/FR-2010-06-28/pdf/2010-15605.pdf). Urban/suburban includes metropolitan statistical areas associated with at least one urbanized area of at least 50,000 population; rural was defined as counties that were not part of a metropolitan statistical area; NHIS: 2013 NCHS urban/rural classification (https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf). Urban/suburban includes large metropolitan, medium metropolitan, and small metropolitan areas, whereas rural includes nonmetropolitan areas with >50,000 population; NSDUH: Rural-Urban Continuum Codes (https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/). Urban/suburban includes large metropolitan, medium metropolitan, and small metropolitan areas; rural includes nonmetropolitan counties.

Table 13.

Characteristic	Affection*	Resilience^†	Positivity^§	Curiosity^¶	Persistence**
6 mos–5 yrs	6 mos–5 yrs	6 mos–5 yrs	6 mos–17 yrs	6–17 yrs	6–17 yrs
15,844	15,844	15,844	59,057	43,213	43,213
97.3 (96.7‒97.8)	89.8 (88.7‒90.8)	99.0 (98.5‒99.3)	91.3 (90.8‒91.8)	84.5 (83.7‒85.2)	76.8 (76.0‒77.7)
Age group (yrs)
97.0 (96.3‒97.6)	87.9 (86.2‒89.4)	98.7 (97.9‒99.1)	93.9 (92.7‒93.8)	NA	NA
NA	NA	NA	93.0 (92.2‒93.8)	84.2 (83.1‒85.3)	73.8 (72.6‒75.1)
NA	NA	NA	86.5 (85.5‒87.5)	84.7 (83.7‒85.7)	79.8 (78.6‒80.9)
Sex
97.0 (96.2‒97.7)	88.6 (86.9‒90.1)	98.7 (98.0‒99.2)	89.9 (89.2‒90.6)	81.2 (80.1‒82.3)	74.3 (73.1‒75.5)
97.5 (96.6‒98.2)	91.1 (89.6‒92.4)	99.2 (98.6‒99.6)	92.8 (92.0‒93.4)	87.8 (86.8‒88.8)	79.5 (78.2‒80.6)
Race/Ethnicity ^§§
96.8 (94.8‒98.0)	85.5 (82.0‒88.4)	98.9 (97.5‒99.5)	89.4 (87.8‒90.8)	84.3 (82.0‒86.3)	76.5 (74.0‒78.9)
97.7 (96.3‒98.6)	85.2 (80.9‒88.6)	97.8 (95.2‒99.0)	89.9 (88.5‒91.2)	80.4 (78.0‒82.5)	74.3 (71.8‒76.7)
97.5 (96.8‒98.0)	93.7 (92.7‒94.6)	99.3 (99.0‒99.5)	92.7 (92.3‒93.2)	85.5 (84.7‒86.2)	77.1 (76.2‒77.9)
96.7 (94.2‒98.2)	79.3 (73.1‒84.3)	99.5 (98.5‒99.8)	91.7 (89.3‒93.6)	87.8 (84.0‒90.9)	85.7 (82.6‒88.3)
FPL ^¶¶
95.4 (93.0‒97.0)	83.1 (79.3‒86.3)	98.6 (97.5‒99.2)	86.3 (84.7‒87.8)	77.3 (75.0‒79.5)	69.4 (66.8‒71.9)
96.4 (94.9‒97.5)	88.1 (85.1‒90.6)	99.0 (98.3‒99.5)	89.5 (88.1‒90.8)	81.7 (79.7‒83.6)	74.1 (72.0‒76.1)
98.2 (97.8‒98.6)	92.7 (91.7‒93.6)	99.0 (98.4‒99.4)	93.6 (93.1‒94.1)	87.7 (86.9‒88.4)	80.3 (79.4‒81.2)
Highest level of parent education***
97.3 (92.5‒99.1)	82.5 (74.5‒88.4)	97.4 (92.1‒99.2)	84.9 (81.7‒87.6)	79.7 (75.6‒83.3)	72.9 (68.4‒77.1)
95.0 (92.6‒96.6)	84.2 (80.0‒87.6)	97.7 (95.8‒98.7)	87.6 (86.1‒89.0)	79.7 (77.6‒81.6)	72.7 (70.5‒74.8)
97.8 (97.3‒98.2)	91.9 (90.9‒92.7)	99.4 (99.2‒99.6)	93.2 (92.7‒93.6)	86.4 (85.7‒87.1)	78.6 (77.7‒79.4)
Health insurance ^†††
Yes
95.9 (94.5‒96.9)	85.9 (83.5‒87.9)	98.7 (97.9‒99.2)	87.7 (86.6‒88.8)	77.0 (75.3‒78.7)	68.6 (66.8‒70.4)
97.8 (97.0‒98.4)	92.0 (90.7‒93.0)	99.4 (99.0‒99.6)	93.6 (93.1‒94.1)	87.6 (86.8‒88.3)	80.3 (79.4‒81.2)
96.5 (93.8‒98.1)	88.4 (80.5‒93.4)	98.1 (95.8‒99.2)	87.5 (84.5‒89.9)	82.2 (78.5‒85.4)	76.3 (72.1‒80.1)
Geographic classification ^§§§
97.5 (96.8‒98.1)	89.7 (88.2‒91.0)	98.9 (98.4‒99.3)	91.5 (90.9‒92.1)	84.7 (83.7‒85.6)	77.5 (76.4‒78.5)
96.2 (94.3‒97.5)	92.1 (89.6‒94.1)	99.2 (98.3‒99.6)	89.8 (88.6‒91.0)	82.5 (80.6‒84.2)	73.4 (71.3‒75.4)

