HHS/ASPE. U. S. Department of Health and Human Services.Background

What Challenges Are Boys Facing, and What Opportunities Exist To Address Those Challenges?

Fact Sheet:
Mental Health*

This Fact Sheet is available on the Internet at:
http://aspe.hhs.gov/hsp/08/boys/FactSheets/mh/

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Contents

All through elementary school, Michael couldn’t sit still in class and frequently interrupted his teachers.  He never seemed to be able to focus long enough to get his work done.  His grades suffered.  Now in the sixth grade, he was diagnosed with attention deficit hyperactivity disorder (ADHD) and started taking medication.  Although Michael’s concentration has improved, completing homework assignments is still difficult and he’s embarrassed to ask his teachers for help.  He is often sad because he feels different from his peers and doesn’t have a lot of friends.  Though they want to be supportive, Michael’s parents aren’t sure what to do to help ease his transition to middle school.

Some Facts About Boys’ Mental Health

In practical terms, mental health means successful mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity. But mental health and mental illness are not polar opposites; they are really two points on the same continuum.(1)

Unfortunately, almost half of all Americans meet the criteria for mental illness at some point in their lives, and these challenges usually start in childhood or adolescence.(2)  In fact, about 1 in 5 boys and girls in the United States between the ages of 9 and 17 have a diagnosable mental health or substance use disorder that affects their ability to function at home, at school, or with friends.(3)  Some of the most common mental health disorders among young people are described below.(4)

Attention Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder

Young people with ADHD have a chronic level of inattention and/or impulsive hyperactivity that interferes with peer and family relationships and school or work performance.

Children and adolescents with conduct disorder have great difficulty following rules and behaving in a socially acceptable way.

Mood Disorders

Anxiety Disorders

Anxiety disorders are one of the most common forms of mental health disorders among girls and boys.(16)

Treatment

Given the high numbers of boys with mental health disorders, seeking and receiving treatment is of vital importance.

Gender and Ethnic Differences in Mental Health

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What Factors Increase or Decrease the Risks for Mental Health Disorders?

Researchers have focused on understanding mental health problems among children and adolescents to help boys like Michael transition successfully to adulthood. In the process, they have learned valuable lessons about boys’ and girls’ risk factors — those traits and life experiences that can jeopardize a person’s healthy development — and protective factors — the characteristics and life experiences that can increase a person’s likelihood of positive outcomes.(31)

Reasons young people may struggle with mental health disorders:

Family and school factors that may contribute to the risk of mental health disorders:

Factors that help protect young people from the risks and ramifications of mental health disorders:

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Conclusion

Researchers have focused on understanding what factors place some young people at risk for mental illness and what protects some young people despite exposure to the same risk factors. What they’ve learned is that the causes of most mental health disorders lie in some combination of genetic and environmental factors.(34)

Although Michael experiences some challenges that cause him to struggle — such as poor social skills, a lack of self-confidence, and academic difficulties — he also has protective factors, including supportive parents who work with him to help him improve his schoolwork.

Increasing awareness of mental health disorders means that boys like Michael have started to get the help they need to succeed in school and life, but many challenges remain.

Research into what works to build boys’ strengths and reduce the challenges they face is still growing. Although the results are promising, efforts continue to pinpoint what strengths make some boys more likely to succeed and what risks, or challenges, increase the likelihood that they will struggle.

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Endnotes

(*)  This fact sheet is based on a comprehensive review of the scientific literature, including computer searches of major bibliographic databases (e.g., PsycINFO, MEDLINE/PubMed, EBSCOhost) looking for epidemiological studies that determine what factors make boys more or less prone to certain outcomes. The literature search was limited to scholarly journal articles and government documents published in 2000 and later unless an article was a seminal piece in the field or contributed to tracking trends over time. The statistics provided are from the most recent year for which data were available. Where possible, data related specifically to boys are included, but when these data were not available, data on youth, ages 10 to 18, are provided.[Return to text]

(1)  U.S. Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services.

(2)  Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.

(3)  U.S. Department of Health and Human Services. (1999).

(4)  U.S. Department of Health and Human Services. (1999).

(5)  Bloom B., & Cohen R. A. (2007). Summary health statistics for U.S. children: National Health Interview Survey, 2006. Vital Health Statistics 10, 234, 1–79. Retrieved March 20, 2008, from http://www.cdc.gov/nchs/fastats/adhd.htm

(6)  Bloom B., & Cohen, R. A. (2007).

(7)  Zuvekas, S. H., Vitiello, B., & Norquist, G. S. (2006). Recent trends in stimulant medication use among U.S. children. American Journal of Psychiatry, 163, 579–585.

