Pediatric mental health problems and associated burden on families

Abstract

Approximately 20% of children in the United States have mental health problems. The factors associated with childhood mental health problems and the associated burdens on families are not well understood. Therefore, our goals were to profile mental health problems in children to identify disparities, and to quantify and identify correlates of family burden. We used the National Survey of Children's Health, 2003 (n = 85,116 children aged 3–17 years) for this analysis. The prevalence, unadjusted and adjusted odds ratios (AOR) of mental health problems and family burden were calculated for children by child-, family- and health systems-level characteristics. The prevalence of mental health problems among children aged 3–17 years was 18%. The odds of mental health problems were higher for boys, older children, children living in or near relative poverty, those covered by public insurance, children of mothers with fair or poor mental health, children living in homes without two parents, children without a personal doctor or nurse and children with unmet health care needs. Among families with children with mental health problems, 28% reported family burden. Correlates of family burden included white race, severity, older age, higher income, non-two-parent family structure and having a mother with mental health problems. In conclusion, childhood mental health problems are common, and disproportionally affect children with fewer family and health care resources. Families frequently report burden, especially if the mental health problem is moderate to severe, but the correlates of family burden are not the same correlates associated with mental health problems. Understanding those highest at risk for mental health problems and family burden will help assist clinicians and policy makers to ensure appropriate support systems for children and families.