Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting

Pediatrics. 2017 Jan;139(1):e20151175. doi: 10.1542/peds.2015-1175. Epub 2016 Dec 12.


Poverty is a common experience for many children and families in the United States. Children <18 years old are disproportionately affected by poverty, making up 33% of all people in poverty. Living in a poor or low-income household has been linked to poor health and increased risk for mental health problems in both children and adults that can persist across the life span. Despite their high need for mental health services, children and families living in poverty are least likely to be connected with high-quality mental health care. Pediatric primary care providers are in a unique position to take a leading role in addressing disparities in access to mental health care, because many low-income families come to them first to address mental health concerns. In this report, we discuss the impact of poverty on mental health, barriers to care, and integrated behavioral health care models that show promise in improving access and outcomes for children and families residing in the contexts of poverty. We also offer practice recommendations, relevant to providers in the primary care setting, that can help improve access to mental health care in this population.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Child
  • Cross-Sectional Studies
  • Follow-Up Studies
  • Health Services Accessibility / organization & administration*
  • Health Services Needs and Demand / statistics & numerical data
  • Humans
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy*
  • Mental Health Services / organization & administration*
  • Mental Health Services / supply & distribution
  • Poverty / psychology*
  • Poverty / statistics & numerical data*
  • Primary Health Care / organization & administration*
  • Risk Factors