Number of children, ages 0-171 with selected chronic conditions, United States.

SOURCE: NCHS, 1997a; NCHS, 1995; NCHS, 1994. NOTE: Data are from the the 1988 National Health Interview Survey, Child Health (learning disability, developmental delay, and emotional/behavioral problems); National Health Interview Survey, 1990-92 (nervous system and respiratory conditions); and National Health Interview Survey, 1994 (physical impairments).

1 Data for learning disability, developmental delay, and emotional/behavioral problems, from the 1988 survey, cover children ages 3-17 only.

Children with Mental Health and Substance Abuse Problems

Approximately 12 million children, or 20 percent of all children, experience some type of mental health problem (e.g., attention-deficit-hyperactivity disorder, severe conduct disorder, and depression) or substance abuse problem (alcohol and other drug abuse or dependence) during childhood or adolescence (CMHS, 1996). An estimated 3.5 million children have serious emotional disturbances (CMHS, 1996). Compared with healthy children, children with physical health problems are more than twice as likely to have a mental health problem as well (Alliance for Health Reform, 1997).

Only about one third of children with severe mental health problems receive appropriate services from specialists (IOM, 1997a). Pediatricians and other primary care practitioners may be the first and only health care professionals to be consulted for childhood behavioral and emotional problems. Although some of these practitioners may be willing to provide appropriate care and referrals for these children, others may not have adequate training or time to do so.

A variety of sources—including community mental health centers, the mental health and substance abuse block grant, and state and local funding for mental health services—support services for these children and their families. National policies set by the National Institute of Mental Health and the Substance Abuse and Mental Health Services Administration promote "systems of care" for children

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