A comparison of federal definitions of severe mental illness among children and adolescents in four communities

Objective: Using data from an epidemiological survey the study compared exi sting definitions of severe mental illness and serious emotional disturbanc e among children and adolescents to demonstrate the range of prevalence rat es resulting from application of different definitions to the same populati on. Methods: Three definitions of severe mental illness and serious emotion al disturbance were applied to data from the Methods for the Epidemiology o f Child and Adolescent Mental Disorders survey, with a sample of 1,285, con ducted in 1991-1992 by the National Institute of Mental Health. The resulti ng proportions of cases identified, demographic characteristics, serc ice u se, and perceived need for sen ices were compared. Results: From 3 to 23 pe rcent of the sampled youth met criteria for sec;ere mental illness or serio us emotional disturbance. From 40 percent to as many as 78 percent of the d efined youth used a mental health service in the year before the survey. Sc hool and ambulatory specialty settings were used most frequently. Generally , more than half of the parents of children with severe mental illness or s erious emotional disturbance thought that their child needed services. Conc lusions: The prevalence and characteristics of severe mental illness and se rious emotional disturbance among children ale sensitive to the definition used and its operationalization, Care should be taken by policy makers and service planners to avoid either over- ol underestimating the prevalence of impaired youth in need of intensive interventions.