Commentary: Timely recognition of mental health needs in young children – parental perception as a way for professionals to understand child, parent, and family needs? – a commentary on McGinnis et al. (2021)

BACKGROUND: There is evidence of unmet psychiatric needs in children under 6. These young children are dependent on their parents to identify their mental health needs. This study tested child and parent factors associations with Parent perception of mental health need in their young child. METHOD: Parents of 917 children (ages 2–6 years) completed a structured diagnostic interview about their child assessing depression, anxiety, ODD/CD, ADHD and impairment. Parents were surveyed about their own depression, anxiety and asked about their psychiatric impairment. Parents were also asked whether they perceived their child as having a mental health need. RESULTS: Only 38.8% of children who met criteria for a diagnosis were perceived by their parent as having a need, similar to previously studied rates in school-aged children. Perception of need was associated with higher levels of symptoms and impairment. Thresholds for at least half of parents perceiving their child as having a need were relatively high: 19 or more symptoms, or 4 or more impairments. There was also evidence of specificity: children with depressive disorders were more likely to be perceived as in need (OR: 6.53) compared with children with no disorder. In terms of parent factors, moderate-high parental depressive symptoms was associated with higher perception of child need when the child had a diagnosis than parents with no or mild depressive symptoms. CONCLUSIONS: Most preschool children that meet criteria for a psychiatric disorder are not perceived as needing help by their parents. Parent perception of need is dependent on both child and parent factors.