Objectives To use the latest data to estimate the prevalence and correlates of currently diagnosed depression, anxiety problems, and behavioral or conduct problems among children, and the receipt of related mental health treatment. Study design We analyzed data from the 2016 National Survey of Children's Health (NSCH) to report nationally representative prevalence estimates of each condition among children aged 3-17 years and receipt of treatment by a mental health professional. Parents/caregivers reported whether their children had ever been diagnosed with each of the 3 conditions and whether they currently have the condition. Bivariate analyses were used to examine the prevalence of conditions and treatment according to sociodemographic and health-related characteristics. The independent associations of these characteristics with both the current disorder and utilization of treatment were assessed using multivariable logistic regression. Results Among children aged 3-17 years, 7.1% had current anxiety problems, 7.4% had a current behavioral/ conduct problem, and 3.2% had current depression. The prevalence of each disorder was higher with older age and poorer child health or parent/caregiver mental/emotional health; condition-specific variations were observed in the association between other characteristics and the likelihood of disorder. Nearly 80% of those with depression received treatment in the previous year, compared with 59.3% of those with anxiety problems and 53.5% of those with behavioral/conduct problems. Model-adjusted effects indicated that condition severity and presence of a comorbid mental disorder were associated with treatment receipt. Conclusions The latest nationally representative data from the NSCH show that depression, anxiety, and behavioral/ conduct problems are prevalent among US children and adolescents. Treatment gaps remain, particularly for anxiety and behavioral/conduct problems.

BACKGROUND: Schools play an important role as providers of mental health services for adolescents; however, information on the broader picture of utilization of mental health services in educational versus other settings is limited because of the lack of national-level data. METHODS:Using multinomial logistic regression models based on national-level data from the 2012-2015 National Survey on Drug Use and Health, we explore the characteristics of adolescents who received mental health treatment in educational and other settings. In addition, the study examines the reasons for seeking services in various treatment settings. RESULTS:The analysis finds that while the majority of adolescents who access mental health services receive care at noneducational settings, slightly more than one-third of them received services only in an educational setting. Adolescents who had public insurance, were from low-income households, and were from racial/ethnic minority groups were more likely to access services in an educational setting only. Common reasons for accessing services in educational settings included problems with schools, friends, and family members. CONCLUSIONS:Despite increased access to treatment in outpatient settings in the last decade, schools play an important role in providing access to mental health services for disadvantaged populations.

Tools stemming from the Patient Health Questionnaire had the most testing and application in primary care settings. However, numerous other tools could meet the needs of primary care practices. This review provides information that PCPs can use to select appropriate tools to incorporate into a screening protocol.

While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches.

Results suggest focusing first on patients with chronic conditions given the greater potential for early gains.