Unmet Need for Mental Health Care Among U.S. Children: Variation by Ethnicity and Insurance Status
Abstract
OBJECTIVE: Policy discussions regarding the mental health needs of children and adolescents emphasize a lack of use of mental health services among youth, but few national estimates are available. The authors use three national data sets and examine ethnic disparities in unmet need (defined as having a need for mental health evaluation but not using any services in a 1-year period) to provide such estimates. METHOD: The authors conducted secondary data analyses in three nationally representative household surveys fielded in 1996-1998: the National Health Interview Survey, the National Survey of American Families, and the Community Tracking Survey. They determined rates of mental health service use by children and adolescents 3-17 years of age and differences by ethnicity and insurance status. Among the children defined as in need of mental health services, defined by an estimator of mental health problems (selected items from the Child Behavior Checklist), they examined the association of unmet need with ethnicity and insurance status. RESULTS: In a 12-month period, 2%-3% of children 3-5 years old and 6%-9% of children and adolescents 6-17 years old used mental health services. Of children and adolescents 6-17 years old who were defined as needing mental health services, nearly 80% did not receive mental health care. Controlling for other factors, the authors determined that the rate of unmet need was greater among Latino than white children and among uninsured than publicly insured children. CONCLUSIONS: These findings reveal that most children who need a mental health evaluation do not receive services and that Latinos and the uninsured have especially high rates of unmet need relative to other children. Rates of use of mental health services are extremely low among preschool children. Research clarifying the reasons for high rates of unmet need in specific groups can help inform policy and clinical programs.
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80% of depressed adolescents refuse to be treated again due to side effects or stigma after the first psychological or drug treatment.
“research has shown that 80% of depressed adolescents refuse to be treated again due to side effects or stigma after the first psychological or drug treatment [58].”
From Systematic review and meta-analysis of the effects of exercise on depression in adolescents (2022) · cites this paper as [58]
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Spinney, E., Yeide, M., Feyerherm, W., Cohen, M., Stephenson, R., & Thomas, C. (2016) · Journal of Crime and Justice · doi:10.1080/0735648x.2015.1133492 · Cited by 57 · see citing works
Mental health issues in children and adolescents with chronic illness
Delamater, A. M., Guzman, A., & Aparicio, K. (2017) · International Journal of Human Rights in Healthcare · doi:10.1108/ijhrh-05-2017-0020 · Cited by 52 · see citing works
Urban Latinx parents’ attitudes towards mental health: Mental health literacy and service use
Dixon De Silva, L. E., Ponting, C., Ramos, G., Cornejo Guevara, M. V., & Chavira, D. A. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2019.104719 · Cited by 53 · see citing works
The economic impact of subthreshold and clinical childhood mental disorders
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Lu, W., Muñoz-Laboy, M., Sohler, N., & Goodwin, R. D. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.30280 · Cited by 41 · see citing works
Furlong, M. J., Fullchange, A., & Dowdy, E. (2017) · School Psychology Quarterly · doi:10.1037/spq0000168 · Cited by 36 · see citing works
Access and quality in child health services: voltage drops
Chung, P. J., & Schuster, M. A. (2004) · Health Affairs · doi:10.1377/hlthaff.23.5.77 · Cited by 35 · see citing works
Taylor, L. K., & Weems, C. F. (2011) · Behavior Therapy · doi:10.1016/j.beth.2010.09.001 · Cited by 34 · see citing works
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Family characteristics and children’s receipt of autism services in low-resourced families
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Youth mental health service preferences and utilization patterns among Latinx caregivers
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Pathways to Care: Need, Attitudes, Barriers
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North American open-label 16-week trial of the MindShift smartphone app for adult anxiety
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- Authors
- Kataoka, S. H., Zhang, L., & Wells, K. B.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- American Journal of Psychiatry
- Published
- 2002-09-01
- Volume
- 159
- Issue
- 9
- Pages
- 1548-1555
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2152802023
- Cited by
- 1,566
- References
- 43
- Citations by year
- 2026: 23 · 2025: 26 · 2024: 44 · 2023: 57 · 2022: 85 · 2021: 108 · 2020: 129 · 2019: 105 · 2018: 84 · 2017: 80 · 2016: 83 · 2015: 94 · 2014: 81 · 2013: 101 · 2012: 70
- FWCI
- 26.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- National Institutes of Health (1k05mh001170-01)
- National Institute of Mental Health (MH 01170)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- unmet mental health needs, child mental health services, ethnic disparities, Latino children, uninsured children, public insurance, mental health service utilization, preschool children, Child Behavior Checklist, health insurance status
- MeSH terms
- Adolescent, Child, Child Health Services, Child, Preschool, Ethnicity, Female, Health Services Needs and Demand, Hispanic or Latino, Humans, Insurance, Health, Male, Mental Health Services, Minority Groups, United States, Health Care Surveys
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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