Racial and Ethnic Disparities in Receipt of Pediatric Mental Healthcare.

BACKGROUND: Studies suggest increasing mental healthcare needs among children but limited capacity to meet those needs, potentially leaving some needs unmet. There are no recent national studies examining 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.

METHODS: We conducted a cross-sectional analysis of the 2019 National Health Interview Survey Parents reported on their child's sociodemographic characteristics, general healthcare 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.

RESULTS: Among 7,168 children surveyed, 1,044 (15%) received mental health treatment, equating to over 7 million U.S. 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.

CONCLUSION: 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.

WHAT'S NEW: In this nationally representative sample, 15% of U.S. children received treatment for a mental health concern, equating to over 7 million U.S. children. Racially and ethnically minoritized children and those without consistent primary care had disproportionate levels of non-receipt.