Document Type

Policy Brief

Publication Date



Cutler, Population Health and Health Policy


The majority of children with mental health problems go untreated, and the gap between need and service use is assumed to be wider in rural than in urban areas, particularly for children with more severe needs.1-2 It is also assumed that rural families of children with mental health problems experience a greater financial and emotional burden than urban families. These assumptions reflect the lower availability of mental health specialty care and support services in rural areas. Lower income and more limited economic opportunities may further hamper the ability of rural families to care for children with mental health problems. The current research literature does not describe how well the needs of children with mental health problems are being met in rural areas. Although there are reasons to believe the burden these needs place on families is higher in rural areas, evidence to support this assumption is limited. Using the 2005-06 National Survey of Children with Special Health Care Needs, we examine the prevalence, access to services, problem severity, and family impact of children’s mental health in rural and urban areas. These data are linked to the Rural-Urban Continuum Codes to examine populations living in urban areas, rural areas adjacent to urban areas, and rural areas not adjacent to urban areas.

Funding Organization or Grant

Supported by the federal Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services, CA#U1CRH03716