Child/Adolescent Health

Mental health problems among children with special health care needs and their caregivers are barriers to care

About 11 to 14 percent of children with special health care needs (CSHCN) have unmet care needs during a given year. The mental health problems of CSHCN and their caregivers appear to be barriers to obtaining care, according to a study supported in part by the Agency for Healthcare Research and Quality (HS10912). To adequately address the health care needs of these children, policy must address their and their caregivers' mental health problems, conclude Darrell J. Gaskin, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, and Jean M. Mitchell, Ph.D., of Georgetown Public Policy Institute.

In a survey of a random sample of 1,088 caregivers of CSHCN who resided in the District of Columbia in 2002, the researchers asked about children's unmet needs, mental health status, and their caregivers' mental health status. They estimated the relationship between mental health status and unmet needs.

Caregivers with symptoms of depression were 26.3 percent more likely to report an unmet need for CSHCN, 67.6 percent more likely to report an unmet hospital and physician need, 66.1 percent more likely to report an unmet mental health care need, and 38.8 percent more likely to report an unmet need for other health care services. Also, caregivers of children with poor psychological adjustment were 26.3 percent more likely to report their child had an unmet need and 92.3 percent more likely to report an unmet mental health care need. Most of the children were black and urban, so findings may differ for children of other races and those residing in rural areas.

See "Health status and access to care for children with special health care needs," by Drs. Gaskin and Mitchell, in the March 2005 Journal of Mental Health Policy and Economics 8, pp. 29-35.

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