TABLE 13. Weighted prevalence estimates of positive indicators of mental health among children and adolescents aged 6 months–17 years, by sociodemographic characteristics — National Survey of Children’s Health, United States, 2018‒2019

Abbreviations: FPL = federal poverty level; NA = not available; NSCH = National Survey of Children’s Health.
* “This child is affectionate and tender with you” (usually or always).
^† “This child bounces back quickly when things do not go his or her way” (usually or always).
^§ “This child smiles and laughs a lot” (usually or always).
^¶ “This child shows interest and curiosity in learning new things” (usually or always).
** “This child works to finish tasks he or she starts” (usually or always).
^†† “This child stays calm and in control when faced with a challenge” (usually or always).
^§§ Estimates exclude other race and ethnicity groups that did not have a large enough sample size to produce stable estimates.

^¶¶ FPL is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. Imputed income files were used to impute family income when it was not provided and family size was imputed using other information about the household when the number of family members was not provided (https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html).

*** The highest level of parent education is based on the highest education level among up to two adults who were identified as primary caregivers in the survey.

^††† Private included any insurance from an employer or union, directly purchased, TRICARE or other military health care, or the Affordable Care Act; coverage from any government assistance plan was considered public, including Medicaid or other state-sponsored health plans including the Children’s Health Insurance Program. Respondents who indicated both public and private insurance coverage were represented in both subcategories.

^§§§ Method for determining geographic classification for NSCH was based on the 2010 Office of Management and Budget metropolitan and micropolitan statistical areas standards (https://www.govinfo.gov/content/pkg/FR-2010-06-28/pdf/2010-15605.pdf). Urban/suburban includes metropolitan statistical areas associated with at least one urbanized area of at least 50,000 population; rural was defined as counties that were not part of a metropolitan statistical area.

CME / ABIM MOC / CE

Mental Health Surveillance Among Children — United States, 2013–2019

Authors: Rebecca H. Bitsko, PhD; Angelika H. Claussen, PhD; Jesse Lichstein, PhD; Lindsey I. Black, MPH; Sherry Everett Jones, PhD, JD; Melissa L. Danielson, MSPH; Jennifer M. Hoenig, PhD; Shane P. Davis Jack, PhD; Debra J. Brody, MPH; Shiromani Gyawali, MS; Matthew J. Maenner, PhD; Margaret Warner, PhD; Kristin M. Holland, PhD; Ruth Perou, PhD; Alex E. Crosby, MD; Stephen J. Blumberg, PhD; Shelli Avenevoli, PhD; Jennifer W. Kaminski, PhD; Reem M. Ghandour, DrPH
CME / ABIM MOC / CE Released: 5/4/2022
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 5/23/2023

Start Activity

Target Audience and Goal Statement

This activity is intended for public health officials, pediatricians, psychiatrists, family practice clinicians, nurses, and other clinicians caring for children with mental health disorders.

The goal of this activity is for learners to be better able to describe mental health among children and adolescents aged 3 to 17 years in the United States, according to a surveillance report of 2013-2019 estimates from 9 federal surveillance systems that updates and expands the previous 2013 report by Perou and colleagues, including data on receipt of mental health services among children, positive indicators of mental health, and state-level estimates.

Upon completion of this activity, participants will:

Describe estimates of mental disorders prevalence among children and adolescents aged 3–17 years in the United States, according to an updated surveillance report of 2013–2019 data
Describe data on receipt of mental health services among children and adolescents aged 3–17 years in the United States, according to an updated surveillance report of 2013–2019 data
Identify clinical and public health implications of data on mental health among children and adolescents aged 3–17 years in the United States, including positive indicators of mental health, according to an updated surveillance report of 2013–2019 data

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Faculty

Rebecca H. Bitsko, PhD

Division of Human Development and Disability
National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Rebecca H. Bitsko, PhD, has disclosed no relevant financial relationships.

