Studies indicate that 12% to 27% of children will have a behavioral-health problem at a given point in time. Seven to 11% will have a significant impairment 1 . One study found nearly 37% of children followed for three to seven years cumulatively qualified for a psychiatric diagnosis 2 . The percentages can be even higher in some populations, including those with socioeconomic disadvantages.

Over the years, research has indicated that providers under-identify patients in need of mental-health services when they rely solely on clinical impressions. One large study found that pediatricians identified only one of five children with behavioral-health problems, whereas they correctly identified 93% of those without, using only their clinical impressions 3 . Similarly, another found over 40% of children with behavioral- health problems who were not in treatment were not identified by their PCP 4 . Studies have found that the identification of potential problems increases when

  • parents indicate to the health-care provider that they have a concern; and
  • standardized tools are used to screen.

Screening tools are not diagnostic. Identifying a concern on a behavioral-health screen does not mean that the child has a behavioral, mental, or health problem. It means that the child is at greater risk for having one and should undergo further assessment.



  1. Weitzman CC and Leventhal JM. Screening for behavioral health problems in primary care. Curr Opin Pediatr. 2006;18:641-648
  2. Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003:60:837-844
  3. Lavigne, JV, Binns HJ, Christoffel KK, Rosenbaum D, Arend R, Smith K, Hayford JR, McGuire PA. Behavioral and emotional problems among preschool children in pediatric primary care: Prevalence and pediatricians' recognition. Pediatrics. 1993;91:649-655
  4. Brugman E, Reijneveld SA, Verhulst FC, Verloove-Vanhorick SP. Identification and management of psychosocial problems by preventive child health care. Arch Pediatr Adolesc Med. 2001;155:462-469
  5. Additional reference: 2000 Report of the Surgeon General's Conference on Children's Mental Health: A National Action Agenda

This information is provided by MassHealth.