Published online June 1, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. 2138-2148 (doi:10.1542/peds.2005-1531)
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Mental Health Care Services for Children With Special Health Care Needs and Their Family Members: Prevalence and Correlates of Unmet Needs

Michael L. Ganz, MS, PhD and Shalini A. Tendulkar, ScM

Harvard School of Public Health, Department of Society, Human Development, and Health, Boston, Massachusetts

OBJECTIVES. To estimate the prevalence and correlates of unmet needs for mental health care services for children with special health care needs and their families.

METHODS. We use the National Survey of Children With Special Health Care Needs to estimate the prevalence of unmet mental health care needs among children with special health care needs (1–17 years old) and their families. Using logistic-regression models, we also assess the independent impact of child and family factors on unmet needs.

RESULTS. Substantial numbers of children with special health care needs and members of their families have unmet needs for mental health care services. Children with special health care needs who were poor, uninsured, and were without a usual source of care were statistically significantly more likely to report that their mental health care needs were unmet. More severely affected children and those with emotional, developmental, or behavioral conditions were also statistically significantly more likely to report that their mental health care needs went unmet. Families of severely affected children or of children with emotional, developmental, or behavioral conditions were also statistically significantly more likely to report that their mental health care needs went unmet.

CONCLUSIONS. Our results indicate that children with special health care needs and their families are at risk for not receiving needed mental health care services. Furthermore, we find that children in families of lower socioeconomic status are disproportionately reporting higher rates of unmet needs. These data suggest that broader policies to identify and connect families with needed services are warranted but that child- and family-centered approaches alone will not meet the needs of these children and their families. Other interventions such as anti-poverty and insurance expansion efforts may be needed as well.

Key Words: medical home • children with special health care needs • parental mental health • mental health

Abbreviations: CSHCN—children with special health care needs • EDB—emotional—developmental—or behavioral • NS-CSHCN—National Survey of Children With Special Health Care Needs • FPL—federal poverty level • MSA—metropolitan statistical area • OR—odds ratio

Accepted Nov 15, 2005.




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