(8)  Nock, M. K., Kazdin, A. E., Hiripi, E., & Kessler, R. C. (2006). Prevalence, subtypes, and correlates of DSM-IV conduct disorder in the National Comorbidity Survey Replication. Psychological Medicine, 36, 699–710.

(9)  Nock, M. K., Kazdin, A. E., Hiripi, E., & Kessler, R. C. (2006).

(10)  Costello, E. J., Compton, S. N., Keeler, G., & Angold, A. (2003). Relationships between poverty and psychopathology: A natural experiment. JAMA, 290, 2023–2029.

(11)  Substance Abuse and Mental Health Services Administration. (2007). Results from the 2006 National Survey on Drug Use and Health: National findings (Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA 07-4293). Rockville, MD.

(12)  Substance Abuse and Mental Health Services Administration. (2007). Results from the 2006 National Survey on Drug Use and Health: National findings.

(13)  Centers for Disease Control and Prevention. (2006). Youth Risk Behavior Surveillance – United States, 2005. MMWR Surveillance Summaries, 55, 1–108.

(14)  Centers for Disease Control and Prevention. (2006).

(15)  Moreno, C., Laje, G., Blanco, C., Jiang, H., Schmidt, A. B., & Olfson, M. (2007). National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Archives of General Psychiatry, 64, 1032–1039.

(16)  U.S. Department of Health and Human Services. (1999).

(17)  Shear, K., Jin, R., Ruscio, A. M., Walters, E. E., & Kessler, R. C. (2006). Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the National Comorbidity Survey Replication. American Journal of Psychiatry, 163, 1074–1083.

(18)  Kilpatrick, D. G., Ruggiero, K, J, Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology, 71, 692–700.

(19)  Copeland, W. E., Keeler, G., Angold, A., & Costello, E. J. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry, 64, 577–584.

(20)  Farmer, E. M. Z., Burns, B. J., Phillips, S. D., Angold, A., & Costello, E. J. (2003). Pathways into and through mental health services for children and adolescents. Psychiatric Services, 54, 60–66.

(21)  Substance Abuse and Mental Health Services Administration. (2007). Results from the 2006 National Survey on Drug Use and Health: National findings.

(22)  U.S. Department of Health and Human Services. (1999).

(23)  Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837–844.

(24)  Roberts, R. E., Roberts, C. R., & Chen, Y. R. (1997). Ethnocultural differences in prevalence of adolescent depression. American Journal of Community Psychology, 25, 95-110.

(25)  Twenge, J. M., & Nolen-Hoeksema, S. (2002). Age, gender, race, socioeconomic status, and birth cohort differences on the Children’s Depression Inventory: A meta-analysis. Journal of Abnormal Psychology, 111, 578–588.

(26)  Centers for Disease Control and Prevention. (n.d.). Web-based injury statistics query and reporting system (WISQARS). Retrieved May 15, 2008, from the National Center for Injury Prevention and Control Web site: http://www.cdc.gov/ncipc/wisqars

(27)  Brent, D. A., Baugher, M., Bridge, J., Chen, T., & Chiappetta, L. (1999). Age- and sex-related risk factors for adolescent suicide. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1497–1505.

(28)  Keenan, K., Shaw, D. S., Walsh, B., Delliquadri, E., & Giovannelli, J. (1997). DSM-III-R disorders in preschool children from low-income families. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 620–627.

(29)  Costello, E. J., Keeler, G. P., & Angold, A. (2001). Poverty, race/ethnicity, and psychiatric disorder: A study of rural children. American Journal of Public Health, 91, 1494–1498.

(30)  Substance Abuse and Mental Health Services Administration. (2007). Results from the 2006 National Survey on Drug Use and Health: National findings.

(31)  Unless noted otherwise, the reference for risk and protective factors related to mental health disorders is: Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. (2007). Promotion and Prevention In Mental Health: Strengthening Parenting and Enhancing Child Resilience. (DHHS Publication No.CMHS-SVP-0175). Rockville, MD.

(32)  U.S. Department of Health and Human Services. (1999).

(33)  U.S. Department of Health and Human Services. (1999).

(34)  U.S. Department of Health and Human Services. (1999).

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Additional Resources

To download an electronic copy of this document visit:
http://aspe.hhs.gov/hsp/08/boys/FactSheets

For additional fact sheets in this series or for more information and resources on boys, including promising interventions and federal approaches to help boys, visit:

Fact Sheets
http://aspe.hhs.gov/hsp/08/boys/FactSheets

Findings Brief
http://aspe.hhs.gov/hsp/08/boys/Findings1

Annotated Bibliography
http://aspe.hhs.gov/hsp/08/boys/Biblio


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