Unmet Need for Pediatric Care Coordination for Children with Mental Health Conditions


A study, published in Pediatrics in March of 2014, revealed a significant level of unmet need for care coordination among parents of children with a mental health condition. Care coordination is a way of connecting children with special health care needs and their families to critical services and resources. This type of care has been linked to lower health care costs, better health outcomes, and it helps families to use the health care system more efficiently. Coordinated care is especially important for children with mental health conditions because their families often have greater difficulty accessing specialty care for their child’s health problems.

The study’s authors analyzed data from the 2007 National Survey of Children’s Health to get a better understanding of the frequency of need for coordinated care and to identify factors that related to this need being unmet. The research sample included more than 7,500 children from ages 2 to 17 years with a diagnosis of depression, anxiety, attention-deficit/hyperactivity disorder, or conduct disorder who had received two or more types of preventive or subspecialty health care services in the last year. The need for care coordination was assessed with a single question: “During the past 12 months, have you felt you could have used extra help arranging or coordinating the child’s care among different health care providers or services?” A large proportion of parents (43%) reported a need for care coordination. Among the parents expressing a need for this type of care, 41% indicated that this need was not met. The authors then looked at sociodemographic, clinical, and parent psychosocial characteristics, to understand which factors may be linked to having an unmet need. They found that parents of children with an anxiety disorder, parenting stress, low income, and public or no insurance were more likely to have unmet need. Whereas, those who reported social support and family-centered medical care seemed be less likely to have unmet coordinated care needs.

This study highlights the need for care coordination among children with mental health conditions and their families, particularly those with anxiety. The study authors concluded from these results that “delivery of family-centered care and enhancing family supports may help to reduce unmet need for care coordination in this vulnerable population.” In a Culture of Health blog post from the Robert Wood Johnson Foundation (RWJF), the first author, Nicole M. Brown, MD, from the RWJF Clinical Scholars Program, commentated that the findings also point to a “need for more training for physicians to help us recognize and diagnose anxiety and other mental health conditions earlier” in order to help connect children and their families to appropriate mental health services.