The first report on childhood chronic disease from the White House’s Make America Healthy Again Commission raises concerns children are being overdiagnosed and overprescribed medication when it comes to behavioral health.
The commission published its report on the causes of childhood chronic disease May 22. President Donald Trump formed the commission by executive order, and directed it to investigate childhood chronic disease.
The report points to ultra-processed foods, exposure to environmental chemicals, pervasive technology use and the overprescribing of medications as the four main drivers of childhood chronic disease.
Mental health presents a “paradox” for clinicians, the report said.
“Overdiagnosis of conditions like ADHD, depression and anxiety coexists with a genuine rise in distress,” the commission wrote.
Here are five things to know:
- American youths face a “deepening psychosocial crisis,” according to the commission. Declining sleep, chronic stress among students and less time spent outdoors could contribute to rising rates of sadness and hopelessness among children and teenagers.
- The commission points to social media and smartphone use as a major contributor to mental health issues. Spending more than three hours a day on social media platforms can put adolescents at higher risk of anxiety and depression than their peers with lower usage. In 2021, teenagers averaged more than eight hours of non-school-related screen time daily.
- Although suicide rates and emergency department visits for self-harm among adolescents have increased, overdiagnosis of mental health conditions is a concern, the comission wrote. ADHD has the “strongest evidence of overdiagnosis,” according to the report, with some studies suggesting the harms of diagnosing mild cases of ADHD may outweigh the benefits.
In 2024, the CDC labeled ADHD a “growing public health concern,” with around 1 in 9 children having received a diagnosis of the disease. In 2024, the CDC said rising rates of ADHD diagnoses could be due to generally increasing awareness of the disease, and an increase in pandemic-associated stressors. - The MAHA Commission called overprescribing of drugs a “recent and emerging crisis.” The report pointed to several psychiatric drugs as overprescribed, with stimulant prescriptions for ADHD doubling between 2006 and 2016, and antidepressant prescriptions rising by 1,400% between 1987 and 2014.
Awais Aftab, MD, an assistant professor of psychiatry at Case Western Reserve University in Cleveland, told The Washington Post the increase in antidepression prescriptions is not inherently dangerous, as pediatric depression was “barely recognized” decades ago.
- The report said some psychiatric prescriptions could have long-term consequences for children. SSRI prescriptions for depression and anxiety carry a black box warning that the drugs can increase suicidal ideation among adolescents. Suicidal thinking and behavior among adolescents taking SSRIs are “difficult to separate from baseline disease” and may go undetected, the commission wrote. Some studies have shown no long-term benefits in children who take medications for ADHD with respect to their grades, relationships, achievement or behavior, the commission wrote, and could cause long-term weight loss.
The American Psychiatric Association has said psychiatric drugs are not intended to be a front-line treatment for mental health disorders for children.
