Despite the magnitude and serious consequences of mental disorders in youth, only about half of those with mental disorders in the US receive mental health services.13,15,28,73,74 However, a recent review of service rates among those with mental disorders identified in community surveys concluded that those with the most severe disorders do indeed receive service.75 Similar patterns have been reported in the UK.75 School services are the most common point of entry for children seeking help, although those who enter through the education sector are unlikely to transition to specialty mental health services.76 The actual diagnostic process and services provided differ dramatically according to the context of entry to service.77 A recent comprehensive review of characteristics of youth with service needs in community surveys highlighted the large gap between assessment of mental disorders among those in clinical and community surveys.75 Factors associated with service utilization include ethnicity, impairment, comorbidity, suicide attempts, parental recognition, and family burden.13,15,19,23,78
