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Michelle M. Garrison, MPH; Laura P. Richardson, MD, MPH; Dimitri A. Christakis, MD, MPH; Frederick Connell, MD, MPH

Arch Pediatr Adolesc Med. 2004;158:781-785.

Objective  To determine if mental health hospitalizations have increased among youth.

Design  A retrospective cross-sectional time trend study. The Washington State Comprehensive Hospital Abstract Reporting System data set was used to examine hospitalizations among youth (aged 5-19 years) from January 1, 1990, through December 31, 1999. The yearly rates of youth hospitalized for mental illness were calculated, as were the proportions of hospitalizations due to mental illness. ² Tests of trend were computed to assess for significant change over time. Additional analyses examined trends in hospital days due to mental illness and repeated hospitalizations and compared mental illness with other major causes of child and adolescent hospitalization.

Results  The rate of school-aged children (aged 5-14 years) hospitalized for mental illness increased by 22% during the 1990s (P = .004). The proportion of hospitalizations due to mental illness in school-aged children increased from 7.8% in 1990 to 12.8% in 1999 (P<.001). Among adolescents (aged 15-19 years), no significant change occurred in the rate of mental illness hospitalizations, but the proportion of hospitalizations due to mental illness increased from 14.5% in 1990 to 21.5% in 1999 (P<.001). Although injuries were the leading cause of hospitalizations among youth in 1990, mental illness has since surpassed injuries as a cause for hospitalization. Mental illness accounted for one third of all hospital days for youth in 1999.

Conclusions  Mental illness hospitalizations account for an increasing proportion of admissions and hospital days among children and adolescents in Washington State. During the past decade, mental illness has surpassed injury as a leading cause of hospitalization for Washington youth.

From the Child Health Institute (Ms Garrison and Drs Richardson, Christakis, and Connell) and Departments of Health Services (Drs Christakis and Connell) and Pediatrics (Drs Richardson, Christakis, and Connell), University of Washington, Seattle.

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