Angelika H. Claussen, PhD

Division of Human Development and Disability
National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Angelika H. Claussen, PhD, has disclosed no relevant financial relationships.

Jesse Lichstein, PhD

Office of Epidemiology and Research
Maternal and Child Health Bureau
Health Resources and Services Administration
Rockville, Maryland

Disclosures

Disclosure: Jesse Lichstein, PhD, has disclosed no relevant financial relationships.

Lindsey I. Black, MPH

Division of Health Interview Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Lindsey I. Black, MPH, has disclosed no relevant financial relationships.

Sherry Everett Jones, PhD, JD

Division of Adolescent and School Health
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Sherry Everett Jones, PhD, JD, has disclosed no relevant financial relationships.

Melissa L. Danielson, MSPH

Division of Human Development and Disability
National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Melissa L. Danielson, MSPH, has disclosed no relevant financial relationships.

Jennifer M. Hoenig, PhD

Division of Surveillance and Data Collection
Center for Behavioral Health Statistics and Quality
Substance Abuse and Mental Health Services Administration
Rockville, Maryland

Disclosures

Disclosure: Jennifer M. Hoenig, PhD, has disclosed no relevant financial relationships.

Shane P. Davis Jack, PhD

Division of Violence Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Shane P. Davis Jack, PhD, has disclosed no relevant financial relationships.

Debra J. Brody, MPH

Division of Health and Nutrition Examination Surveys
National Center for Health Statistics
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Debra J. Brody, MPH, has disclosed no relevant financial relationships.

Shiromani Gyawali, MS

Division of Surveillance and Data Collection
Center for Behavioral Health Statistics and Quality
Substance Abuse and Mental Health Services Administration
Rockville, Maryland

Disclosures

Disclosure: Shiromani Gyawali, MS, has disclosed no relevant financial relationships.

Matthew J. Maenner, PhD

Division of Human Development and Disability
National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Matthew J. Maenner, PhD, has disclosed no relevant financial relationships.

Margaret Warner, PhD

Division of Vital Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Margaret Warner, PhD, has disclosed no relevant financial relationships.

Kristin M. Holland, PhD

Division of Overdose Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Kristin M. Holland, PhD, has disclosed no relevant financial relationships.

Ruth Perou, PhD

Office of the Director
National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Ruth Perou, PhD, has disclosed no relevant financial relationships.

Alex E. Crosby, MD

Division of Injury Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Alex E. Crosby, MD, has disclosed no relevant financial relationships.

Stephen J. Blumberg, PhD

Division of Health Interview Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Stephen J. Blumberg, PhD, has disclosed no relevant financial relationships.

Shelli Avenevoli, PhD

National Institute of Mental Health
Bethesda, Maryland

Disclosures

Disclosure: Shelli Avenevoli, PhD, has disclosed no relevant financial relationships.

Jennifer W. Kaminski, PhD

Division of Human Development and Disability
National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Jennifer W. Kaminski, PhD, has disclosed no relevant financial relationships.

Reem M. Ghandour, DrPH

Office of Epidemiology and Research
Maternal and Child Health Bureau
Health Resources and Services Administration
Rockville, Maryland

Disclosures

Disclosure: Reem M. Ghandour, DrPH, has disclosed no relevant financial relationships.

CME Author

Laurie Barclay, MD

Freelance writer and reviewer
Medscape, LLC

Disclosures

Disclosure: Laurie Barclay, MD, has disclosed the following relevant financial relationships:
Stock, stock options, or bonds: AbbVie Inc. (former)

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Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP

Associate Director, Accreditation and Compliance
Medscape, LLC

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Disclosure: Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP, has disclosed no relevant financial relationships.

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From Morbidity & Mortality Weekly Report

CME / ABIM MOC / CE

Mental Health Surveillance Among Children — United States, 2013–2019

Authors: Rebecca H. Bitsko, PhD; Angelika H. Claussen, PhD; Jesse Lichstein, PhD; Lindsey I. Black, MPH; Sherry Everett Jones, PhD, JD; Melissa L. Danielson, MSPH; Jennifer M. Hoenig, PhD; Shane P. Davis Jack, PhD; Debra J. Brody, MPH; Shiromani Gyawali, MS; Matthew J. Maenner, PhD; Margaret Warner, PhD; Kristin M. Holland, PhD; Ruth Perou, PhD; Alex E. Crosby, MD; Stephen J. Blumberg, PhD; Shelli Avenevoli, PhD; Jennifer W. Kaminski, PhD; Reem M. Ghandour, DrPHFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC / CE Released: 5/4/2022

Valid for credit through: 5/23/2023

processing....

