Pediatric Mental Health Needs, Unmet Care, and Disaster-Related Displacement

Extreme weather disasters leave behind long-lasting mental and physical health problems. Displacement related to climate change disproportionately impacts children, whose developmental stage leaves them particularly at risk to its devastating effects.

To compare pediatric mental health needs and care for those in need between displaced households and other households.

This repeated cross-sectional analysis with multivariable logistic regression models used data from the US Census Household Pulse Survey, a nationally representative dataset, from June 1, 2023, through September 31, 2024. The study included biweekly, individual-level data reported by individual adults for all members of their household.

Experience of displacement in the past year due to a natural disaster.

Mental health needs were defined based on response to a question asking whether any children in the household needed mental health treatment, such as counseling or medication, in the past 4 weeks. Then the likelihood of receiving mental health treatment was examined for those who reported mental health needs.

Of the 324 466 households with children identified during the study period, 277 081 respondents (mean [SD) age, 42.7 [0.05) years; 162 288 [58.6%] female) were included in the analytic sample. This sample represents approximately 35 million US households with children. Among households with children, those that experienced displacement due to natural disaster had a significantly higher chance of reporting that the children needed mental health counseling or medication (odds ratio, 1.29; 95% CI, 1.12-1.48; P < .001). Among households with reported pediatric mental health needs, displaced households were more likely to report inadequate or no treatment, even after controlling for socioeconomic hardships (odds ratio, 0.55; 95% CI, 0.38-0.66; P < .001).

The cross-sectional study found that displaced children experience more unmet mental health needs after natural disasters compared with nondisplaced children, which may negatively impact their long-term development. As climate change progresses, targeted research is urgently needed to understand how best to meet these needs.