Improving Access to Children’s Mental Health Care

Learn how CDC works to identify policies and practices that connect more families to mental health care

Access to mental health care is important when children have difficulty with emotions or behavior. It can be challenging for some families to get mental health care for their children. Nearly 1 in 5 children have a mental, emotional, or behavioral disorder1, such as anxiety or depressionattention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), disruptive behavior disorder, or Tourette syndrome. Children with these disorders benefit from early diagnosis and treatment.

Unfortunately, only about 20% of children with mental, emotional, or behavioral disorders receive care from a specialized mental health care provider2. In addition, many children with other types of developmental and learning disorders may also have difficulty with emotions or behavior and need treatment.

Some families cannot find mental health care because of the lack of providers in their area. Some families may have to travel long distances or be placed on long waiting lists to receive care. High costs, lack of insurance coverage, and the time and effort involved make it harder for parents to get mental health care for their child.

What CDC is doing to improve access to mental health care for children

CDC is committed to helping children and families get the mental health care they need. There are many ways to improve access to mental health care, and CDC has many activities around improving lifelong mental health. This page provides an overview of examples, but is not a complete description of CDC’s work on children’s mental health. Some of the ways CDC is working to improve access to mental health care for children include the following:

  • Improving strategies to connect families to mental health care
  • Understanding gaps in the mental health workforce serving children
  • Investigating how funding policies affect mental health care
  • Understanding social determinants of health that make it harder for some families to get access to mental health care

Improving strategies to connect families to mental health care

One of the barriers to obtaining mental health care that families face is not being able to connect to mental health care providers. Policies that address this barrier may be one way to improve access.

  • Behavioral Health Integration (BHI) is one approach that can improve access to mental health services for children and their families. A CDC-sponsored report on BHI published by the Milbank Memorial Fundexternal icon showed that partnerships between primary medical care practices and mental health care specialists can make mental health services more accessible for some families.
  • CDC conducted a systematic review of policy leversexternal icon affecting children’s mental health care access that showed that policies that allow mental health care to be located in primary medical care and in schools can help improve access.
  • CDC developed a policy report that presents promising practices for delivering mental health care in rural areas, including telemedicine, school-based health centers, and integrating behavioral health in primary care.
  • CDC sponsored a report on Integrated Family Careexternal icon that examined five service providers’ successes and challenges with implementing the Integrated Family Care model by expanding care focused on the child alone to meet the emerging physical health, mental health, and social service needs of families with young children.
  • CDC reviewed the research evidence to understand how couple‐ and family‐based psychosocial interventionsexternal icon can be used to promote infant and early childhood mental health.
  • CDC supported a telemental health workshop by The National Academies of Sciences, Engineering, and Medicineexternal icon to discuss how telemental health services could be a critical tool for improving mental health care access for children during and after the pandemic, and to examine limitations.

Addressing gaps in the workforce

  • CDC funds the National Resource Center on ADHDexternal icon and the Tourette Association of Americaexternal icon to increase the capacity of healthcare providers and educators to support the health, mental health, and education of children with ADHD and/or Tourette syndrome and associated conditions, and help individuals find the best health services and educational supports to improve their health and well-being.
  • CDC is partnering with the American Academy of Pediatrics (AAP) to create educational modules for pediatricians and other health care providers. These modules will be available for free as an AAP PediaLinkexternal icon. This education will provide training on best practices in health care for children and adolescents with specific disorders like Tourette syndrome and fragile X syndrome.
  • CDC and partner organizations examined whether U.S. emergency departments (EDs) have policies in place to care for children with mental health and social concerns and found that less than half of EDs had such a policy, identifying gaps that could improve access if filled.
  • Using data on behavioral health service providers from around the nation, CDC created state maps showing the availability of providers who can assess, refer, or treat children’s mental health concerns in 2015. View state maps showing the number of U.S. behavioral health providers per 10,000 children by county in 2015.
  • CDC is currently characterizing differences in the rules that states have about licensure and credentialing for child mental health service providers (social workers, marriage and family therapists, and licensed professional counselors) to identify laws and policies that could affect the mental health workforce.

Investigating how funding issues affect mental health care

Children in rural areas

Understanding how social determinants of health affect mental health care

Social determinants of health are conditions in the places where children live, learn, and play that affect a wide range of health and developmental outcomes.

Identifying children who need more support

  • CDC and other federal partners collect data to understand children’s mental health and to identify how many children are diagnosed with different disorders. A comprehensive children’s mental health report using data from 9 different sources to describe mental health, mental disorders, and mental health treatment in children during 2013–2019 showed that poor mental health among children continues to be a substantial public health concern. CDC funded the development of an Opening Playbookexternal icon for state, tribal, and local health departments that shows ways to use available data to improve child and adolescent mental health. The playbook shows how three indicators that schools generally have available or can make available, specifically attendance, disciplinary actions, and school readiness, can be used to begin assessing children’s mental health at the population level.

Addressing concerns early and supporting well-being of families

In addition to increasing access to mental health care for children, CDC works to improve healthy child development, and to increase emotional, psychological, and social well-being. Mental health is also an aspect of the Whole School, Whole Community, Whole Child (WSCC) approach. CDC supports adolescent and school mental health efforts such as the following:

Mother and father lifting their happy child into the air

CDC also provides families with tools that help them identify concerns about children’s emotions and behavior early and learn strategies to support their children.

  • CDC and partners funded the National Academies of Sciences, Engineering, and Medicine Forum for Children’s Well-Beingexternal icon to inform a forward-looking agenda for building a stronger research and practice base around the development and implementation of programs, practices, and policies to promote all children’s mental, emotional, and behavioral health and prevent mental disorders.
  • CDC funded the National Academies of Sciences, Engineering, and Medicine to develop a suite of microlearning, graphic novel style toolsexternal icon based on cognitive behavioral therapy techniques—available in both English and Spanish—to promote coping and resilience and help children and youth manage feelings of stress, anxiety, and sadness.
  • CDC developed the Milestone Tracker App to help parents track their child’s developmental milestones from age 2 months to 5 years, get tips from CDC for encouraging their child’s development, and find out what to do if they are ever concerned about how their child is developing.
  • CDC funded the Association of University Centers on Disabilities to pilot 12 Children’s Mental Health Champions (CMHC) in 10 states and 1 territory. The Champions work to implement effective strategies for mental health promotion, prevention supports, and the creation of networks (e.g., school, health care, and community) to promote better connections between these systems.

Resources

Journal Articles

 Reports

Other Resources

More Information

References

  1. National Research Council and Institute of Medicine. (2009). Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. O’Connell, T. Boat, & K. E. Warner Eds. Washington, DC. The National Academic Press.
  2. Martini R, Hilt R, Marx L, et al.; for the American Academy of Child and Adolescent Psychiatry. Best principles for integration of child psychiatry into the pediatric health home. pdf iconpdf icon[217 KB, 13 pages]external icon