A new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) finds that depression is increasing among teenage girls, but smoking and substance use are decreasing among all adolescents.
This is SAMHSA's second National Behavioral Health Barometer — an annual report on substance use and mental illness among Americans, including drug and alcohol use, depression and suicidal ideation.
The report, which summarizes data from the 2013 National Survey on Drug Use and Health, shows that illicit drug use among adolescents ages 12 to 17 dropped from 10.1 percent to 8.8 percent from 2011 to 2013. These drugs include marijuana, nonmedical use of psychotherapeutics, hallucinogens, inhalants, cocaine and heroin.
Past-month cigarette use among adolescents has also decreased. In 2009, 9 percent of youth ages 12 to 17 reported that they had smoked cigarettes within the past month, compared with 5.6 percent in 2013.
The statistics related to alcohol use among teens suggest a similar downward trend. In 2013, 6.2 percent of U.S. adolescents reported rates of alcohol use that qualified as binge drinking — a 2.7 percentage point decrease from 2008.
"It is premature to determine why the numbers are decreasing, but hopefully it is because [the nation's] public health campaigns are working," says Rob Lyerla, PhD, an epidemiologist at SAMHSA's Center for Behavioral Health Statistics and Quality. "These types of statistics do not change quickly because it takes time to change public perceptions."
Although the percentage of overall illicit drug use decreased, marijuana use has increased gradually in recent years. Marijuana use among high school students increased from 19.7 percent to 23.4 percent from 2007 to 2013. There was a 9 percentage point increase from 2009 to 2013 in the percentage of teens who perceived no great risk from smoking marijuana once or twice a week.
"In the last decade, there have been significant changes in the legal status of marijuana, and we are trying to be in tune with the local communities so we can be responsive as an organization," says Lisa Patton, PhD, a clinical psychologist at SAMHSA's Center for Behavioral Health Statistics and Quality. "In capturing data about marijuana usage, for example, we're in the process of examining language for data collection purposes."
Historically, marijuana has been surveyed as one of several illicit drugs but it is now legal in some areas. "We need to ensure we are accurately collecting data on the topic regardless of legal status across a variety of jurisdictions," Patton says.
One notable change from last year's report was the increase in the percentage of teenage girls who experienced a major depressive episode. In 2013, 16.2 percent of females ages 12 to 17 reported a depressive episode, compared with 11.7 percent in 2009. There was not a significant change for male adolescents during the same time period.
Data suggest that this surge has not been followed by an increase in mental health treatment. About 38 percent of teens who reported a major depressive episode received treatment for depression in 2013 — which has not changed significantly from 2009.
The data also show that relatively few Americans are seeking treatment for alcohol abuse. Nine out of 10 people age 12 and older with alcohol dependence or abuse reported that they did not need treatment for their alcohol use. This is reflected by the fact that only 6.3 percent of people with alcohol dependence or abuse problems received treatment for alcohol dependence in 2013.
By contrast, 13.4 percent of those age 12 or older with illicit drug dependence or abuse received treatment for drug use within the year prior to being surveyed.
This year's report was the first to look at how poverty level and health insurance status can impact mental health. Serious thoughts of suicide were nearly twice as likely among adults in households whose income was less than 100 percent of the federal poverty level compared with adults at a higher income level. There was a similar difference in suicidal thoughts among people without health insurance compared with those who have health insurance.
The report is intended to help states decide how best to allocate their health and mental health funding, Patton says.
"It is meant to be a diagnostic tool more than a report card that can help each state address specific behavioral health care needs," says Lyerla.
— Heather Stringer