CORRELATES OF UNMET NEED FOR MENTAL-HEALTH-SERVICES BY CHILDREN AND ADOLESCENTS

Background. Little is known about the extent and correlates of unmet n eed for mental health services in community samples of children and ad olescents. Methods. Data were obtained from the 1285 parent/youth pair s interviewed at four sites in the USA and Puerto Rico in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) S tudy. Unmet need was defined to exist if psychopathology and associate d functional impairment were present but no mental health services had been received in the previous 6 months. Results. Of the total sample, 17.1 % had unmet need. Adjusting for demographic variables, logistic regression analyses revealed that unmet need was significantly associa ted with: indicators of economic disadvantage, such as being on public assistance and not being covered by health insurance; opinions of the parents and children or adolescents that the latter had poor mental h ealth; parental psychopathology; poor school grades; and parent-report ed access barriers such as concern that the child would want to solve the problem unassisted, would refuse to attend mental health services, or would be hospitalized or taken away against the parent's will. No youth-reported access barriers were significantly associated with unme t need. Conclusions. The economic correlates of unmet need may attain increased importance in the light of current reform in health care fin ancing in the USA. Access may be facilitated by increasing parental kn owledge of mental health services and enabling children and adolescent s to initiate contact with services independently of their families.