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50% of at-risk youth not receiving needed mental health services


Researchers at the University of New Hampshire (UNH) found that more than 50% of at-risk children in the United States are not receiving the behavioral and mental health services that could improve their developmental outcomes. 

The national cross-section of 11,896 young children and teens found that the group receiving the least number of services was young Black children with significantly lower levels of clinical contact compared with non-Hispanic white children. 

David Finkelhor, professor of sociology and director of UNH’s Crimes against Children Research Center said other studies have had similar findings, but this data is more updated . He said he expected the result in comparison to previous studies on the topic. The research was supported by grants from the Office of Juvenile Justice and Delinquency Prevention at the U.S. Department of Justice. 

This research is unique because the crime surveys that are conducted by the U.S. government don’t include any victimizations of persons under the age of 12. They also don’t cover some  kinds of victimization that are most common for children like bullying, abuse by family members and sexual abuse that doesn’t involve violent rape.  

To conduct the research, they interviewed children aged 10 and older, and interviewed the parents of the children if they were below the age of 10. They looked at children with high levels of adverse childhood experiences (ACEs), and or high distress symptoms. They also observed children with symptoms like depression, anxiety, anger, post-traumatic stress and dissociation.   

The untreated portion of high-risk juveniles ranged between 41% to 63%. Among those aged two to nine years old, no clinical services were reported for 57% of the group with high ACEs, and 53% of the group with high distress symptoms. Among those aged 10 to 17 years, the no clinical contact group comprised of 63% of the adolescents with high ACEs and 52% of those with high distress symptoms. 

Finkelhor said a lot of people in the field are very frustrated and frequently comment on the lack of services for children. He said there’s an insufficient supply of people who are providing the services and there are long waits in many parts of the country for kids to be seen. 

He explained that reimbursement rates are low so there aren’t enough people coming into the field. Additionally, he said some of the people working particularly in large community mental health agencies aren’t that well trained. He added that some of the most up-to-date techniques and modalities are not in use yet and there is the problem that it is very difficult to get an immediate appointment so a lot of people give up on it. 

There’s been a lot of research in recent years showing that high numbers of childhood adversities are strongly associated with poor mental and physical health, according to Finkelhor. He said there has been a big effort to try and find the kids who are experiencing these high burdens, called toxic stress, and try to help them have better coping skills and reduce the number of adversities they’re encountering. This added support is also generally seen as one of the big ways of reducing health care costs in the long run. 

Finkelhor also believes schools can play a large part in helping students overcome mental health adversities, by putting more behavioral health services in the schools. 

Finkelhor explained that there also might be some reduction in stigma because children could be getting help from somebody they’ve seen around the school. “That can make a big difference,” he said. “The other thing that schools can do is they can do a better job of proactively screening kids for problems and the treatment. So, sometimes the kids are not doing well in school because they’re dealing with trauma of some sort.”  

Finkelhor lamented that schools are already juggling many tasks  and finding the resources in the school day and in the budget for those kinds of programs  can be difficult. But ideally, he would like to see a more comprehensive curriculum that covers important life skills and self-protection to reduce the number of adversities and give kids better coping skills. He believes this would probably lead to less need for mental health and behavioral health treatment.  

According to Finkelhor, children are a disadvantaged segment of the population that have not always been well cared for. He said the level of child poverty has remained high and society has been slow to address some of the problems that they can suffer from. Suffered in disproportionate numbers, problems like these are “treated like ‘wow, you know, that’s just what childhood is about.’ Or, abusive parents, ‘well, you know, some kids just get tough love,’” he explained. “But I think attitudes about that are changing.” 

Photo courtesy of UNH Today.

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