Public knowledge and assessment of child mental health problems: Findings from the national stigma study-children

Objective: Child and adolescent psychiatry confronts help-seeking delays and low treatment use and adherence. Although lack of knowledge has been cited as an underlying reason, we aim to provide data on public recognition of, and beliefs about, problems and sources of help. Method: The National Stigma Study-Children is the first nationally representative study of public response to child mental health problems. A face-to-face survey of 1,393 adults (response rate 70.1%, margin of error ±3.5%) used vignettes consistent with diagnoses of attention-deficit/hyperactivity disorder (ADHD) and depression. Descriptive and multivariate analyses provide estimates of the levels and correlates of recognition, labeling, and treatment recommendations. Results: Respondents do differentiate "daily troubles" from mental health problems. For the cases that meet diagnostic criteria, 58.5% correctly identify depression and 41.9% correctly identify ADHD. However, respondents are less likely to see ADHD as serious, as a mental illness, or needing treatment compared with depression. Moreover, a substantial group who correctly identifies each disorder rejects its mental illness label (ADHD 19.1%, depression 12.8%). Although women are more knowledgeable, the influence of other socio-demographic characteristics, particularly race, is complex and inconsistent. More respondents see general practitioners, mental health professionals, and teachers as suitable sources of advice than psychiatrists. Behaviors and perceived severity seem to drive public responses. Conclusions: Americans have clear and consistent views of children's mental health problems. Mental health specialists face challenges in gaining family participation. Unless systematically addressed, the public's lack of knowledge, skepticism, and misinformed beliefs signal continuing problems for providers, as well as for caregivers and children seeking treatment.