Children with special health care needs report unmet needs for mental health care services

June 22, 2006

Boston, MA -- Children with special health care needs (CSHCN) and members of their families are at risk of not getting the mental health care services they need. In addition, poorer children are less likely to have their mental health care needs met. Those are two of the key results from a study by Harvard School of Public Health (HSPH) researchers, published in the June 2006 issue of Pediatrics (http://pediatrics.aappublications.org/cgi/content/abstract/117/6/2138).

Lead author Michael Ganz, Assistant Professor of Society, Human Development, and Health at HSPH and his colleague, Shalini Tendulkar, an HSPH doctoral student, analyzed data from the National Survey of Children With Special Health Care Needs, a nationally representative survey conducted by the federal government. Of the overall group of 372,174 children interviewed between 2000 and 2002, Ganz focused his study on 36,512 who were among those identified as CSHCN.

The researchers found that approximately 26 percent of CSHCN and 13 percent of their family members reported mental health care needs. Of those reporting needs, 18.4 percent of the CSHCN and 21.3 percent of their family members reported that their needs were not met. Applying these findings to the general population suggests there are some 416,000 children and 249,000 family members in the United States whose needs for mental health care services have not been met.

Ganz and Tendulkar found that the following factors were strongly associated with unmet mental health care needs for CSHCN: poverty, lack of insurance, lack of a usual source of medical care, the severity of condition, having an emotional, developmental or behavioral condition (EDB) and unmet needs of family mental health care.

The data suggests that more can be done to improve access to mental health care services for CSHCN and their families. Other possible interventions mentioned by the authors include the expansion of insurance coverage and efforts to combat poverty. "This problem is not just specific to the children. There is evidence that unmet needs among children with special health care needs and their family members are linked. Interventions targeting the children might have positive spillover effects to the rest of the family," said Ganz.
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The work was supported in part by funding from a Maternal and Child Health Bureau grant.

Harvard T.H. Chan School of Public Health

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