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Rutgers study: Disparities in mental health treatment for children

Mental health treatment and counseling services are disproportionately received according to racial and socioeconomic factors, finds Rutgers University-Camden research study

Journal Staff Report | 2/13/2017, 9:52 a.m.
As Wenhua Lu explains, most studies on mental health care disparities have typically focused on either adult populations or youths ...

CAMDEN – As Wenhua Lu explains, most studies on mental health care disparities have typically focused on either adult populations or youths only, leaving children younger than six years under-investigated.

“Accumulating evidence shows that mental health issues are quite prevalent in preschool children,” says Lu, an assistant professor of childhood studies at Rutgers University–Camden.

In an alarming new research study, Lu finds that, despite mental health issues universally affecting this vulnerable population, those actually receiving treatment or counseling are disproportionately based on a range of racial and socioeconomic factors.

In the forthcoming study, to be published in the May 2017 issue of the Journal of Health Care for the Poor and Underserved, Lu analyzed national data for parents of children ages 2 to 27 – a total of 85,637 – and found that 7,819 children needed mental health care, but only 61 percent actually received treatment or counseling. Just as importantly, she discovered that children who are Caucasian, ages 5 to 17, and with public insurance, had higher probabilities of receiving health care than Hispanics and Blacks, and children ages 2 to 5.

“Mental health problems know no boundaries and can affect every child, but the strain is acute for youth and those from low-income and minority families,” says Lu, a Brooklyn resident.

According to the Rutgers–Camden researcher, there is an interplay of factors at different socioecological levels that can lead to the discrepancy between children’s mental health needs and actual service use, including stigma and shame at the child level; negative peer influence at the interpersonal level; unawareness, low mental health literacy, and inaccurate perceived severity of children’s problems at the parent level; poor family communication and functioning at the family level; low access to health care and negative living conditions at the community level; and service fragmentation at the health care system level.

“With regard to ethnic minority families, factors such as cultural mistrust of mental health professionals and cultural differences in perceived treatment benefits can further prevent children and their parents from seeking professional help,” says Lu.

The childhood studies expert cautions that untreated mental health problems can have lifelong health consequences on children’s health and well-being, leading to children with mental health problems to have an increased risk for developing chronic physical disorders, such as diabetes, or other comorbid mental disorders.

In addition, Lu explains, for some children, mental health problems can result in school failure, violence, sexual risk behaviors, substance use, and even juvenile and criminal justice involvement.

“Most seriously, mental health problems can lead to suicide, which is the second leading cause of death in youth ages 10 to 19,” she says. “If left untreated, childhood mental disorders often persist into adulthood and can insure higher health care costs.”

Lu maintains that ongoing empirical research is needed to further clarify the mechanisms underlying the vast discrepancy between children’s mental health needs and actual service use. At the community level, particularly in low-income minority communities, she notes, psychoeducational campaigns are warranted to improve parents’ mental health literacy, awareness of child mental health problems, ability to communicate with children, and competency to seek appropriate professional help.

At the school level, she says, more educational efforts are needed to increase children’s understanding of mental health problems and improve their ability to seek help.

Furthermore, she notes, although children covered by public insurance are more likely to use mental health services, continued efforts are needed to increase parents’ awareness of such programs and make sure eligible children are enrolled.

Lu is currently working on a follow-up study to investigate facilitators and barriers to seeking professional help among minority children with mental health problems.

“Considering the unique physical, social, and policy environment minority youth may face in the U.S., such empirical evidence will be valuable to inform future culturally tailored interventions for these underserved populations,” she says.