ATLANTA — A major new study has revealed a substantial increase in mental health and neurodevelopmental disorder diagnoses among children covered by public health insurance in the decade leading up to the COVID-19 pandemic.
Published Thursday in the Journal of the American Medical Association (JAMA), the study analyzed Medicaid and Children’s Health Insurance Program (CHIP) claims data from nearly 30 million children aged 3 to 17 across 22 U.S. states between 2010 and 2019. It is the most comprehensive investigation to date into mental health trends among children with public insurance coverage.
According to researchers from Emory University and Children’s Healthcare of Atlanta, the annual percentage of publicly insured children diagnosed with mental health or neurodevelopmental disorders rose from 10.7% in 2010 to 16.5% in 2019—a 6.7 percentage point increase when adjusted for population changes over the period.
Dr. Janet Cummings, the study’s lead author and a professor in Emory University’s Rollins School of Public Health, called the findings “alarming and clinically significant.”
“The size of the increase is alarming and clinically significant on its own,” Cummings said. “But it is even more concerning that we saw this increase and our last year of data was 2019, when we know from other sources that mental health among children continued to decline after the onset of the COVID-19 pandemic.”
Largest Increases Seen in ADHD, Anxiety, Autism, and Depression
The study examined 13 diagnostic categories and found significant increases in nine. The most notable surges were seen in diagnoses for attention-deficit/hyperactivity disorder (ADHD), anxiety, autism spectrum disorders, trauma- and stressor-related disorders, and depression.
Importantly, the rise in diagnoses spanned all demographic subgroups. Children of all ages, sexes, races, and ethnic backgrounds—whether living in urban, suburban, or rural communities—experienced notable increases in mental health and neurodevelopmental conditions during the study period.
Mounting Pressure on Underfunded Mental Health Systems
Cummings warned that the rising number of diagnoses poses a serious challenge for public mental health systems, which have long struggled with inadequate funding and staffing.
“Our data represents a significant number and percentage of the children in our communities,” she said. “These increases in both the number and rates of children being diagnosed with mental health and neurodevelopmental disorders have important implications for chronically underfunded mental health systems that have already been struggling to meet the needs of this vulnerable population.”
She emphasized the urgency of investing in resources and infrastructure to support the growing mental health needs of publicly insured children.
“As mental health diagnoses among children increase, we must make sure the systems that support them have enough resources to address their challenges and help them get better,” Cummings said. “Mental health is foundational for a child’s development, and investment in the systems that serve children with public insurance is critical for their well-being, their life trajectory, and their long-term success.”
The findings add to a growing body of research highlighting the mental health crisis among American youth and underline the need for systemic reform to ensure accessible, equitable, and effective care for all children.
