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Surveys suggest that between 4.3% and 11.5% of children living in the United States have a serious emotional disturbance (SED). SED is defined in the Federal Register, and federal block grants are allocated to states based on the prevalence of SED. Accurate measurement of SED is critical, yet surveys have used different methodologies and instrumentation to obtain prevalence estimates. Two expert panels were convened by the Substance Abuse and Mental Health Services Administration (SAMHSA) in the fall of 2014 to discuss the current state of the field in operationalizing and measuring SED. The aims of this article are to (a) provide an update on SED prevalence rates from survey research, (b) summarize key discussion points that emerged during the SAMHSA expert panel meetings, and (c) make specific recommendations for next steps in measuring the prevalence of SED. Issues addressed in this article are important not only for federal allocation of service dollars to meet the needs of children with SED, but also for broader mental health surveillance efforts within the context of large national research surveys.

This study examines depression among caregivers of young children involved in investigations of child maltreatment, in terms of 12-month prevalence of depression across 5 to 6 years. Data were from the National Survey of Child and Adolescent Well-Being, a national probability study of 5,501 children investigated for maltreatment. The study sample comprised 1,244 female caregivers (95.5% biological mothers) of children not placed out of home and younger than 5 years old. About a quarter of caregivers had, at any given point, a score indicating major depression in the previous 12 months; across all follow-ups, 46% of caregivers had a score indicating major depression at some point. Depression was associated with caregivers’ report of intimate-partner violence and fair or poor health status. Caregivers of maltreated children are at substantial risk for depression that does not diminish over the course of 5 years. Assessing and providing assistance for intimate-partner violence and health problems may help decrease depression prevalence.

This study examines mental health and special education needs and service use at school entry among children involved in maltreatment investigations as infants. Data are from the National Survey of Child and Adolescent Well-Being, a national probability study of 5,501 children investigated for maltreatment. The study sample comprised 959 children who were infants at baseline and 5 to 6 years old at the last follow-up. Half had behavioral or cognitive needs at entry to school. About a quarter received outpatient mental health or special education services. Logistic regression showed that compared to children residing with biological parents, adopted and foster children were more likely to receive mental health services, and children adopted or in kinship care were more likely to receive educational services. Increased monitoring of behavioral and cognitive needs of infants reported for maltreatment may facilitate their access to services and ease the transition to school.