Parent-Reported Problems Accessing Mental Health Services Among a National Sample of Youth with Autism Spectrum Disorder and Anxiety

Abstract

Objective: The objective of this study was to identify factors associated with parent-reported problems accessing needed mental health services (MHS) in youth with autism spectrum disorder and anxiety. Methods: This study is a secondary analysis using the National Survey of Children's Health 2016 to 2017 data sets with multivariable logistic regression. Subjects are 6 to 17 year olds with parent-reported autism spectrum disorder (ASD) and anxiety. Outcome is parent-reported challenge accessing needed mental health treatment, dichotomized to not a problem versus problem. Covariates included race/ethnicity, intellectual disability, insurance, medical home, poverty level, and parent education level. Results: The sample included 568 youth with ASD and anxiety-78% male subjects, mean age 12.5 years, and 63% White, non-Hispanic. Fifty-three percent of youth with ASD and anxiety had parent-reported problems accessing needed MHS. Lack of medical home (adjusted odds ratio [aOR] 5.97, 95% confidence interval [CI] [2.72-13.09]) and coexisting intellectual disability (aOR 2.23, 95% CI [1.08-4.60]) were significantly associated with problems accessing MHS. Reported family incomes at 0% to 99% and 100% to 199% of the federal poverty level as compared with family income at 400% federal poverty level or above (aOR 0.32, 95% CI [0.11-0.94] and aOR 0.35, 95% CI [0.13-0.95], respectively) was associated with decreased problems accessing MHS. Conclusion: In this nationally representative study, more than half of youth with ASD and anxiety had parent-reported problems accessing needed MHS. Lack of a medical home, co-occurring intellectual disability, and higher socioeconomic status (SES) are associated with problems accessing MHS. Therefore, policies to support the medical home; increase mental health supports available for those with ASD, anxiety, and coexisting intellectual disability; and support access for all SES levels may increase mental health access.

Mental Health Care Use Among Children and Adolescents With High Health Care Costs in Ontario, Canada

“…Access to outpatient mental health care has typically been poor for children and adolescents and has likely worsened with the COVID-19 pandemic. To ensure that children and adolescents with mental and behavioral disorders receive timely care, it is important to address wait times . Moreover, better integration and coordination of clinical and social care may help address children’s and adolescents’ mental health needs, which could be achieved without significant additional investments by adopting similar health care delivery models used in other pediatric care settings (eg, oncology) .…”

“…To ensure that children and adolescents with mental and behavioral disorders receive timely care, it is important to address wait times. 32 , 33 Moreover, better integration and coordination of clinical and social care may help address children’s and adolescents’ mental health needs, which could be achieved without significant additional investments by adopting similar health care delivery models used in other pediatric care settings (eg, oncology). 5 The implementation of integrated youth services, an emerging model of care offering a broad range of mental health and social services for children and adolescents in 1 location, could help in this regard.…”