High-income countries fail to provide adequate mental health services for children


One in eight children suffers from mental disorders that cause symptoms and disabilities and therefore require treatment, but even in high-income countries, most of these children will not have access to services to treat them, a published study reports in the review Evidence-Based Mental Health.

Mental disorders that begin in childhood and adolescence can significantly affect well-being and development.

Despite the social and economic implications of not addressing these disorders, including the costs of long-term health care, the costs of the justice system, and the loss of human potential, the provision of mental health services for children lags behind in service delivery for physical health issues, even in income-producing countries.

To better understand the burden of mental disorders in children and their treatment, the authors analyzed data from 14 studies in 11 countries published between 2003 and 2020. The countries were the United States (four studies) and Australia, the Canada, Chile, Denmark. , Great Britain, Israel, Lithuania, Norway, South Korea and Taiwan (one study each).

The studies included 61,545 children aged 18 or younger and the analysis showed that the overall prevalence of mental disorders in children was 12.7%.

The most common mental disorders were anxiety (5.2%), attention deficit hyperactivity disorder (ADHD) (3.7%), oppositional defiant disorder (eg, argumentative behavior) ( 3.3%), substance use disorders (eg problematic alcohol or cannabis use). ) (2.3%), conduct disorder (1.3%) and depression (1.3%).

“Regarding, only 44.2% of children with mental disorders received services for these conditions,” say the authors. “In contrast, strong services are in place for children’s physical health issues such as cancer, diabetes and infectious diseases in most of these countries.”

These shortages also exist despite extensive research evidence on effective interventions to prevent and treat childhood mental disorders.

They say their findings have shed light on “an invisible crisis in children’s mental health.” “We have portrayed a high prevalence of mental disorders in children coupled with unacceptable service deficits in high-income countries – to a degree that violates children’s rights.”

High-income countries can “afford to do better,” they add. “Many countries will need to dramatically increase budgets for children’s mental health.” They noted: “This is particularly urgent given the documented increase in children’s mental health needs since COVID-19 – needs that are expected to continue.”

The authors note several limitations in their article, in particular variations in the methods used in the included studies, including their diagnostic approaches and how they assessed service use. Nonetheless, all studies reported data on children who presented not only symptoms but also impairment due to their mental disorder, highlighting the need for treatment.

“We believe that our review can provide policymakers with a better understanding of the mental health needs of children in high-income countries,” they said. “In particular, policymakers can use our prevalence figures as benchmarks – by calculating the number of people in need of treatment at any given time in a given population or jurisdiction, and then comparing the numbers in need with numbers actually receiving mental health services. “

They point out that families may seek services for children in distress who do not meet diagnostic criteria, meaning that prevalence data may under-represent service needs.

Studies that assessed service use mostly captured contact data, so there was limited data on the type, duration, and intensity of any treatment intervention that would be useful for planning. services, add the authors. They stressed that it is also crucial for policy makers to ensure that effective services are offered, whether for prevention or treatment.

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External peer review? Yes

Type of evidence: systematic review and meta-analysis

Subjects: Children

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