H. Mental Health and Autism

MENTAL HEALTH AND AUTISM

The presence of behavioral health disorders can impact not only individuals and their families but also systems within the community, such as schools or the juvenile justice system. 22 Behavioral health is an LHI of Healthy People 2020 with primary objectives focusing on reducing the proportion of adolescents aged 12-17 years old who experience major depressive episodes (MDEs). The CDC lists the following set of facts on the widespread abundance of mental health disorders affecting children across the nation: • 9.4% of children aged 2-17 years have received an ADHD diagnosis;23 • 7.4% of children aged 3-17 years have a diagnosed behavior problem; • 7.1% of children aged 3-17 years have diagnosed anxiety; • 3.2% of children aged 3-17 years have diagnosed depression; and • 1 in 6 U.S. children aged 2–8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder.

One measure to determine demand for mental health services is to study the age-adjusted Emergency Room (ER) rate, of patients under 18, with a primary diagnosis related to mental health. Orange County has 29.8 ER visits per 10,000 populations under 18 years old. 24 As seen in the graph below, the age cohort with the highest ER utilization was age cohort 15-17 (93.7 per 10,000), followed by age cohort 10-14 (59.7 per 10,000), and age cohort 5-9 (7.0 per 10,000).

Compared to other California counties, Orange County falls within the top 50% of counties who do well in addressing ER utilization for mental health. According to the Orange County’s Healthier Together (an initiative led by the Health Improvement Partnership), treatment for mental disorders is a major cause of hospitalization for children and adolescents between the ages of 10 and 21 years. As for hospitalization rate due to pediatric mental health, Orange County’s age-adjusted rate is 18.5 hospitalizations per 10,000 populations under 18-year-

100

80

60

40

20

0

Orange County Emergency Department Rate due to Mental Health by Age Cohort

3.5

0-4 7

5-9 59.7

10-14 93.7

15-17 29.8

Overall

Source: ochealthiertogether.org and the Office of Statewide Health Planning and Development, 2017

22 Orange County Children’s Partnership (2019). The 24th Annual report on the Conditions of Children in Orange County [Report]. 23 Attention-deficit/hyperactivity disorder (ADHD) is a disorder that makes it difficult for a person to pay attention and control impulsive behaviors. He or she may also be restless and almost constantly active. 24 Conduent Healthy Communities Institute, 2015-2017 CA Office of Statewide Health Planning and Development. As cited on OCHealthierTogether.org, an initiative led by HIP. Retrieved 8/2019.

olds. 25 The age group who have significantly higher hospitalization rates due to pediatric mental health is the 15 to 17-year-old with 68.6 hospitalizations/10,000 populations under 18-year-olds.

According to KidsData.org, a Stanford Lucile Packard program, approximately 19% of all Orange County children, ages three to 22 years old, in special education, have been diagnosed with autism, a dramatic increase from 2000 when less than 3% were diagnosed with autism. The autism rate in Orange County is the highest in the state, followed by Los Angeles County (17.0%), Tuolumne County (16.9%), and Butte County (16.8%).

Percentage of Special Education Students Diagnosed with Autism by County, 2018

Inyo County Santa Cruz County Marin County Sonoma County Madera County Monterey County Shasta County Tulare County Mendocino County Napa County Fresno County San Bernardino County Kings County Santa Barbara County Riverside County Stanislaus County San Luis Obispo County Lake County Kern County Ventura County Contra Costa County

Solano County San Mateo County San Joaquin County Sacramento County

Merced County Imperial County California San Francisco County Humboldt County San Diego County Alameda County Santa Clara County Butte County Tuolumne County Los Angeles County Orange County

0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0% 20.0%

Source: KidsData.org and the California Department of Education, 2018

25 Conduent Healthy Communities Institute, 2015-2017 CA Office of Statewide Health Planning and Development. As cited on OCHealthierTogether.org, an initiative led by HIP. Retrieved 8/2019.