Specialist and Mental Health Care
Many CSHCN have unmet needs for specialty medical care.1 In the NSCH, parents of children who needed care from a specialist in the past year were asked whether their children had problems accessing that care. Of those children who needed specialist care, CSHCN were more likely to have problems accessing specialty care: 27.0 percent had problems, compared to 21.2 percent of children without special health care needs. At the state level, the percentage of CSHCN with problems accessing specialty care ranged from 14.2 percent to 42.7 percent.
CSHCN with more complex service needs may have particular need for medical care given that their health conditions are more likely to affect their ongoing functioning. Of CSHCN with more complex service needs, 30.7 percent had problems gaining access to the specialists that they needed (data not shown).
Health insurance may also help facilitate specialist access. Of CSHCN without health insurance, more than half (57.6 percent) were reported to have problems accessing specialty care, as did nearly one-third (31.8 percent) of CSHCN with public insurance (data not shown).
Access to mental health care can be difficult as well. Of CSHCN who had one of seven emotional, behavioral, or developmental conditions, 48.8 percent did not receive mental health services.
Among CSHCN, more than half of Black children with emotional, behavioral, or developmental conditions (50.7 percent) who needed mental health services did not receive them, compared to 40.2 percent of Hispanic CSHCN in Spanish-speaking households with these conditions. Nearly half of White CSHCN and Hispanic CSHCN in English-speaking households with these conditions who were in need of mental health services did not receive them (49.5 and 48.8 percent, respectively).
1 Mayer ML, Skinner AC, Slifkin RT. Unmet need for routine and specialty care: data from the National Survey of Children with Special Health Care Needs. Pediatrics. 2004; 113(2).