Date of Defense:
Objective: To determine which factors influence unmet mental health needs of families who have children with special health care needs (CSHCN).
Methods: We analyzed data from the 2005-2006 National Survey of Children with Special Health Care Needs. Using Aday and Andersen’s model of health care access, we examined the impact of predisposing factors (family structure, race/ethnicity, age, maternal education), enabling factors (family income, health insurance, medical home), and need factors (condition severity, hours spent providing care, employment impact, financial impact) on unmet mental health needs of families who have CSHCN.
Results: 12.3% of families caring for special needs children indicated a need for mental health services and 19.4% of these families were not receiving the services they need. The odds of having unmet mental health needs were greatest among families with low incomes (OR=1.76), without insurance (OR=2.62), and without a medical home (OR=3.13). Caring for a child with a severe condition (OR=1.39), experiencing financial problems due to the child’s health (OR=2.47), and reducing work hours or quitting work due to the child’s health (OR=1.36) also increased the odds of having unmet needs for family mental health services.
Conclusion: The presence of a medical home, having public or private insurance and adequate financial resources are significant predictors of families receiving needed mental health care. Ensuring that all eligible families are enrolled in health insurance programs as well as having a medical home for their CSHCN may reduce the level of unmet family mental health needs.