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American Academy of Pediatrics
Special Article

Overlooked and Underserved: “Action Signs” for Identifying Children With Unmet Mental Health Needs

Peter S. Jensen, Eliot Goldman, David Offord, Elizabeth J. Costello, Robert Friedman, Barbara Huff, Maura Crowe, Lawrence Amsel, Kathryn Bennett, Hector Bird, Rand Conger, Prudence Fisher, Kimberly Hoagwood, Ronald C. Kessler and Robert Roberts
Pediatrics November 2011, 128 (5) 970-979; DOI: https://doi.org/10.1542/peds.2009-0367
Peter S. Jensen
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Eliot Goldman
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David Offord
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Elizabeth J. Costello
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Robert Friedman
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Barbara Huff
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Maura Crowe
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Lawrence Amsel
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Kathryn Bennett
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Hector Bird
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Rand Conger
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Prudence Fisher
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Kimberly Hoagwood
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Ronald C. Kessler
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Robert Roberts
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Abstract

OBJECTIVE: The US Surgeon General has called for new approaches to close the mental health services gap for the large proportion of US children with significant mental health needs who have not received evaluation or services within the previous 6 to 12 months. In response, investigators sought to develop brief, easily understood, scientifically derived “warning signs” to help parents, teachers, and the lay public to more easily recognize children with unmet mental health needs and bring these children to health care providers' attention for evaluation and possible services.

METHOD: Analyses of epidemiologic data sets from >6000 children and parents were conducted to (1) determine the frequency of common but severely impairing symptom profiles, (2) examine symptom profile frequencies according to age and gender, (3) evaluate positive predictive values of symptom profiles relative to Diagnostic and Statistical Manual of Mental Disorders diagnoses, and (4) examine whether children with 1 or more symptom profiles receive mental health services.

RESULTS: Symptom-profile frequencies ranged from 0.5% to 2.0%, and 8% of the children had 1 or more symptom profile. Profiles generated moderate-to-high positive predictive values (52.7%–75.4%) for impairing psychiatric diagnoses, but fewer than 25% of children with 1 or more profiles had received services in the previous 6 months.

CONCLUSIONS: Scientifically robust symptom profiles that reflect severe but largely untreated mental health problems were identified. Used as “action signs,” these profiles might help increase public awareness about children's mental health needs, facilitate communication and referral for specific children in need of evaluation, and narrow the child mental health services gap.

  • children
  • adolescents
  • mental health
  • services use
  • underserved
  • unmet need
  • Accepted August 8, 2011.
  • Copyright © 2011 by the American Academy of Pediatrics

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Pediatrics
Vol. 128, Issue 5
1 Nov 2011
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Overlooked and Underserved: “Action Signs” for Identifying Children With Unmet Mental Health Needs
Peter S. Jensen, Eliot Goldman, David Offord, Elizabeth J. Costello, Robert Friedman, Barbara Huff, Maura Crowe, Lawrence Amsel, Kathryn Bennett, Hector Bird, Rand Conger, Prudence Fisher, Kimberly Hoagwood, Ronald C. Kessler, Robert Roberts
Pediatrics Nov 2011, 128 (5) 970-979; DOI: 10.1542/peds.2009-0367

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Overlooked and Underserved: “Action Signs” for Identifying Children With Unmet Mental Health Needs
Peter S. Jensen, Eliot Goldman, David Offord, Elizabeth J. Costello, Robert Friedman, Barbara Huff, Maura Crowe, Lawrence Amsel, Kathryn Bennett, Hector Bird, Rand Conger, Prudence Fisher, Kimberly Hoagwood, Ronald C. Kessler, Robert Roberts
Pediatrics Nov 2011, 128 (5) 970-979; DOI: 10.1542/peds.2009-0367
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