Sarah Fleury, LICSW, CPHQ, lead behavioral health clinical program specialist, Blue Cross & Blue Shield of Rhode Island; and Karyn Horowitz, MD, director of Outpatient Child Psychiatry & Behavioral Health Services at Lifespan

A new study of medical claims by the Blue Cross Blue Shield Association (BCBSA) finds that nearly 2.4 million commercially insured children (from two to 18 years old) were diagnosed with attention deficit hyperactivity disorder (ADHD), climbing 31% from 2010 to 2017. In Rhode Island, ADHD diagnoses jumped from 7.6 cases per every 100 people in 2010 to 9.4 cases per 100 in 2017, a 24% increase. The Health of America report, “The Impact of Attention Deficit Hyperactivity Disorder on the Health of America’s Children," also found that about four in 10 children with ADHD were also diagnosed with at least one other behavioral health disorder, most notably anxiety, depression and learning disorders. In general, ADHD was found to be most prevalent among middle school-aged children (11-13 years old), and boys are diagnosed about twice as much as girls.

The prevalence rate of ADHD in childhood magnifies the impact to families – some studies have found that nearly 10% of children nationally have been diagnosed with ADHD in recent years. When it comes to diagnosis rates in individual states, the study found Rhode Island to be higher than the national average when it comes to diagnosing children with ADHD.  Nine out of every 100 children were diagnosed with ADHD in Rhode Island, while the national average is six per 100. Although other states have begun diagnosing ADHD at higher rates over the last decade, Rhode Island still remains second highest nationally in terms of total ADHD diagnoses (behind Louisiana).

Pediatricians on the front line are often the first to make an ADHD diagnosis, so it’s critical to make sure they have the tools they need to support their patients. Rhode Island is fortunate to have a resource like the Pediatric Psychiatry Resource Network (PediPRN) for just this reason. 

PediPRN is led by Bradley Hospital under a grant from Rhode Island’s Executive Office of Health and Human Services, The Rhode Island Foundation and the van Beuren Charitable Foundation. This telephonic consultation program allows pediatricians to consult with pediatric behavioral health specialists – in real-time while a patient is in the pediatrician’s office - thus improving access to and delivery of high-quality pediatric behavioral health services. The free service is offered to all pediatricians in Rhode Island. While many pediatricians are readily able to manage ADHD in their practice, PediPRN can serve as a resource for addressing more complex patients for whom the diagnosis is less clear, have had medication side effects, or for those who may have comorbid disorders (such as anxiety and depression). For the many Rhode Island pediatricians who are diagnosing ADHD during an office visit, when needed,  the support of PediPRN can help families leave with a more-informed care plan the same day their child is diagnosed, with no need to follow-up on a referral.

 As ADHD diagnoses continue to rise, it’s important to have a strong network of resources and support. There are several organizations that families recently receiving an ADHD diagnosis may find helpful:

CHADD of RI (Children and Adults with Hyperactivity Attention Deficit Disorder)

• This support group is the local chapter of the national nonprofit organization CHADD, which seeks to promote and provide education and support about ADHD in adults and children. The local chapter of CHADD meets the first Wednesday of the month at Bradley Hospital. Contact information: (401) 369-0045 or www.chadd.org                

Rhode Island Parent Information Network (RIPIN)

• RIPIN assists individuals, parents, families and children to achieve their goals for health, education, and socio-economic well-being by providing information, training, education, support and advocacy for person/family centered care and system change. Contact information: (401) 270-0101 or www.ripin.org

Parent Support Network of Rhode Island

• The Parent Support Network (PSN) is an organization of families supporting families with children, youth and young adults who experience or are at risk for serious behavioral, emotional and/or mental health challenges. PSN seeks to strengthen and preserve families and reduce family isolation by promoting positive mental health and well-being and building a culturally and linguistically competent system of care, through advocacy, education, training and increased public awareness. Contact information: (401) 467-6855 www.psnri.org

BCBSRI also offers behavioral health case managers who can facilitate access to resources and services, provide education and support regarding behavioral health conditions, and coordinate care between treatment providers. The BCBSRI Behavioral Health Line can be reached at 1-800-274-2958.

This ADHD report is the 25^th study of the Blue Cross Blue Shield, The Health of America Report^® series, a collaboration between BCBSA and Blue Health Intelligence^®, which uses a market-leading claims database to uncover key trends and insights into health care affordability and access to care. For more information, visit https://www.bcbs.com/the-health-of-america.