Trends in US School-aged Children's Mental Health and Health Care, 2016-2021

To examine recent trends and patterns in school-aged children's mental health and health care-related measures.

Data came from the 2016 to 2021 National Survey of Children's Health (n = 155,178). Adjusted logistic regression models were used to test for significant time trends and between-group differences. Measures included mental, emotional, behavioral conditions (MEB; depression, anxiety, behavioral/conduct problems), positive indicators of mental/emotional well-being, and mental health care access/utilization.

In 2021, 20.4% of children aged 6 to 17 years (over 10 million) had at least 1 current MEB, up from 18.1% in 2016 (+13%; trend p < 0.001). Two-thirds (68.8%) of children with an MEB received treatment/counseling in the past year. Over half (53.6%) of children had difficulty getting mental health care, up from 44.0% in 2018 trend p < 0.001; 6.4% had unmet mental health care needs, up from 4.3% in 2016 (trend p = 0.01). Four of 5 positive indicators significantly decreased over time (range: -8% to -14%; trend p < 0.001). Across 2016 to 2021, access to mental health treatment was lower for publicly insured, uninsured, lower income, and racial/ethnic minority children.

An increasing burden of MEB conditions in children aged 6 to 17 years has been accompanied by stagnant rates of mental health treatment and increasing challenges in accessing services. Access to treatment varied across population subgroups, indicating gaps in access to prevention, diagnosis, and treatment.