Ambulatory Pediatrics
Volume 7, Issue 6 , Pages 431-438, November 2007

Unmet Mental Health Need and Access to Services for Children With Special Health Care Needs and Their Families

From the Department of Health Services, School of Public Health, University of California, Los Angeles, UCLA Center for Healthier Children, Families, and Communities, Los Angeles, Calif (Dr Inkelas and Dr Ortega); George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Mo (Dr Raghavan); and the Department of Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine, University of California, Los Angeles, UCLA Center for Healthier Children, Families, and Communities, Los Angeles, Calif (Dr Larson and Dr Kuo)

Received 11 February 2007; accepted 6 August 2007.

Objectives

Studies suggest that children with disabilities or serious health conditions are vulnerable to mental health problems due to adjustment and limitation problems. The aim of this study was to examine rates and predictors of unmet mental health need among children with special health care needs (CSHCN) and their family members and to determine if race/ethnicity and language are associated with unmet need for the child and family members who have a mental health need attributed to the child's special needs.

Methods

Data are from the 2001 National Survey of Children with Special Health Care Needs, a nationally representative sample of CSHCN.

Results

Rates of unmet need were higher for CSHCN and family members of CSHCN with a chronic emotional, behavioral, or developmental problem (EBDP) compared to CSHCN with a mental health need but not a chronic EBDP. In multivariate analysis controlling for condition impact and demographics, among CSHCN with a chronic EBDP, African-American children had greater odds of unmet need (OR 1.60, 95% CI, 1.12–2.28), and family members of Hispanic children with a Spanish language parent interview had greater odds of unmet need compared to others (OR 4.48, 95% CI, 1.72–11.63). Lacking a personal doctor or nurse was associated with higher odds of unmet need for CSHCN with and without a chronic EBDP.

Conclusion

Parents reported prevalent mental health needs of CSHCN as well as family members. Given the importance of family members to the care of CSHCN, research on racial/ethnic disparities in access to perceived needs should focus on children and their family members.

Key Words: access, chronic illness, mental health, special health care needs

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 Preliminary data were presented at the Pediatric Academic Societies Annual Meeting in May 2004 in San Francisco and the Maternal and Child Health Epidemiology Conference in December 2004 in Atlanta.

PII: S1530-1567(07)00143-8

doi:10.1016/j.ambp.2007.08.001

Ambulatory Pediatrics
Volume 7, Issue 6 , Pages 431-438, November 2007

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