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Critical Adolescent Health Issues - Mental Health and Substance Abuse

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Adolescence can be a very stressful time and poor coping skills can lead to adolescents using other avenues (i.e. substance use) to escape. Also mental health issues spike in occurence during this developmental period.

According to the 21 Critical Health Objectives, binge drinking; using illicit substances; access to mental health treatment, especially for children and adolescents with disabilities; and suicide attempts and completions are the most serious health and safety issues related to mental health and substance abuse faced by many of U.S. adolescents. The AAP is focusing on additonal, important mental health and substance abuse issues that adolescents face, including underage drinking, prescription drug abuse, and the assessment and management of the sad/anxious/irritiable child.

Data on Adolescent Mental Health and Substance Abuse Issues

Suicide is the 3rd leading cause of death in adolescents:

  • The suicide rate among children aged 10-14 was 1.5/100,000, or 300 deaths among 19,895,072 children in this age group.
  • The suicide rate among adolescents aged 15-19 was 8.2/100,000, or 1,621 deaths among 19,882,596 adolescents in this age group.
    (source: National Alliance on Mental Illness)

Attempted suicide: 6.9% of 9th-12th grade students, which is a decrease during the period of 2001-2007

Current marijuana use: 19.7% of 9th-12th grade students

Lifetime methamphetamine use: 4.4% of 9th-12th grade students (a decrease from 2005)

(Data source: YRBS 2007, CDC)

The CDC - Division of Adolescent and School Health Website includes national data and state level data related to school age youth who participate in the YRBS.

A number of other sources of statistics for mental heath and substance use have been collated by the AAP IMPACT project, including relevant links to the CDC, SAMSHA, etc.

Relevant AAP Policies Statements and Clinical Reports

A sample of the AAP policy statements, clinical reports, technical reports that are relevant to mental health and substance abuse include:

Mental Health

Suicide and Suicide Attempts in Adolescents
Committee on Adolescence
Pediatrics, Vol 120, No. 3, September 2007, pp 669-676

School-based Mental Health Services
Committee on School Health
Pediatrics Vol 113, No. 6 June 2004, pp. 1839-1845

Pediatric Mental Health Emergencies in the Emergency Medical Services System
AAP Committee on Pediatric Emergency Medicine, American College of Emergency Physicians and Pediatric Emergency Medicine Committee
Pediatrics. 2006; 118:1764-1767.

The IMPACT project also has developed a fuller list of reports related to mental health and the AAP Policy database can search relevant policy statements, AAP News articles and more (use key words adolescent & mental health & substance abuse for your search.)

Substance Abuse

Mental health issues and substance abuse are often co-morbidities. The Committee on Substance Abuse develops policy statements, technical reports and other resources to support pediatricians in working with children and youth experiencing substance abuse.

Other AAP Resources

The IMPACT project provides a full complement of resources to help with pediatricians providing mental health assessment and related health services, as well as resources on how to network and coordinate services for children and youth.

  • statistics
  • chapter action tool kit
  • Continuing educaiton, including the "15-Minute Mental Health Visit" Webcasts
  • collaborative projects between primary care and mental health professionals
  • bi-monthly e-newsletter, and more.

Issues of Adolescent Psychological Development in the 21st Century
Gutgesell ME. and Payne N.
Pediatrics in Review, Vol. 25, No. 3, March 2004

Diagnosis and Treatment of Depression in Adolescence
Hagman J.
Adolescent Health Update, Vol. 13, No 3, July 2001
AAP Members can access back issues from the last four years of the Adolescent Health Update. The AAP Section on Adolescent Health publishes Adolescent Health Update. Go to the SOAH Benefits to learn more about the section and the member benefits.

Adolescent School Failure: Failure to Thrive in Adolescence
Reiff, MI.
Pediatrics in Review, Vol. 19, No. 6, June 1998

Teen Reach: Outcomes From a Randomized, Controlled Trial of a Tobacco Reduction Program for Teens Seen in Primary Medical Care
Hollis JF, Polen, MR, Whitlock EP, et al.
Pediatrics, Vol. 115 No. 4 April 2005

Clinical Evaluation of Substance Abuse
Kaul P. and Coupey SM.
Pediatrics in Review, Vol. 23, No 3, March 2002

Management of Substance Abuse
Barangan CJ. and Alderman EM.
Pediatrics in Review, Vol. 23, No 4, April 2002

Office Management of Substance Use
Levy S. and Knight JR.
Adolescent Health Update, Vol. 15, No. 3, July 2003
AAP Members can access back issues from the last four years of the Adolescent Health Update. The AAP Section on Adolescent Health publishes Adolescent Health Update. Go to the SOAH Benefits to learn more about the section and the member benefits.

AAP Raising Resilient Teens -- these Web pages help teens and parents develop a managment plan for stress

Patient handouts, can be purchased through the AAP Bookstore.

Frequently Asked Questions About Alcohol and Drugs – A Guide for Parents
This patient education fact sheet was distributed in conjunction with the July 2003 issue of Adolescent Health Update. AAP Members can access back issues from the last four years of the Adolescent Health Update. The AAP Section on Adolescent Health publishes Adolescent Health Update. Go to the SOAH Benefits to learn more about the section and the member benefits.

Spotlight on Child Health Issues: Mental Health & Medical Home

Mental Health Awareness Day

Healthy People 2010 Chapter awards -- Mental Health projects ( This is an AAP News article which is accessible to AAP members)


Links to Additional Adolescent Mental Health and Substance Abuse Resources


Governors Spouse's program is focusing on substance abuse issues and a pilot project has been developed in Ohio in conjunction with the Ohio AAP Chapter.

Centers for Mental Health in Schools (UCLA Center and University of Maryland Center)

Children's Safety Network

Suicide Prevention Resource Center

Other critical adolescent health issues include:
Mortality, Sexual Health, Injury, Violence, and Chronic Diseases