What are the Parent-Reported Reasons for Unmet Mental Health Needs in Children?(Report‪)‬

Parents of children with long-term emotional and behavioral problems often struggle to access mental health services for their children. When a child has extensive treatment needs, even parents with high incomes can be confronted with treatment costs that are unaffordable. They are often advised to relinquish custody of their child to the state to access Medicaid benefits, which can lower parent's expenses on care and can offer a comprehensive array of mental health services, including long-term residential treatment. A National Alliance for the Mentally I11 (NAMI) (1999) survey of families with children who have a mental illness found that 23 percent of respondents reported having been told they should relinquish custody of their children to access needed mental health services. Twenty percent reported relinquishing custody, and another 36 percent reported that their children were placed in juvenile justice facilities because needed mental health services were not obtained (NAMI, 1999). A 2001 General Accounting Office (GAO) (the investigative arm of Congress) survey of child welfare directors in 19 states and juvenile justice systems in 30 counties found over 12,700 children in custody due to mental health service needs alone (U.S. GAO, 2003). This number is doubtless much higher nationwide, given that the GAO did not receive data from 32 states, including the five states with the highest populations of children, and there was only limited surveying of county juvenile justice officials. No federal agency formally tracks these children or maintains data on their characteristics. In Missouri, over 600 children were in state custody due to mental health needs alone as of November 2003 (Smith, 2003).