The number of Maine children hospitalized for mental health or substance abuse rose 30 percent between 2000 and 2003, an increase that should concern parents and policy-makers. The phenomenon is not limited to Maine, but the issue deserves to be examined here to see whether the children affected could receive earlier treatment and avoid being hospitalized and whether this would save the state’s health care system money and allow it to provide care for more residents.

The Maine Children’s Alliance annually publishes a statistical glimpse of the health of Maine’s children in a booklet called the Kids Count Data Book. It has chronicled the rise of hospitalizations for a couple of years and notes in its 2005 book that six of the leading 10 diagnoses for inpatient care of teens ages 13 through 17 are for mental illnesses, with patients ages 6 through 17 most often hospitalized for depression and mood-related disorders.

The average length of stay for teenagers with affective psychoses, which include depression, bipolar or manic disorders, is about two weeks; for younger kids, ages 6 to 12, it is 22 days. Besides the affliction for those suffering these illnesses, the cost for treatment is in the tens of million of dollars. Money spent on these services obviously can’t be spent elsewhere. The question for health care policy-makers is whether Maine can develop a better way to deliver needed services.

To do that, Maine needs an understanding of how access to different kinds of care affects the number of hospitalizations, socioeconomic status of the kids being hospitalized, whether patients have insurance and what services are covered and which sub-age groups are driving the increased demand for services. Were general hospitals taking these cases under different diagnoses previously and are out-of-state placements less available now? In 2003, 2,645 Maine kids were hospitalized for mental-health or, in a relatively small number of cases, substance abuse, so the issue is well worth exploring.

The Kids Count book is filled with other important measures of children’s health as well – poverty trends are not encouraging, nor was the percentage of children hurt in automobile accidents. There was good news too: high-school dropout rates are falling and so are teen pregnancies. But the big trend among Maine children, as with the Maine population overall, is with health care, in this case the hospitalization rates for mental-health issues.

Every year, the Children’s Alliance gives copies of its report to lawmakers. They should notice this expensive trend in mental health and begin asking questions.