Background. Little is known about the extent and correlates
of unmet need for mental health
services in community samples of children and adolescents.
Methods. Data were obtained from the 1285 parent/youth
pairs interviewed at four sites in the USA
and Puerto Rico in the Methods for the Epidemiology of Child and
Adolescent Mental Disorders
(MECA) Study. Unmet need was defined to exist if psychopathology and
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
associated 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 health;
parental psychopathology; poor school grades; and parent-reported 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 unmet need.
Conclusions. The economic correlates of unmet need may attain
increased importance in the light
of current reform in health care financing in the USA. Access may be
facilitated by increasing
parental knowledge of mental health services and enabling children and
adolescents to initiate
contact with services independently of their families.