State Differences in Children's Mental Health Care

Area of Science:

• Child and Adolescent Health
• Health Services Research
• Mental Healthcare Access

Background:

• Access to mental healthcare for children is a critical public health issue.
• Significant variations in unmet need and access difficulties exist across the United States.
• Understanding these disparities is crucial for targeted interventions.

Purpose of the Study:

• To estimate and compare state-specific probabilities of unmet need for child mental health care.
• To assess and compare state-specific difficulties in accessing child mental health care.
• To analyze these probabilities across racial/ethnic, income, and insurance subgroups.

Main Methods:

• Retrospective, cross-sectional study design using pooled 2016-2019 National Survey of Children's Health data.
• Logistic regression models with marginal post-estimation to generate adjusted probabilities.
• Analysis of national, state, and subgroup estimates for unmet need and access difficulties.

Main Results:

• National adjusted probabilities: 21% unmet need, 46% difficulty accessing care.
• State probabilities for unmet need ranged from 8% to 32%, with significant variations.
• State probabilities for access difficulty ranged from 28% to 57%, with geographic inequities often larger than sociodemographic ones.

Conclusions:

• Persistent geographic inequities in children's mental health care access exist.
• State-level disparities in access are more pronounced than variations across sociodemographic groups.
• Addressing these geographic disparities is essential for improving child mental health outcomes nationwide.