Mental and behavioral health conditions are common among children and adolescents in the United States. The purpose of this state-of the-art review article is to describe inequities in mental and behavioral health care access and outcomes for children and adolescents, characterize mechanisms behind the inequities, and discuss strategies to decrease them. Understanding the mechanisms underlying these inequities is essential to inform strategies to mitigate these health disparities. Half of United States children with a treatable mental health disorder do not receive treatment from a mental health professional. Children and adolescents in racial, ethnic, sexual, sex, and other minority groups experience inequities in access to care and disparities in outcomes for mental and behavioral health conditions. Suicide rates are nearly twice as high in Black compared to White boys 5 to 11 years old and have been increasing disproportionately among adolescent Black girls 12 to 17 years old. Children identifying as a sexual minority have >3 times increased odds of attempting suicide compared to heterosexual peers. Adverse experiences of children living as part of a minority group, including racism and discrimination, have immediate and lasting effects on mental health. Poverty and an uneven geographic distribution of resources also contribute to inequities in access and disparities in outcomes for mental and behavioral health conditions. Strategies to address inequities in mental and behavioral health among United States children include investing in a diverse workforce of mental health professionals, improving access to school-based services, ensuring equitable access to telehealth, and conducting quality improvement with rigorous attention to equity.

中文翻译：

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儿童心理和行为健康状况的差异。

心理和行为健康问题在美国儿童和青少年中很常见。这篇最先进的评论文章的目的是描述儿童和青少年在心理和行为保健获取和结果方面的不平等，描述不平等背后的机制，并讨论减少不平等的策略。了解这些不平等背后的机制对于制定减轻这些健康差距的战略至关重要。一半患有可治疗心理健康障碍的美国儿童没有接受心理健康专业人士的治疗。种族、族裔、性别和其他少数群体的儿童和青少年在获得护理方面存在不平等，精神和行为健康状况的结果也存在差异。5 至 11 岁的黑人男孩的自杀率几乎是白人男孩的两倍，并且 12 至 17 岁的黑人青少年女孩的自杀率增长得不成比例。与异性恋同龄人相比，被认定为性少数群体的儿童尝试自杀的几率增加了 3 倍以上。少数群体儿童的不良经历，包括种族主义和歧视，对心理健康产生直接和持久的影响。贫困和资源地理分布不均也会导致获取资源的不平等以及精神和行为健康状况结果的差异。解决美国儿童心理和行为健康不平等问题的策略包括投资于多元化的心理健康专业人员队伍、改善获得学校服务的机会、确保公平获得远程医疗以及在严格关注公平的情况下进行质量改进。