Alyssa Burnett, MPH, PMP, highlights treatment gap in child mental health

Recent national data indicate a substantial rise in child mental health conditions and persistent gaps in treatment access, according to Alyssa Burnett, MPH, PMP, project manager at the Harvard Pilgrim Health Care Institute.

In recent years, multiple surveys and trend analyses have shown that diagnosed child mental health conditions increased by approximately 35% between 2016 and 2023. Despite this rise, access to care has not kept pace. In 2023, a separate national data set found that among adolescents aged 12 to 17 years who experienced a major depressive episode, 40% did not receive treatment.

To better understand household-level experiences, Burnett and colleagues analyzed 2023-2024 data from the US Census Bureau’s Household Pulse Survey. The study focused on parent-reported perceptions of children’s mental health treatment needs, whether those needs were met, and whether families encountered difficulty accessing care.

Using survey-weighted national estimates, the researchers found that approximately 20% of US households with children reported that at least 1 child had a mental health treatment need. Among those households, approximately 25% reported an unmet need, meaning the child did not receive the services needed.

The analysis also examined characteristics associated with unmet need or difficulty accessing care. Family structure emerged as a significant factor. Households with more than 1 child were more likely to report unmet mental health treatment needs. Single-parent households were more likely to report that a child did not receive care because of difficulty accessing services. These findings suggest that caregiving demands and limited household resources may influence treatment access.

Insurance type was another important variable. Parents with private insurance were the least likely to report that their child had a mental health treatment need. However, among parents who reported that a child did not receive care because of difficulty, similar proportions were observed among families covered by Medicaid and those who were uninsured. This raises questions about whether public insurance coverage alone is sufficient to ensure timely access to pediatric mental health services.

Schooling type was also associated with unmet need. Higher rates of unmet mental health treatment needs were reported among households in which all children attended public school or were homeschooled, compared with those attending private school. Because schools are often key settings for identifying and addressing mental health concerns, these differences highlight the role educational environments may play in connecting children to care.

Burnett emphasized that the study’s cross-sectional and self-reported design limits causal interpretation. She called for larger, more diverse data sets and further research to better understand specific barriers contributing to unmet need and to inform targeted strategies that can improve access to mental health care for children and adolescents.

No relevant disclosures.

Reference

Burnett AL, Breslau J, Cantor JH, et al. US child mental health care need, unmet needs, and difficulty accessing services. JAMA Pediatr. Published online February 16, 2026. doi:10.1001/jamapediatrics.2025.6162