State-Level Variation in Racial-Ethnic Disparities in Access to Children's Mental Health Care.

Area of Science:

• Child and Adolescent Psychiatry
• Health Services Research
• Health Equity

Background:

• Mental health treatment disparities are well-documented in children and adolescents.
• Understanding state-level variations in these disparities is crucial for targeted interventions.

Purpose of the Study:

• To examine state-specific disparities in unmet mental health needs among Black and Hispanic children compared to White children.
• To assess variations in difficulty accessing mental health care across U.S. states for these demographic groups.

Main Methods:

• Retrospective cross-sectional study using pooled National Survey of Children's Health data (2016-2019).
• Logistic regression with complex survey weights to analyze disparities in unmet needs and care access.
• State-level adjusted estimates for Black (vs. White) and Hispanic (vs. White) children.

Main Results:

• Significant disparities in unmet mental health needs were found in four states for Black children.
• Four states showed disparities in care access favoring Black children.
• Hispanic children had fewer unmet needs in seven states but more in one; care access disparities varied by state.

Conclusions:

• National averages obscure significant state-level variations in children's mental health disparities.
• Further state-level policy and systems analysis is needed to address structural drivers of these disparities.
• Targeted, state-specific strategies are essential to improve mental health care equity for diverse youth.