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Objective The authors reported use of mental health services among children in the United States between ages six and 11 who were described by their parents as having emotional or behavioral difficulties (EBDs). Methods Using data from the 2010–2012 National Health Interview Survey, the authors estimated the national percentage of children ages six to 11 with serious or minor EBDs (N=2,500) who received treatment for their difficulties, including only mental health services other than medication (psychosocial services), only medication, both psychosocial services and medication, and neither type of service. They calculated the percentage of children who received school-based and non–school-based psychosocial services in 2011–2012 and who had unmet need for psychosocial services in 2010–2012. Results In 2010–2012, 5.8% of U.S. children ages six to 11 had serious EBDs and 17.3% had minor EBDs. Among children with EBDs, 17.8% were receiving both medication and psychosocial services, 28.8% psychosocial services only, 6.8% medication only, and 46.6% neither medication nor psychosocial services. Among children with EBDs in 2011–2012, 18.6% received school-based psychosocial services only, 11.4% non–school-based psychosocial services only, and 17.3% both school- and non–school-based psychosocial services. In 2010–2012, 8.2% of children with EBDs had unmet need for psychosocial services. Conclusions School-age children with EBDs received a range of mental health services, but nearly half received neither medication nor psychosocial services. School-based providers played a role in delivering psychosocial services, but parents reported an unmet need for psychosocial services among some children.

This study examined the use of general health, mental health, and other medical specialty services by elderly persons 65 and older with mental disorders and compares them with adults 45 to 64 and 18 to 44. Data were collected at the Bunker Hill Health Center (BHHC), a Boston neighborhood health center providing a broad range of ambulatory medical and specialty mental health services. Results show that the 5-year rate of mental disorder diagnoses for elderly individuals is not significantly different from persons 45 to 64, although it is higher than the rate for young adults 18 to 44. Not only were elderly adults less likely to see a mental health specialist, but when they did, their use of mental health specialty services was usually lower.

Ninety‐six per cent of mentally ill elderly persons who are not in the community reside in nursing homes, yet the mental health care they receive here is minimal or unavailable. Data are presented from the 1984 pretest of the National Nursing Home Survey. Five hundred and twenty‐six patients in 112 nursing homes in four US metropolitan areas were sampled. Overall, the prevalence of mental disorder was found to be 68%; 39% of the patients had a diagnosis of organic brain syndrome (OBS) and 29% had other mental disorders (OMD). Only about one‐third (31%) of residents had no mental disorder. These three patient groups, those with OBS, those with OMD, and those with no mental disorder, were compared on demographic, clinical, and treatment characteristics. The authors conclude that the balance between the Federal and State roles in financing care for the mentally ill in nursing homes needs to result in a more equitable system of care which does not discriminate against the mentally ill. Further, the mental health service system needs to assume greater responsibility for this population. While signnificant attention is given to residents' physical needs, behavioural and emotional problems are seriously neglected.

The growth in prison facilities and the growth in prisoner populations are outstripping the more meager growth in mental health services. These results suggest that mental health services are becoming less available to the prison population, and service populations are becoming more concentrated in the facilities that do offer such services.

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This article presents a description of case managers who serve community-based chronically mentally ill (CMI) persons through the Community Support Program (CSP). Information is presented on case managers' demographic characteristics, education, job training, job history, current job activities, and locus of employment. Data were generated through the Case Manager Background Questionnaire, a 23-item self-administered instrument developed in conjunction with the CSP, a pilot Federal-State collaboration project designed to explore strategies for improving the delivery of community-based mental health and related services to the CMI. Results of the study suggest that a typical CSP case manager is white, female and in the mid-thirties. Case managers are a highly educated group; nearly one-half have graduate degrees and about two-thirds have participated in an in-service or continuing education program. Currently, two out of three CSP case managers are employed at Community Mental Health Centers and about one-third of their time is spent in direct service provision. While CSP case managers have been working at their present location for about one and one-half years, they have been in the community-based mental health system for about four years, and with the mentally disabled an average of seven years. A critical issue emerging from this analysis is the need for future research on the relationships among job training, education, job functions, and service delivery.

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