Summary

Mental health encompasses a range of mental, emotional, social, and behavioral functioning and occurs along a continuum from good to poor. Previous research has documented that mental health among children and adolescents is associated with immediate and long-term physical health and chronic disease, health risk behaviors, social relationships, education, and employment. Public health surveillance of children’s mental health can be used to monitor trends in prevalence across populations, increase knowledge about demographic and geographic differences, and support decision-making about prevention and intervention. Numerous federal data systems collect data on various indicators of children’s mental health, particularly mental disorders. The 2013–2019 data from these data systems show that mental disorders begin in early childhood and affect children with a range of sociodemographic characteristics. During this period, the most prevalent disorders diagnosed among U.S. children and adolescents aged 3–17 years were attention-deficit/hyperactivity disorder and anxiety, each affecting approximately one in 11 (9.4%–9.8%) children. Among children and adolescents aged 12–17 years, one fifth (20.9%) had ever experienced a major depressive episode. Among high school students in 2019, 36.7% reported persistently feeling sad or hopeless in the past year, and 18.8% had seriously considered attempting suicide. Approximately seven in 100,000 persons aged 10–19 years died by suicide in 2018 and 2019. Among children and adolescents aged 3–17 years, 9.6%–10.1% had received mental health services, and 7.8% of all children and adolescents aged 3–17 years had taken medication for mental health problems during the past year, based on parent report. Approximately one in four children and adolescents aged 12–17 years reported having received mental health services during the past year. In federal data systems, data on positive indicators of mental health (e.g., resilience) are limited. Although no comprehensive surveillance system for children’s mental health exists and no single indicator can be used to define the mental health of children or to identify the overall number of children with mental disorders, these data confirm that mental disorders among children continue to be a substantial public health concern. These findings can be used by public health professionals, health care providers, state health officials, policymakers, and educators to understand the prevalence of specific mental disorders and other indicators of mental health and the challenges related to mental health surveillance.

Page 1 of 7

Introduction

CME / ABIM MOC / CE Information

References

References

Disclaimer

The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been approved by the US Food and Drug Administration, off-label uses of approved products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

Table 1.

Table 2.

Table 3.

Table 4.

Table 5.

Table 6.

Table 7.

Table 8.

Table 9.

Table 10.

Table 11.

Table 12.

Table 13.

Faculty and Disclosures

Faculty

Rebecca H. Bitsko, PhD

Angelika H. Claussen, PhD

Jesse Lichstein, PhD

Lindsey I. Black, MPH

Sherry Everett Jones, PhD, JD

Melissa L. Danielson, MSPH

Jennifer M. Hoenig, PhD

Shane P. Davis Jack, PhD

Debra J. Brody, MPH

Shiromani Gyawali, MS

Matthew J. Maenner, PhD

Margaret Warner, PhD

Kristin M. Holland, PhD

Ruth Perou, PhD

Alex E. Crosby, MD

Stephen J. Blumberg, PhD

Shelli Avenevoli, PhD

Jennifer W. Kaminski, PhD

Reem M. Ghandour, DrPH

CME Author

Laurie Barclay, MD

Editor/Compliance Reviewer

Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP

CME / ABIM MOC / CE

Mental Health Surveillance Among Children — United States, 2013–2019

Target Audience and Goal Statement

Disclosures

Faculty

Rebecca H. Bitsko, PhD

Angelika H. Claussen, PhD

Jesse Lichstein, PhD

Lindsey I. Black, MPH

Sherry Everett Jones, PhD, JD

Melissa L. Danielson, MSPH

Jennifer M. Hoenig, PhD

Shane P. Davis Jack, PhD

Debra J. Brody, MPH

Shiromani Gyawali, MS

Matthew J. Maenner, PhD

Margaret Warner, PhD

Kristin M. Holland, PhD

Ruth Perou, PhD

Alex E. Crosby, MD

Stephen J. Blumberg, PhD

Shelli Avenevoli, PhD

Jennifer W. Kaminski, PhD

Reem M. Ghandour, DrPH

CME Author

Laurie Barclay, MD

Editor/Compliance Reviewer

Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP

Accreditation Statements

For Physicians

For Nurses

Instructions for Participation and Credit

Mental Health Surveillance Among Children — United States, 2013–2019

Summary

Table of Contents