The demand for children's mental health services will increase as children's behavioral health screening becomes more widespread and states are asked to address the goals of mental health system transformation. This poses a challenge to rural policymakers, as there is no "easy fix" for improving access to children's mental health services. In collaboration with the Urban Institute, this study pools data from the Urban Institute's 1997, 1999, and 2002 waves of the National Survey of America's Families (NSAF) to examine and compare the use of mental health services by rural and urban children, age 6 to 17, relative to their need for mental health care, family income, and insurance status. Using these data, the research questions that we seek to address include:

1. What is the prevalence of identified mental health need among children, age 6 to 17, in rural and in urban areas?
2. What percentage of children, age 6 to 17, used any mental health service in the past year in rural and in urban areas? What is the average number of mental health visits in the past year among children using any mental health service in rural and in urban area?
3. What percentage of children with an identified mental health need received any mental health service in the past year in rural and in urban areas? What is the average number of mental health visits received by these children (users) in rural and in urban areas?
4. What factors are associated with differences in mental health need and service use, and do these factors differ for rural and urban children?

A major obstacle that policymakers face in addressing the under-service of children's mental health services in rural area is the paucity of national-level data on need, service use, and insurance status. The NSAF provides a rich data set that can be used to fill this gap, and we will disseminate our findings through a policy brief, working paper and journal article(s).

Publications

• Rural Children Don't Receive the Mental Health Care They Need
  Policy Brief
  Maine Rural Health Research Center
  Date: 01/2009
  Controlling for other characteristics that affect access to care, rural children are 20% less likely to have a mental health visit than urban children. Having Medicaid or SCHIP increases the likelihood that a child will receive services, and this is pronounced in rural areas.