title: Unmet mental health need and access to services for children with special health care needs and their families.
abstract: OBJECTIVE
  Studies suggest that children with disabilities or serious health conditions are vulnerable to mental health problems due to adjustment and limitation problems. The aim of this study was to examine rates and predictors of unmet mental health need among children with special health care needs (CSHCN) and their family members and to determine if race/ethnicity and language are associated with unmet need for the child and family members who have a mental health need attributed to the child's special needs.
  
  
  METHODS
  Data are from the 2001 National Survey of Children with Special Health Care Needs, a nationally representative sample of CSHCN.
  
  
  RESULTS
  Rates of unmet need were higher for CSHCN and family members of CSHCN with a chronic emotional, behavioral, or developmental problem (EBDP) compared to CSHCN with a mental health need but not a chronic EBDP. In multivariate analysis controlling for condition impact and demographics, among CSHCN with a chronic EBDP, African-American children had greater odds of unmet need (OR 1.60, 95% CI, 1.12-2.28), and family members of Hispanic children with a Spanish language parent interview had greater odds of unmet need compared to others (OR 4.48, 95% CI, 1.72-11.63). Lacking a personal doctor or nurse was associated with higher odds of unmet need for CSHCN with and without a chronic EBDP.
  
  
  CONCLUSIONS
  Parents reported prevalent mental health needs of CSHCN as well as family members. Given the importance of family members to the care of CSHCN, research on racial/ethnic disparities in access to perceived needs should focus on children and their family members.
authors.affiliation: Department of Health Services, School of Public Health, University of California, Los Angeles, UCLA Center for Healthier Children, Families, and Communities, Los Angeles, CA 90024, USA. minkelas@ucla.edu
authors.forename: Moira
authors.initials: M
authors.lastname: Inkelas
authors.forename: Ramesh
authors.initials: R
authors.lastname: Raghavan
authors.forename: Kandyce
authors.initials: K
authors.lastname: Larson
authors.forename: Alice A
authors.initials: AA
authors.lastname: Kuo
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Ortega
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005192:Family Health; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008913:Minority Groups / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D012959:Socioeconomic Factors