The researchers analyzed data from the 2016 National Child Health Study, a nationwide study administered to parents of children and teenagers. Of the 46.6 million children aged 6 to 18, whose parents conducted the study, 7.7 million had at least one mental health condition – such as depression, anxiety or attention deficit / hyperactivity disorder – and only half received treatment or counseling from a mental health provider in the 12 months prior to the study.
The number of children with a mental health condition varied greatly from state to state. For example, in Hawaii, 7.6% of the children had one of the conditions compared to 27.2% in Maine. The number of children with diagnosed mental health who were not treated by a provider also varied greatly from 29.5% in Washington, DC, to 72.2% in North Carolina.
Mark Peterson, associate professor at the University of Michigan Medicine and senior author of the study, has a long history of studying childhood health conditions and resulting in disability later in life.
"Historically, I have studied everything from the neck down," he said. Peterson said he has recently taken a step back to thinking about issues that affect children from an early age in a more comprehensive way. which led him to study mental health. He did not expect to find such high numbers.
But children and young psychiatrists and psychologists were not at all surprised at the results.
"Unfortunately, it's not news for us," said Dr. Barbara Robles-Ramamurthy, child and adolescent psychiatrist at the Long School of Medicine at UT Health San Antonio, who was not involved in the study.
"We have known that the number of children who have mental illness and who are not treated is very high," she added.
There are a number of difficulties and challenges for children and their families in accessing mental health services, explained Jennifer Mautone, psychologist at the Department of Child and Adolescent Psychiatry and Behavioral Sciences at the Children's Hospital of Philadelphia.
Families are concerned about stigma and coverage
Within some families and communities, mental illness is still seen in a negative light, Robles-Ramamurthy explained.
"We have just started working properly on stigmatizing mental illness over the last few decades," she said. As a result, families and young people do not often feel good at accessing mental health services, Mautone added.
The next big problem is insurance coverage, Robles-Ramamurthy said.
"There is great variability in what is covered, how much is covered, and people are concerned. Mental treatment is usually not a type every month," Robles-Ramamurthy says. "For families struggling to make ends meet, spending can pose a real challenge."
Even in states with appropriate provisions for families seeking psychiatric treatment, there may not be enough qualified providers.
There is a serious shortage of mental health providers
This means that many families face long waiting times, which in turn can lead to worsening of the underlying mental condition of the child and possibly the need for more treatment sessions than if the condition had been treated in its early stages, Mautone explained.
The available qualified providers face another challenge: Communicating with other systems that nurture children.
There are many systems in this country designed to care for children, explained Robles-Ramamurthy, including the education system, healthcare, juvenile justice system and child protection system.
"All of these systems that need to care for children often do not talk to each other," Robles-Ramamurthy said. "Many times, the children fall through the cracks, and the families do not get the necessary support they need," she added.
The way forward
In an effort to provide immediate mental health services for children, many children's health systems have been integrated into child care agencies.
By embedding with pediatricians, psychiatric providers build on the existing trust and are able to reach families in a familiar environment, said Mautone, who runs such a program – Healthy Minds, Healthy Kids Initiative at Children's Hospital of Philadelphia. .
"We are easily accessible, many times the same day, to explain our service, meet the family, and begin to understand what the challenges are," she added.
The program has earned more than 2,500 patients over the past two years and continues to expand. Robles-Ramamurthy sees this as a sign of progress, but says there's much more to do.
"Untreated childhood mental illness has serious implications for our society, including high levels of suicide, academic decline and unemployment," she said.