Table 2. Patterns and Trends in the Prevalence of Treatment Use by Sources of Service for MDE and SUD Among Adolescents With Co-occurring MDE and SUD in the National Survey on Drug Use and Health.
| Source of service | Adolescents per survey year, % (95% CI)a | OR (95% CI) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 2011 (n = 280) | 2012 (n = 280) | 2013 (n = 258) | 2014 (n = 188) | 2015 (n = 205) | 2016 (n = 192) | 2017 (n = 213) | 2018 (n = 214) | 2019 (n = 242) | ||
| MDE treatment useb | ||||||||||
| Overnight in hospital | 8.3 (4.3-12.3) | 7.6 (4.1-11.1) | 7.2 (3.7-10.7) | 16.5 (9.5-23.4) | 15.8 (9.2-22.3) | 19.4 (12.5-26.3) | 11.7 (6.6-16.9) | 8.4 (3.7-13.1) | 12.9 (7.1-18.7) | 1.06 (0.99-1.12) |
| Residential treatment facility | 4.1 (1.2-7.0) | 6.7 (3.2-10.1) | 5.1 (2.0-8.1) | 10.3 (5.0-15.6) | 8.6 (3.3-13.8) | 13.9 (7.6-20.2) | 6.7 (2.6-10.8) | 5.2 (1.3-9.2) | 10.9 (5.2-16.6) | 1.07 (0.99-1.16) |
| Day treatment programs | 6.6 (3.5-9.8) | 8.5 (4.6-12.5) | 4.6 (1.6-7.6) | 9.1 (4.1-14.1) | 10.9 (5.4-16.4) | 14.8 (8.7-21.0) | 8.7 (3.9-13.5) | 8.7 (3.9-13.6) | 7.8 (3.4-12.3) | 1.04 (0.97-1.11) |
| Mental health clinic | 12.1 (7.6-16.6) | 12.7 (7.9-17.4) | 10.7 (6.2-15.2) | 16.3 (9.8-22.8) | 27.1 (19.0-35.2) | 28.1 (20.2-36.1) | 19.2 (12.8-25.6) | 14 (8.5-19.5) | 21.5 (14.5-28.5) | 1.08 (1.03-1.14)c |
| Private therapist | 34.2 (26.7-41.7) | 33.7 (26.5-40.9) | 32.4 (24.9-40.0) | 46.4 (37.3-55.4) | 44.5 (35.5-53.5) | 46.7 (37.9-55.6) | 44 (35.5-52.5) | 46.5 (36.9-56.1) | 43.6 (35.2-52.0) | 1.07 (1.02-1.12)c |
| In-home counselor | 12.3 (7.9-16.8) | 8.8 (4.9-12.7) | 12.4 (6.7-18.1) | 18.4 (11.2-25.6) | 18.8 (11.3-26.3) | 20.1 (13.1-27.0) | 9.8 (4.9-14.6) | 14.4 (6.9-21.9) | 13 (7.2-18.9) | 1.07 (1.02-1.11) |
| School social worker, counselor, or psychologist | 23.5 (16.7-30.3) | 25.5 (18.5-32.5) | 21.2 (14.8-27.5) | 27.4 (19.3-35.5) | 26.8 (18.7-34.9) | 33.2 (24.4-41.9) | 29.5 (21.5-37.5) | 31.6 (22.4-40.8) | 27.9 (20.2-35.7) | 1.05 (0.99-1.10) |
| Special school or program | 12.3 (6.9-17.6) | 16.1 (9.5-22.7) | 10.8 (6.2-15.5) | 11.1 (4.5-17.7) | 14.3 (8.3-20.3) | 19.1 (12.1-26.0) | 12.1 (6.3-17.8) | 17.7 (10.2-25.2) | 14.4 (8.4-20.5) | 1.03 (0.97-1.10) |
| Pediatrician or family physician | 8.9 (4.1-13.8) | 15.7 (9.9-21.6) | 7.3 (3.9-10.6) | 8.3 (4.0-12.6) | 12.5 (6.6-18.5) | 18.5 (11.0-26.0) | 14.2 (7.8-20.6) | 12.6 (6.1-19.1) | 11.7 (6.2-17.2) | 1.04 (0.97-1.11) |
| Juvenile detention, prison, or jaild | 3.3 | 0.3 | 1.2 | 2.6 | 0 | 2.2 | 0.4 | 0.2 | 1.1 | 0.86 (0.73-1.02) |
