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Falling through the cracks: Gaps and barriers in the mental health system for America's disadvantaged children

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  • Bringewatt, Elizabeth H.
  • Gershoff, Elizabeth T.

Abstract

The system for providing mental health services to children is fragmented and complex, and children and their families face multiple barriers to accessing care. This is especially true for children in low-income families, who have the greatest rate of mental health disorders but have the highest underutilization of services. The first section of this paper describes the unmet need for children's mental health services, including reasons for the disproportionate need among low-income children. The second section provides a brief overview of the history of children's mental health policies. The third section outlines the types of services available to children, highlighting the problems with this service delivery system. This is followed by a discussion of barriers that families face in accessing care. The paper concludes with recommendations for improving this fragmented system of service delivery.

Suggested Citation

  • Bringewatt, Elizabeth H. & Gershoff, Elizabeth T., 2010. "Falling through the cracks: Gaps and barriers in the mental health system for America's disadvantaged children," Children and Youth Services Review, Elsevier, vol. 32(10), pages 1291-1299, October.
    • Handle: RePEc:eee:cysrev:v:32:y:2010:i:10:p:1291-1299
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    References listed on IDEAS

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    1. Gyamfi, Phyllis, 2004. "Children with serious emotional disturbance: the impact of poverty and receipt of public assistance on behavior, functioning, and service use," Children and Youth Services Review, Elsevier, vol. 26(12), pages 1129-1139, December.
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    1. Acri, Mary C. & Bornheimer, Lindsay A. & Hamovitch, Emily & Lambert, Kate, 2018. "An examination of the relationship between maternal depression and barriers to child mental health services," Children and Youth Services Review, Elsevier, vol. 93(C), pages 270-275.
    2. Jain, Sonia & Reno, Rebecca & Cohen, Alison K. & Bassey, Henrissa & Master, Mansi, 2019. "Building a culturally-responsive, family-driven early childhood system of care: Understanding the needs and strengths of ethnically diverse families of children with social-emotional and behavioral co," Children and Youth Services Review, Elsevier, vol. 100(C), pages 31-38.
    3. Keyser, Daniel & Ahn, Haksoon & Unick, Jay, 2017. "Predictors of behavioral problems in young children 3 to 9years old: The role of maternal and child factors," Children and Youth Services Review, Elsevier, vol. 82(C), pages 149-155.
    4. Rubén Chávez, Noé & “TK” Halmai-Gillan, Kristina & Esquivel, Krysta & McCarthy, Megan & DeVico, Nicholas & Lee, Sophia & Ferrer, Mildred & Ramos, Amy L., 2023. "Improving healthy connections in under-resourced youth: A YMCA San Diego mental health initiative," Children and Youth Services Review, Elsevier, vol. 150(C).
    5. Vostanis, Panos & Ruby, Florence & Jacob, Jenna & Eruyar, Şeyda & Mironga Getanda, Elijah & Haffejee, Sadiyya & Krishna, Murali & Edbrooke-Childs, Julian, 2022. "Youth and professional perspectives of mental health resources across eight countries," Children and Youth Services Review, Elsevier, vol. 136(C).
    6. Bailin, Abby & Bearman, Sarah Kate, 2022. "Brief, digital, self-directed, and culturally adapted: Developing a parenting intervention for primary care," Children and Youth Services Review, Elsevier, vol. 132(C).
    7. Scrivens, Catherine & Logan, Jayden & Reid, Natasha, 2023. "Navigating the barriers to supporting neurodevelopmental disorders in children in out-of-home care," Children and Youth Services Review, Elsevier, vol. 153(C).
    8. Hill, Katharine, 2017. "Prevalence, experiences, and characteristics of children and youth who enter foster care through voluntary placement agreements," Children and Youth Services Review, Elsevier, vol. 74(C), pages 62-70.
    9. Anderson, Joanna K. & Howarth, Emma & Vainre, Maris & Jones, Peter B. & Humphrey, Ayla, 2017. "A scoping literature review of service-level barriers for access and engagement with mental health services for children and young people," Children and Youth Services Review, Elsevier, vol. 77(C), pages 164-176.
    10. Stephan, Sharon H. & Connors, Elizabeth H. & Arora, Prerna & Brey, Laura, 2013. "A learning collaborative approach to training school-based health providers in evidence-based mental health treatment," Children and Youth Services Review, Elsevier, vol. 35(12), pages 1970-1978.
    11. Wathen, Maria V. & Decker, Patrick L.F. & Richards, Maryse H. & Tyson McCrea, Katherine & Onyeka, Cynthia & Weishar, Charity N. & DiClemente, Cara & Donnelly, Will, 2021. "Towards improving engagement of youth of color in cross-age mentoring programs in high poverty, high crime neighborhoods," Children and Youth Services Review, Elsevier, vol. 128(C).
    12. McCrea, Katherine Tyson & Richards, Maryse & Quimby, Dakari & Scott, Darrick & Davis, Lauren & Hart, Sotonye & Thomas, Andre & Hopson, Symora, 2019. "Understanding violence and developing resilience with African American youth in high-poverty, high-crime communities," Children and Youth Services Review, Elsevier, vol. 99(C), pages 296-307.
    13. Semanchin Jones, Annette & Kim, JaeRan & Hill, Katharine & Diebold, Josal, 2018. "Voluntary placements in child welfare: A comparative analysis of state statutes," Children and Youth Services Review, Elsevier, vol. 88(C), pages 387-394.
    14. Glassgow, Anne Elizabeth & Gerges, Michael & Martin, Molly A. & Estrada, Isela & Issa, Zahra & Lapin, Katerine & Morell, Laura & Solis, Nitza & Van Voorhees, Benjamin & Risser, Heather J., 2018. "Integration of mental health services into an innovative health care delivery model for children with chronic conditions," Children and Youth Services Review, Elsevier, vol. 95(C), pages 144-151.

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