(PS5-96) Mental Health Service Use in a National Sample of Children Ages 5-12

Abstract Text: Mental health disorder rates among school-aged children are increasing, yet many children do not receive the services they need (Houtrow et al., 2014; Simon et al., 2015). Understanding up-to-date estimates of service utilization, particularly among those with severe symptoms, is essential for informing research, policy, and intervention efforts. The current study examined mental health service utilization in a nationally representative survey conducted in 2024, in which 1,000 parents of children aged 5–12 reported on their child’s mental health and service use over the past six months. Using the Service Assessment for Children and Adolescents (SACA; Hoagwood et al., 2000), we assessed service utilization across multiple settings, including outpatient, school-based, residential, child welfare, and juvenile justice systems.
Results indicate that 22.4% of all children received some form of mental health services, with higher rates observed among children experiencing more severe symptoms. Specifically, among those scoring above the 70th and 90th percentiles for symptoms, service use was most common for depression (46.2%; 73.3%), followed by those with anxiety (46.6%; 62.7%), conduct disorder (43.7%; 60.4%), oppositional defiant disorder (37.0%; 59.1%), and ADHD (39.6%; 57.0%). Outpatient services, particularly those provided by primary care physicians, psychologists, and psychiatrists, were the most frequently utilized, followed by school-based services such as counseling and behavioral support. Children above the 70th and 90th percentiles for depressive symptoms were the most likely to access nearly all types of services.
Children with multiple comorbid symptom clusters above the 70th or 90th percentiles were more likely to engage with multiple service sectors and access acute care services, including inpatient psychiatric treatment and involvement with the juvenile justice system. Despite these levels of engagement, a sizable minority of children with severe symptoms (30% to 40%) did not receive any form of intervention, underscoring critical gaps in care. These findings highlight the urgent need to expand accessible and effective mental health care services for children. By providing updated national estimates of service utilization, this study offers essential insights for policymakers and mental health professionals working to close treatment gaps and mitigate the long-term consequences of untreated childhood mental health conditions.