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.

中文翻译：

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家长报告的全国自闭症谱系障碍和焦虑青少年样本中获取心理健康服务的问题

客观的： 

本研究的目的是确定与父母报告的自闭症谱系障碍和焦虑症青少年在获得所需心理健康服务 (MHS) 的问题相关的因素。

方法： 

本研究是使用多变量逻辑回归的 2016 年至 2017 年全国儿童健康调查数据集进行的二次分析。受试者是 6 至 17 岁的父母报告的自闭症谱系障碍 (ASD) 和焦虑症。结果是父母报告的挑战获得所需的心理健康治疗，分为不是问题与问题。协变量包括种族/民族、智力残疾、保险、医疗之家、贫困水平和父母教育水平。

结果： 

样本包括 568 名患有 ASD 和焦虑症的青年——78% 的男性受试者，平均年龄 12.5 岁，63% 的白人，非西班牙裔。53% 的患有 ASD 和焦虑症的青少年在获得所需的 MHS 时遇到了父母报告的问题。缺乏医疗之家（调整优势比 [aOR] 5.97, 95% 置信区间 [CI] [2.72–13.09]）和并存的智力障碍（aOR 2.23, 95% CI [1.08–4.60]）与访问 MHS 的问题显着相关. 与联邦贫困线 400% 或以上的家庭收入相比，报告的家庭收入为联邦贫困线的 0% 至 99% 和 100% 至 199%（aOR 0.32, 95% CI [0.11–0.94] 和 aOR 0.35, 95 % CI [0.13–0.95]，分别）与访问 MHS 的问题减少有关。

结论： 

在这项具有全国代表性的研究中，超过一半的患有 ASD 和焦虑症的青少年在获得所需的 MHS 时遇到了父母报告的问题。缺乏医疗之家、同时发生的智力残疾和较高的社会经济地位 (SES) 与获取 MHS 的问题有关。因此，政策支持医疗之家；为患有 ASD、焦虑症和并存智力障碍的人增加心理健康支持；和支持所有 SES 级别的访问可能会增加心理健康访问。