Cross-Sectional Assessment of Mental Health and Service Disparities in a High-Risk Community

Certain demographic factors have been shown to impact children's mental health; however, few studies have directly evaluated these in relation to rates of diagnosis and service access. This study examined the demographic and clinical profiles of children at a low-income, urban, community health clinic to gain better understanding of how these variables are related to mental health diagnosis and service access/utilization. Mental health status was assessed (N = 126) in children aged 3-16 years. Diagnoses were compared with Diagnostic and Statistical Manual of Mental Disorders, fifth edition, prevalence rates. Service utilization rates were compared with rates of diagnosis and clinical need. Autism spectrum disorder was first diagnosed at a median age of 10 years and attention-deficit/hyperactivity disorder at a median age of 8 years. Mental health diagnoses were present at much higher rates compared with Diagnostic and Statistical Manual of Mental Disorders, fifth edition, estimates for attention-deficit/hyperactivity disorder (51% vs. 7%), autism spectrum disorder (18% vs. 1%), anxiety (29% vs. 1%), depression (18% vs. 4%), and posttraumatic stress disorder (21% vs. 4%). Gaps in access to services were evident, such that a large number of participants were not receiving mental health services. Results indicate that children raised in similar low-income, urban areas may be at high-risk for mental health diagnoses and reduced service access/utilization. The observed delay in mental health diagnoses can contribute to lifelong disease burden. Greater awareness of mental health conditions and access to services are required in similar communities to reduce mental health disparities, particularly given the presence of language and cultural barriers.