Pediatric Mental Health Needs, Unmet Care, and Disaster-Related Displacement

Importance: Extreme weather disasters leave behind long-lasting mental and physical health problems. Displacement related to climate change disproportionately impacts children, whose developmental stage leaves them particularly at risk to its devastating effects. Objective: To compare pediatric mental health needs and care for those in need between displaced households and other households. Design, Setting, and Participants: This repeated cross-sectional analysis with multivariable logistic regression models used data from the US Census Household Pulse Survey, a nationally representative dataset, from June 1, 2023, through September 31, 2024. The study included biweekly, individual-level data reported by individual adults for all members of their household. Exposure: Experience of displacement in the past year due to a natural disaster. Main Outcomes and Measures: Mental health needs were defined based on response to a question asking whether any children in the household needed mental health treatment, such as counseling or medication, in the past 4 weeks. Then the likelihood of receiving mental health treatment was examined for those who reported mental health needs. Results: Of the 324 466 households with children identified during the study period, 277 081 respondents (mean [SD) age, 42.7 [0.05) years; 162 288 [58.6%] female) were included in the analytic sample. This sample represents approximately 35 million US households with children. Among households with children, those that experienced displacement due to natural disaster had a significantly higher chance of reporting that the children needed mental health counseling or medication (odds ratio, 1.29; 95% CI, 1.12-1.48; P < .001). Among households with reported pediatric mental health needs, displaced households were more likely to report inadequate or no treatment, even after controlling for socioeconomic hardships (odds ratio, 0.55; 95% CI, 0.38-0.66; P < .001). Conclusions and Relevance: The cross-sectional study found that displaced children experience more unmet mental health needs after natural disasters compared with nondisplaced children, which may negatively impact their long-term development. As climate change progresses, targeted research is urgently needed to understand how best to meet these needs.