The study did not examine what caused the trends, but Dr. JoAnna Leyenaar, one of the paper’s co-authors, pointed to “a growing, growing use of social media among children and adolescents and in particular, growing use among younger adolescents,” which she said had been shown to increase symptoms of depression.
Whatever, the reason, she added, “we don’t have the magic formula to figure out how to dial this back and make things better.”
Dr. Leyenaar said the research was informed by her personal experience as a hospital pediatrician: Though her training included no formal mental health experience beyond a six-week rotation in medical school, children hospitalized after a suicide attempt or self injury are now a central focus of her working life.
“Five years ago, my care for these patients didn’t look very different from my care for children with respiratory illnesses,” said Dr. Leyenaar, an associate professor of pediatrics at Dartmouth’s Geisel School of Medicine. Her team has added trainings on safety planning and cognitive behavioral therapy, in the hope that younger doctors “leave residency better equipped to care for youth with mental health conditions than we did.”
The findings should spur policymakers to place more mental health care services in school and community settings, which “may well result in decreased hospitalizations,” said Mary Arakelyan, a research project manager at Dartmouth Health Children’s and another co-author. Meanwhile, she said, hospitals should confront their increasingly central role as mental health providers.
“For so long, the culture has been, in the hospital, that medical emergencies are the true emergencies,” said Dr. Christine M. Crawford, a child and adolescent psychiatrist at Boston Medical Center, who was not involved in the study.
Mental health training, she said, should be given throughout the hospital, “kind of like how everyone in the medical staff is trained on how to do CPR.” And, she said, hospitals need to be incentivized to add inpatient psychiatric units, which, because of reimbursement rates, “hemorrhage money.”