Although the current mental health crisis in the US is pervasive and the need for additional mental health professionals is profound, this unmet need is not uniform for all children.
Children who are not identified as non-Hispanic White typically have less access to and receive worse quality of care for mental health conditions. However, there are multiple mental health conditions, and nobody has separated out the data to look at these conditions separately.
Andrew Chang, MMSc, and Natalie Slopen, ScD, at Harvard University analyzed data from the National Survey of Children’s Health (NSCH) to examine disparities in unmet treatment needs for 4 mental health conditions:
- Depression
- Anxiety
- Attention deficit-hyperactivity disorder (ADHD)
- Behavioral problems.
Their article, entitled “Racial and Ethnic Disparities for Unmet Needs by Mental Health Condition: 2016-2021,” is being early released in Pediatrics this week (10.1542/peds.2023-062286).
Using the protocol published by the NSCH and recommended by the US Census Bureau, the authors categorized the children as non-Hispanic White, Hispanic, non-Hispanic Black, Asian, and non-Hispanic other. Children were categorized as having an unmet mental health need if:
- A doctor or mental health professional had ever provided a mental health diagnosis,
- The parent confirmed the diagnosis, and
- When asked the question, “During the past 12 months, has this child received any treatment or counseling from a mental health professional?” the parent responded “no, but needed to see a mental health professional.”
For any mental health condition and compared with children who were non-Hispanic White, children who were of any other racial/ethnic group had lower prevalence of a diagnosed mental health condition. However, these children had higher odds of having unmet needs for these conditions:
- For all mental health conditions combined, children who were non-Hispanic Black had 56% higher odds of having unmet needs, and this was largely driven by the increased unmet needs for behavioral problems, specifically.
- With regard to anxiety, children who were Asian had nearly 3 times the rate of having unmet needs, and children who were Hispanic also had higher odds of having unmet needs.
An important strength of this study is that the sample of children who identified as Asian was large enough to find this important disparity in care. The major limitation of this study is that the authors did not have enough numbers to look specifically at the “non-Hispanic other” group, which is also likely to experience increased rates of unmet needs.
I encourage you to take a look at this study and consider what structural barriers there are to getting all of our children, particularly those of minority racial and ethnic groups, into appropriate mental health care.
