Kids' Mental Health Concerns Meet Barriers In Primary, Specialty Care

Main Category: Pediatrics / Children's Health
Also Included In: Mental Health;  Primary Care / General Practice
Article Date: 16 Dec 2008 - 4:00 PST

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Middle childhood and adolescence are stages in a child's development fraught with physical, mental and emotional changes. These are particularly difficult periods for many parents who may look to their child's primary care physician for guidance and assistance with getting treatment if needed.

But according to the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health, for most parents, primary care physicians or PCPs aren't asking them if they have concerns about their child's mental health.

"We found that more than one-half of parents (56 percent) report that their primary care physician never asks about whether they have mental health concerns for their child," says Matthew M. Davis, M.D., M.A.P.P., director of the National Poll on Children's Health. "We're concerned that some PCPs may not ask about mental health problems because of not being able to address the issues themselves or because of the lack of specialty mental health services available to which they could refer kids if problems come up."

The poll asked parents of children ages 5 - 17 the degree to which they interacted with their children's primary care physicians about mental health issues and how often their child whether or not they were diagnosed with a mental illness received specialty mental health services.

Though many parents say their child's PCP never asks about mental health concerns for their kids, 22 percent of parents report that their child's PCP regularly asks and 22 percent report being asked sometimes.

For parents who have discussed mental health concerns with their child's PCP, 62 percent report having used specialty mental health services for their children.

According to national estimates, 1 in 10 children in the United States suffers from a serious emotional or mental disturbance. One in five parents in this poll indicate one or more of their children ages 5 - 17 is currently diagnosed with a mental health disorder most common of which are attention deficit hyperactivity disorder, general behavioral problems and depression.

Of parents whose children have mental health diagnoses, 25 percent say they've had difficulty finding the specialty mental health services they want for their child, while only 3 percent of parents with an undiagnosed child report the same difficulty.

The National Poll on Children's Health also finds:

-- 1 in 4 parents have used specialty mental health services for their children and most of these parents (15 percent overall) have done so in the past year.

-- Overall, 7 percent of parents say there has been a time when they could not get the specialty mental health services they wanted for their child.

-- For parents who say they've had difficulty getting specialty mental health services for their child, 46 percent of parents cite difficulty finding a provider as the reason; 43 percent of parents say services cost too much; 35 percent say they could not get a timely appointment, and 33 percent say they did not know where to go.

-- When asked about insurance coverage, 45 percent of parents report having full coverage for mental health services; 20 percent have limited coverage; 8 percent have no coverage; and 27 percent say they are unsure about whether or not they had coverage.

"We know from other studies that mental health services are in short supply nationally, so even though parents may be referred for specialty mental health services, they may have trouble getting in for a variety of reasons," Davis says. "Those reasons can range from lack of comprehensive coverage for mental health services in their health insurance plans to lack of knowledge among PCPs about services available in their communities."

Davis says that legislators can help parents by voting for mental health parity laws when being considered at both the state and federal level. Legislators could also vote for new laws that would encourage training of mental health services providers by giving new loan forgiveness programs in social work, psychology or psychiatry programs or encourage PCPs to get additional training by offsetting the cost of that training for the providers themselves.

Other resources:

National Conference of State legislatures Children's Policy Initiative: Mental Health Services for Children: http://www.ncsl.org/programs/cyf/CPI02.htm.

For the complete report, poll questions, figures and podcast about poll results, visit the C.S. Mott Children's Hospital National Poll on Children's Health online at http://www.med.umich.edu/mott/npch.

Methodology: For its report, the National Poll on Children's Health used data from a national online survey conducted in August 2008 in collaboration with Knowledge Networks, Inc. The survey was administered to a random sample of 2,245 adults, ages 18 and older, who are a part of Knowledge Network's online KnowledgePanel®. For this analysis, a subset of parents with children age 5-17 years was used (n=1,473). The sample was subsequently weighted to reflect U.S. population figures from the U.S. Census Bureau. About three-fourths of the sample included households with children. The margin of sampling error is plus or minus 2 to 11 percentage points, depending on the question.

To learn more about Knowledge Networks, visit http://www.knowledgenetworks.com.

Purpose/Funding: The C.S. Mott Children's Hospital National Poll on Children's Health funded by the Department of Pediatrics and Communicable Diseases and part of the CHEAR Unit at the U-M Health System is designed to measure major health care issues and trends for U.S. children.

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