The growth in the overall prevalence of antidepressant use was greater among girls (68 percent) than boys (34 percent).

In summary, among youth populations with a diagnosis of depression, anxiety, or other psychiatric disorder other than attention deficit hyperactivity disorder, roughly one-third to one-half receive psychotropic medication, for an overall rate of 4 to 6 percent of psychotropic drug use among adolescents of an age from which military enlistees are drawn. Of those adolescents with attention deficit hyperactivity disorder, roughly half will be using stimulant medication.

In the Methods for the Epidemiology for Child and Adolescent Mental Disorders Survey, for youth with a psychiatric disorder, ambulatory services were used by 24 to 45 percent and school-based services were used by 27 to 64 percent. Those who used inpatient services ranged from 2 to 15 percent (Narrow et al., 1998).

Psychiatric hospitalization among youth ages 5 to 18 from 1990-1999 was assessed in a retrospective cross-sectional time trend study using the Washington State Comprehensive Hospital Abstract Reporting System dataset (Garrison et al., 2004). The rate of hospitalization for school-age children (ages 5 to 14) increased by 22 percent during the 1990s (from 8 percent in 1990 to 13 percent in 1999). Among adolescents ages 15 to 19, there was no significant change in the rate of psychiatric hospitalization, but the proportion of hospitalizations due to psychiatric conditions increased from 14.5 percent in 1990 to 21.5 percent in 1999. Mental illness accounted for one-third of all hospital days for youth in 1999 and surpassed injury as the leading cause of hospitalization for youth in Washington State.

Of 3,803 youth ages 2 to 14 in the child welfare system, 48 percent had clinically significant emotional or behavioral problems. However, only one-fourth (11.7 percent) received any specialty mental health care during the 12 months prior to the survey. Outpatient services were used most commonly (15 percent), whereas psychiatric hospitalization was the least commonly used service (3 percent) (Burns et al., 2004).

Ethnicity has been related to receipt of mental health treatment services. Compared with whites, black and Asian teenagers with depression were found to be less likely to seek mental health treatment, especially in the case of males (Sen, 2004).

Socioeconomic factors have been associated with mental health service utilization in youths. Elevated service use for boys compared to girls and for single-parent compared to two-partner households as well as