Research consistently shows that as many as one in five children and adolescents have mental health problems, and primary care providers (PCPs) identify 19% of children with behavioral and emotional disorders. Although these providers frequently refer children for mental health treatment, significant barriers exist to referral, including lack of available specialists, insurance restrictions, appointments delays, and stigma. Approximately 25% of the population lives in rural settings, and rural departments of health report an even greater problem with access to specialists for rural residents than their urban counterparts. In adults, and probably children and adolescents, the lack of mental health services leads to undertreatment, poor outcomes such as higher rates of suicide and homicide, as well as increased use of emergency services, hospitalizations, and placement in mental health institutions.
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