Falling through the cracks: Gaps and barriers in the mental health system for America's disadvantaged children

The system for providing mental health services to children is fragmented and complex, and children and their families face multiple barriers to accessing care. This is especially true for children in low-income families, who have the greatest rate of mental health disorders but have the highest underutilization of services. The first section of this paper describes the unmet need for children's mental health services, including reasons for the disproportionate need among low-income children. The second section provides a brief overview of the history of children's mental health policies. The third section outlines the types of services available to children, highlighting the problems with this service delivery system. This is followed by a discussion of barriers that families face in accessing care. The paper concludes with recommendations for improving this fragmented system of service delivery. (C) 2010 Elsevier Ltd. All rights reserved.