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Children and youth in Florida are facing serious mental-health challenges, made worse by Florida law.

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The subject line of the email declared: “Protecting the health of Florida’s children is a priority for the department, we aspire to do all we can to ensure the well-being of every child.”

The irony of these words from the Florida Department of Health is disturbing and incomprehensible, for the department has repeatedly remained silent as state lawmakers atrociously attack youth. Even worse, the department has allowed misinformation to drive harmful policies and practices.

American youth are exhibiting unprecedented mental-health difficulties. Marginalized youth, already at increased risk for poor health outcomes, have been Florida’s target for detrimental policies. Specifically, girls, LGBTQ+ and Black youth are suffering. Given recently passed Florida laws that contradict every accredited medical and psychological association, one must ask, why has the Florida Department of Health remained silent?

LGBTQ+ youth are four times more likely to attempt suicide than their peers and experience substantial levels of psychological distress, homelessness and violence. State laws banning classroom discussions of gender identity and sexual orientation, criminalization of evidence-based gender-affirming care, discrimination of transgender and gender-diverse athletes, and increased vile rhetoric demonizing LGBTQ+ people are direct contraindications of “ensuring the well-being of every child.”

After Florida’s “Don’t say gay” law, anti-LGBTQ+ “grooming” rhetoric surged by 400% online. American youth spend approximately eight hours per day on screens, making exposure to shaming and potentially trauma-inducing language inevitable. Florida political leaders have spewed hateful rhetoric that has shaken the core of young LGBTQ+ people, as the majority of these youth report that laws restricting their rights have negatively affected their mental health.

Yet, silence.

For the first time in recent history, Black youth are nearly twice as likely to die by suicide as white youth, while suicide attempts among Black youth have risen faster than in any other racial or ethnic group over the past 20 years. In order to dismantle institutional and structural racism, which contributes to increased suicidal behavior among Black youth, students must learn about U.S. history, such as slavery and racial discrimination. Yet Florida’s Stop Woke Act prohibits ny discussion or teaching regarding critical race theory.

Silence.

Recent data from the Centers for Disease Control and Prevention shows that teen girls are experiencing record high levels of sadness, sexual violence and rape. Females are combating dismal levels of control over their own bodies, yet, Gov. Ron DeSantis signed a six-week abortion ban. Disturbingly, this law will require survivors to prove rape through documentation. No person should ever have to provide documentation to prove they endured heinous sexual violence. Instead of passing laws to improve health outcomes for girls, who we know are suffering tremendously, Florida’s law perpetuates their shaming and psychological harm.

Silence.

Gun violence has become innately pervasive within our society. In the United States, firearm-related injuries are the leading cause of death among children and adolescents, while suicide is the second-leading cause of death among young people. Youth firearm suicide has reached an all-time high, constituting 40% of youth suicides. It’s no surprise that states with weaker gun laws have higher rates of gun deaths. Florida is already home to two of the deadliest mass shootings in history, and soon it now is legal to purchase and carry a gun without a permit or training.

Silence.

Data drives policy. Through data collection, we learn the domains in which youth need increased support, then can develop policies to promote the well-being of children and adolescents. Yet, last year, the Florida Department of Education withdrew from the Centers for Disease Control and Prevention Youth Risk Behavior Survey. Florida has turned a blind eye to children and adolescents who are in crisis.

Silence.

Physicians and psychologists are at the forefront of ensuring youth well-being by abiding to respect all people and striving to do no harm. Healthcare providers in Florida can now deny care to patients based on their moral or ethical beliefs, per the Medical Conscience Act. In other words, healthcare workers and insurance companies can overtly discriminate and withhold life-saving care from children and their families due to personal bias.

Silence.

The odds of thriving have been stacked tremendously high against Florida’s youth because of the governor’s recent egregious acts. Laws and policies grounded in data and science are desperately needed across settings, such as healthcare and school, to ensure the health and well-being of Florida’s youth.

The silence from the Florida Department of Health is deafening.

Natasha L. Poulopoulos, Ph.D., and Melisa Oliva, PsyD are pediatric psychologists in Miami. They are members of the Society of Pediatric Psychology and have co-authored several peer-reviewed publications.

Poulopoulos

Oliva

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Lars Vedel Kessing, DMSc

Credit: Dagens Medicin

A recent investigation conducted in Denmark has shed light on the lifetime risk of experiencing mental health disorders and receiving psychotropic medication, as well as the long-term socioeconomic difficulties associated with it.1

The findings showed the prevalence of mental health disorders and the use of psychotropic medication are considerably higher than previously reported, with approximately 80% of the population seeking treatment for a mental health disorder.

The rates of mental health disorders are known to have been rising, prompting the US Preventive Services Task Force (USPSTF) to publish new guidelines urging for more primary care screenings for major depression disorder (MDD) and anxiety.2

The current study, which analyzed data from a nationwide population-based register, included a randomly selected sample of 1.5 million individuals from Denmark between 1995 and 2018.1

A team of investigators led by Lars Vedel Kessing, DMSc, from Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, evaluated the lifetime incidence of treated mental health disorders and their correlation with socioeconomic functioning.

The research accounted for the competing risk of all-cause death and examined various measures, including hospital diagnoses, prescription statistics, and socioeconomic indicators such as education, employment, income, residential status, and marital status.

Among the 462,864 individuals in the sample with a mental health disorder, the median age was 36.6 years, and approximately 50.5% were men. The cumulative incidence of a hospital-diagnosed mental health disorder was found to be 29.0%, with slightly higher rates for women (31.8%) compared with men (26.1%).

However, when psychotropic prescriptions were also considered, the cumulative incidence of any mental health disorder or psychotropic prescription increased significantly to 82.6%, with women showing a higher incidence (87.5%) than males (76.7%).

Investigators also observed a strong association between mental health disorders/psychotropic prescriptions and long-term socioeconomic difficulties. Individuals with mental health disorders were more likely to experience lower income, unemployment or disability benefit reliance, living alone, and being unmarried during the follow-up period.

Across sensitivity analyses, the results were consistent while highlighting the far-reaching impact of mental health disorders on various aspects of individuals’ lives.

Investigators noted the significance of the implications of this study. The high lifetime incidence of mental health disorders, coupled with the observed socioeconomic difficulties, calls for a shift in societal attitudes and increased mental health literacy.

By acknowledging the prevalence of mental health disorders and the associated challenges individuals face, society can work towards reducing stigma and promoting primary prevention measures, according to the study.

“These findings may be used to change attitudes toward mental health disorders, promote greater mental health literacy, and promote policies to support needed services,” investigators wrote.

The team further stated these findings provide a basis for reframing perceptions of mental health, fostering a greater understanding of mental illness, and advocating for comprehensive mental health support.

References:

1. Kessing LV, Ziersen SC, Caspi A, Moffitt TE, Andersen PK. Lifetime Incidence of Treated Mental Health Disorders and Psychotropic Drug Prescriptions and Associated Socioeconomic Functioning. JAMA Psychiatry. Published online July 12, 2023. doi:10.1001/jamapsychiatry.2023.2206
2. Walter K. USPSTF Announces New Guidance for Depression, Anxiety Screenings. HCPLive. June 20, 2023. https://www.hcplive.com/view/uspstf-announces-new-guidance-depression-anxiety-screenings

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