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PEDIATRIC MENTAL HEALTH PROBLEMS AND ASSOCIATED BURDEN ON FAMILIES
Amy J Houtrow1, Megumi J Okumura
1Department of Pediatrics, University of California at San Francisco.
Insights
Childhood mental health issues are common, affecting 18% of U.S. children. Disparities exist, with vulnerable children facing higher risks and their families reporting significant burden.
Area of Science:
- Pediatric mental health
- Public health
- Family studies
Background:
- Childhood mental health problems affect approximately 20% of U.S. children.
- Factors and family burdens associated with these conditions are not well understood.
Purpose of the Study:
- To profile mental health problems in children and identify disparities.
- To quantify and identify correlates of family burden.
Main Methods:
- Analysis of the National Survey of Children's Health, 2003 (N=85,116 children aged 3-17 years).
- Calculation of prevalence and odds ratios for mental health problems and family burden by child, family, and health system characteristics.
Main Results:
- 18% of children aged 3-17 years had mental health problems.
- Higher odds of mental health problems were associated with being male, older age, poverty, public insurance, maternal mental health, non-two-parent households, lack of a personal doctor, and unmet health needs.
- 28% of families with children experiencing mental health problems reported family burden, with correlates including race, severity, age, income, family structure, and maternal mental health.
Conclusions:
- Childhood mental health problems are prevalent and disproportionately impact children with fewer resources.
- Family burden is common, particularly with moderate to severe conditions, but its correlates differ from those of the mental health problems themselves.
- Identifying at-risk populations is crucial for developing targeted support systems for children and families.
Abstract:
Approximately 20% of children in the United States have mental health problems. The factors associated with childhood mental health problems and the associated burdens on families are not well understood. Therefore, our goals were to profile mental health problems in children to identify disparities, and to quantify and identify correlates of family burden. We used the National Survey of Children's Health, 2003 (N=85,116 children aged 3-17 years) for this analysis. The prevalence, unadjusted and adjusted odds ratios of mental health problems and family burden were calculated for children by child-, family- and health systems- level characteristics. The prevalence of mental health problems among children aged 3-17 years was 18%. The odds of mental health problems were higher for boys, older children, children living in or near relative poverty, those covered by public insurance, children of mothers with fair or poor mental health, children living in homes without two parents, children without a personal doctor or nurse, and children with unmet health care needs. Among families with children with mental health problems, 28% reported family burden. Correlates of family burden included White race, severity, older age, higher income, non-two parent family structure, and having a mother with mental health problems. In conclusion, childhood mental health problems are common and disproportionally affect children with fewer family and health care resources. Families frequently report burden, especially if the mental health problem is moderate to severe, but the correlates of family burden are not the same correlates associated with mental health problems. Understanding those highest at risk for mental health problems and family burden will help assist clinicians and policy makers to ensure appropriate support systems for children and families.
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