National Clinician Scholars Program (TR Elliott and JG Elmore), Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles.
UCLA School of Nursing (KR Choi), Los Angeles, Calif; Department of Health Policy and Management (KR Choi and JG Elmore), Fielding School of Public Health, UCLA, Los Angeles, Calif.
Acad Pediatr. 2024 Aug;24(6):987-994. doi: 10.1016/j.acap.2024.01.024. Epub 2024 Feb 5.
Studies suggest increasing mental health care needs among children but limited capacity to meet those needs, potentially leaving some needs unmet. There are no recent national studies examining the receipt of mental health treatment among children. We sought to identify the correlates of treatment receipt in a nationally representative sample of children in the United States.
We conducted a cross-sectional analysis of the 2019 National Health Interview Survey. Parents reported on their child's sociodemographic characteristics, general health care engagement, mental health using the Strengths and Difficulties Questionnaire, and whether their child received therapy or medication in the prior year. Weighted logistic regressions tested associations among child characteristics and receipt of mental health treatment while controlling for parental report of child mental health symptoms.
Among 7168 children surveyed, 1044 (15%) received mental health treatment, equating to over 7 million US children. Hispanic children (adjusted odds ratio [AOR]: 0.46 [95% confidence interval (CI): 0.34-0.62]) and non-Hispanic Black children (AOR: 0.35 [95% CI: 0.23-0.54]) had lower odds of receiving treatment compared to non-Hispanic White children, controlling for mental health symptoms. Children with a well-child visit in the last year (AOR: 2.05 [95% CI: 1.20-3.52]) and whose usual place of care was a doctor's office (AOR 2.10 [95% CI: 1.33-3.34]) had higher odds of treatment receipt.
Racially and ethnically minoritized children and those without primary care access have disproportionately low levels of receipt of mental health treatment. Interventions to meet the needs of these groups should be prioritized to reduce mental health disparities.
研究表明，儿童的心理健康照护需求不断增加，但满足这些需求的能力有限，这可能导致一些需求未得到满足。目前尚无近期的全国性研究调查美国儿童接受心理健康治疗的情况。我们旨在确定具有代表性的美国儿童样本中治疗接受情况的相关因素。
我们对 2019 年全国健康访谈调查进行了横断面分析。父母报告了他们孩子的社会人口统计学特征、一般医疗保健参与度、使用长处和困难问卷评估的心理健康状况，以及他们的孩子在过去一年中是否接受过治疗或药物治疗。加权逻辑回归检验了儿童特征与接受心理健康治疗之间的关联，同时控制了父母对儿童心理健康症状的报告。
在接受调查的 7168 名儿童中，有 1044 名（15%）接受了心理健康治疗，相当于美国有超过 700 万名儿童。与非西班牙裔白人儿童相比，西班牙裔儿童（调整后的优势比 [AOR]：0.46 [95%置信区间 [CI]：0.34-0.62]）和非西班牙裔黑人儿童（AOR：0.35 [95% CI：0.23-0.54]）接受治疗的可能性较低，同时控制了心理健康症状。在过去一年中接受过常规儿童保健检查的儿童（AOR：2.05 [95% CI：1.20-3.52]）和常规医疗场所为医生办公室的儿童（AOR：2.10 [95% CI：1.33-3.34]）接受治疗的可能性更高。
少数族裔儿童和缺乏初级保健的儿童接受心理健康治疗的比例过低。应优先考虑干预措施，以满足这些群体的需求，从而减少心理健康方面的差异。
