Mood and Behavior Disorders in Children and Adolescents - Past, Present, and Future

Award Year: 2013	Investigator: Laura Hirshbein	Budget: $264,196	Categories: Mental Health, Child Health, Adolescent Health
Abstract: Over the last decade, researchers and epidemiologists have reported extraordinarily high rates of mental illness among American children and adolescents. Though it would seem logical to focus policy interventions on access to care and dissemination of evidence-based practices, what if the prevalence data is based on problematic methods to diagnose mental illness? And what do we do if the evidence-based practice itself is deeply flawed? It is vital to have a valid framework on which to build future policy interventions. This project will critically analyze the basis and evolution of diagnostic categories in children, changes in treatment theories and practices, and different stakeholders' roles in expanding the scope of pediatric mental illness diagnoses. I will particularly examine clinical trials for medications in children and adolescents and the role of the pharmaceutical industry in the creation of diagnostic categories and treatment formulations. I will further outline strategic research blueprints to help guide future health policy. The current crisis in children's mental health does not lead to obvious action. Some advocate for early interventions in schools, aggressive outpatient treatment, and improved access to medications. Others question the validity of psychiatric diagnoses and advocate for limitations on the use of psychiatric medications in children. This project will reveal the gaps in knowledge about diagnoses and treatments. It will also outline future research projects, both small scale and community-based, that can address real needs of families and communities instead of just padding the pocketbooks of the pharmaceutical industry. This project will take three years to complete, and will result in the publication of scholarly articles, as well as a monograph, for policy makers, researchers, and clinicians.