Characteristics of fifth-grade students who self-identify a need for mental health care

Children can reliably identify their mental health needs, yet research on characteristics of children who self-identify a need for care is limited. This study examined demographic, mental health, and protective factors associated with fifth-grade students' self-identification of mental health care need, using data from the 2024-2025 California Healthy Kids Survey (N = 19,132 students).

Multivariable logistic regression models with restricted cubic splines were used to examine nonlinear associations between self-identified need for care and negative emotions, victimization experiences, and parental involvement.

A need for mental health care was self-identified by 39% of study participants. Females were more likely and Asian/Pacific Islander youth were less likely than their peers to self-identify a need for care. Unadjusted and adjusted odds of self-identifying a need increased significantly with increasing frequency of negative emotions. The adjusted association with victimization was non-linear, with participants with moderate and high levels most likely to identify a need for care. The adjusted association with parent involvement in school was weakly negative.

Future research should evaluate whether a brief question assessing need can serve as a valid and reliable initial indicator to identify children who may benefit from further screening and support.