Pediatric access to mental health services

Whitney DG, Peterson MD. US National and State-Level Prevalence of Mental Health Disorders and Disparities of Mental Health Care Use in Children. JAMA Pediatr. 2019 Feb 11. doi:10.1001/jamapediatrics.2018.5399. [Epub ahead of print]

In children, mental health disorders have deleterious consequences on individual and socioeconomic factors and can impede healthful transitioning into adulthood, and the incidence of mental health disorders has been increasing over the decades. Recent initiatives led by global and national agencies were created to identify priority focus areas regarding the mental health–related burden. Some of the emerging priorities included developing child mental health policies, implementing prevention and early intervention strategies for transition-age youth, and reducing disparities for mental health care use. This study sought to inform these initiatives by providing recent national and state-level estimates of the prevalence of treatable mental health disorders and mental health care use in children…

An estimated 46.6 million children were included for analysis. The national prevalence of at least 1 mental health disorder was 16.5% (weighted estimate, 7.7 million). After adjustments, all covariates were associated with mental health disorders except for continuous insurance. The state-level prevalence of at least 1 mental health disorder ranged from 7.6% (Hawaii) to 27.2% (Maine).

The national prevalence of children with a mental health disorder who did not receive needed treatment or counseling from a mental health professional was 49.4%, which ranged from 29.5% (Washington, DC) to 72.2% (North Carolina). After transforming state-level data into quartiles, Figure, A shows the prevalence of mental health disorders in children and Figure, B shows the prevalence of children with at least 1 mental health disorder who did not receive needed treatment or counseling from a mental health professional.

The principal finding was that half of the estimated 7.7 million US children with a treatable mental health disorder did not receive needed treatment from a mental health professional. This estimate varied considerably by state. Of the 13 states that were in the top quartile for mental health disorder prevalence, Alabama, Mississippi, Oklahoma, and Utah were also in the top quartile for the prevalence of children with a mental health disorder who did not receive needed treatment.

State-level practices and policies play a role in health care needs and use,6 which may help to explain the state variability observed in this study. Nevertheless, initiatives that assist systems of care coordination have demonstrated a reduction of mental health–related burdens across multiple domains. Policy efforts aimed at reducing burden and improving treatment across states are needed.

Courtesy of:  https://www.medpagetoday.com/publichealthpolicy/healthpolicy/77962