As a pediatrician in my first year of training, I read Patricia Wen’s “Children’s access to mental care grows” with great interest. Wen highlights the importance of easy access to mental health services for children, but does not explore the disparate burden of mental health problems for children from low-income families who most need these services.

According to the National Center for Children in Poverty, low-income children are approximately twice as likely to have mental health problems — 21 percent compared with about 10 percent nationally. In addition, about half of children in the child welfare system and two-thirds of youth in the juvenile justice system have mental health problems. How can we shift the discussion to focus on improving the delivery of services for those in highest need?

In my clinic at Boston Medical Center, we take care of an inner-city population with significant mental health concerns. I have the privilege of working alongside social workers and can refer to behavioral health specialists, but this doesn’t go far enough. We need to go beyond our clinics to develop a broad network of mental health providers in schools, in the community, and in the child and youth service systems to reach these marginalized populations.


Dr. Davida M. Schiff
Jamaica Plain