| Foster care | 1.3 (0.0-2.6) | 2.5 (0.1-5.0) | 0.5 (0.0-1.1) | 0.9 (0.1-2.0) | 2.1 (0.0-4.4) | 2.7 (0.0-5.5) | 1.3 (0.0-3.2) | 0.9 (0.0-2.1) | 0.6 (0.1-1.4) | 0.94 (0.82-1.08) |
| SUD treatment usee | ||||||||||
| Overnight in hospital | 4.9 (1.1-8.8) | 2.1 (0.2-4.0) | 0.9 (0.3-2.2) | 6.1 (1.3-10.9) | 2.1 (0.0-4.2) | 4.1 (0.2-8.0) | 2.5 (0.4-4.7) | 4.5 (1.2-7.7) | 0.4 (0.0-1.2) | 0.94 (0.84-1.05) |
| Residential rehabilitation facility | 3.9 (0.8-7.0) | 1.4 (0.0-3.1) | 0.7 (0.0-1.8) | 2.2 (0.0-4.5) | 0.7 (0.0-1.7) | 4.6 (0.7-8.7) | 1.5 (0.0-3.0) | 1.6 (0.0-3.3) | 0.4 (0.0-1.2) | 0.91 (0.79-1.05) |
| Outpatient rehabilitation facility | 4.4 (1.2-7.6) | 4.4 (1.0-7.8) | 3.8 (0.2-7.4) | 3.0 (0.6-5.4) | 1.7 (0.0-3.5) | 4.8 (0.9-8.8) | 2.8 (0.5-5.1) | 1.7 (0.0-3.6) | 0.4 (0.0-1.0) | 0.86 (0.77-0.96)c |
| Mental health clinic | 6.1 (2.1-10.0) | 3.6 (0.8-6.3) | 3.0 (0.0-6.1) | 2.8 (0.5-5.1) | 2.9 (0.6-5.2) | 6.1 (1.8-10.4) | 2.5 (0.2-10.8) | 3.9 (0.6-7.2) | 1.6 (0.1-3.0) | 0.93 (0.83-1.03) |
| Private physician’s office | 1.8 (0.0-4.0) | 1.6 (0.0-3.7) | 0.6 (0.0-1.5) | 4.3 (1.0-7.6) | 1.1 (0.0-2.7) | 1.5 (0.0-3.4) | 2.1 (0.0-4.9) | 4.3 (0.0-9.2) | 0.6 (0.0-1.4) | 1.02 (0.87-1.20) |
| Emergency departmentd | 2.0 | 1.7 | 0.0 | 5.4 | 1.3 | 3.8 | 1.4 | 2.3 | 0.1 | 0.95 (0.85-1.06) |
| Prison or jaild | 0.1 | 0.0 | 0.3 | 1.1 | 1.4 | 0.0 | 0.0 | 0.2 | 0.5 | 1.03 (0.84-1.26) |
| Self-help groupd | 3.7 | 3.4 | 4.6 | 4.8 | 3.3 | 3.4 | 3.6 | 2.2 | 0.0 | 0.88 (0.80-0.97)f |
Abbreviations: OR, odds ratio; MDE, major depressive episode; SUD, substance use disorder.
Weighted percentages are presented. Specific sources of service use are not mutually exclusive. No mathematical correction was made for multiple comparisons.
All adolescents were asked if they had received treatment or counseling from each of 11 specialty and nonspecialty sources of service for behavioral or emotional problems that were not caused by alcohol or drug use. When restricting analysis to adolescents with co-occurring MDE and SUD, there may be overreport bias by adolescents who sought treatment for problems other than MDE or underreport bias by those whose emotional or behavioral problems were caused by alcohol or drug use. Therefore, these estimations are for illustration purpose and should be interpreted with caution.
P ≤ .01.
95% CIs could not be computed for percentages owing to zero observed values.
Adolescents were asked if they had used treatment or counseling for illicit drug or alcohol use at any of 8 designated locations in the past 12 months.
P ≤ .05.