Abstract
Large numbers of children and adolescents experience diagnosable psychiatric disturbances; however, the majority of those with need do not utilize mental health services. Characteristics of caregivers are important predictors of which youth will access and continue to use services over time. In recent years school-based mental health intervention programs have played a key role in identifying youth with mental health needs and linking them to treatment. In this study we sought to identify the caregiver demographic and contextual factors that predict days of service use among youth participating in a school-based mental health intervention program. Our sample included 85 youth ages 5–18 and their caregivers. We analyzed the data using bivariate and multivariate Poisson regressions with caregiver factors as the independent variables and days of service as the dependant variable. We found significant bivariate and multivariate associations for every caregiver demographic (sex, age, race) and contextual (education, employment, income, insurance, health, strain, and was it the caregivers idea to seek treatment) factor that was examined. In this study we identified the caregiver factors that are likely important in predicting youth service utilization even when steps have been taken to improve identification and access.
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Alexandre, P. K. B., Dowling, K., Stephens, R. M., Laris, A. S., & Rely, K. (2008). Predictors of outpatient mental health service use by American youth. Psychological Services, 5, 251–261.
Angold, A., Messer, S., Stangl, D., Farmer, E., Costello, E., & Burns, B. (1998). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, 88, 75–80.
Atkins, M., Frazier, S., Birman, D., Adil, J., Jackson, M., Craczyk, P., et al. (2006). School-based mental health services for children living in high poverty urban communities. Administration and Policy in Mental Health and Mental Health Services Research, 33, 146–159.
Bannon, W., & McKay, M. (2005). Are barriers to service and parental preferene match for service related to urban child mental health service use? Families in Society, 86, 30–34.
Brannan, A., Heflinger, C., & Foster, E. (2003). The role of caregiver strain and other family variables in determining children’s use of mental health services. Journal of Emotional and Behavioral Disorders, 11, 77–91.
Bussing, R., Zima, B., Gary, F., Mason, D., Leon, C., Sinha, K., et al. (2003). Social networks, caregiver strain, and utilization of mental health services among elementary school students at high risk for ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 842–850.
Costello, J., Angold, A., Burns, B., Stangl, D., Tweed, D., Erkanli, A., et al. (1996). The great smoky mountains study of youth: Goals, design, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry, 53, 1129–1136.
Cuffe, S., Waller, J., Addy, C., McKeown, R., Jackson, K., Moloo, J., et al. (2001). A longitudinal study of adolescent mental health service use. The Journal of Behavioral Health Services and Research, 28, 1–11.
Cuffe, S., Waller, J., Cuccaro, M., Pumariega, A., & Garrison, C. (1995). Race and gender differences in the treatment of psychiatric disorders in young adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1536–1543.
Dierker, L., Nargiso, J., Wiseman, R., & Hoff, D. (2001). Factors predicting attrition within a community initiated system of care. Journal of Child and Family Studies, 10, 367–383.
Farmer, E., Stangl, D., Burns, B., Costello, E., & Angold, A. (1999). Use, persistence, and intensity: Patterns of care for children’s mental health across one year. Community Mental Health Journal, 35, 31–46.
Glied, S., Hoven, C., Moore, R., Garrett, A., & Regier, D. (1997). Children’s access to mental health care: Does insurance matter? Health Affairs, 16, 167–174.
Gunther, N., Slavenburg, B., Feron, F., & Os, J. (2003). Childhood social and early developmental factors associated with mental health service use. Society of Psychiary and Psychiatric Epidemiology, 38, 101–108.
Harpaz-Rotem, I., Leslie, D., & Rosenheck, R. (2004). Treatment retention among children entering a new episode of mental health care. Psychiatric Services, 55, 1022–1028.
Harrison, M., McKay, M., & Bannon, W. (2004). Inner-city child mental health service use: The real question is why youth and families do not use services. Community Mental Health Journal, 40, 119–131.
Juszczak, L., Melinkovich, P., & Kaplan, D. (2003). Use of health and mental health services by adolescents across multiple delivery sites. Journal of Adolescent Health, 32S, 108–118.
Kataoka, S., Zhang, L., & Wells, K. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159, 1548–1555.
Kazdin, A., Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65(65), 453–463.
Kodjo, C., & Auinger, P. (2004). Predictors for emotionally distressed adolescents to receive mental health care. Journal of Adolescent Health, 35, 368–373.
Leaf, P., Alegria, M., Cohen, P., Goodman, S., Horwitz, S., Hoven, C., et al. (1996). Mental health service use in the community and schools: Results from the four-community meca study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 889–897.
Logan, D., & King, C. (2002). Parental identification of depression and mental health service use among depressed adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 296–304.
Manteuffel, B., Stephens, R. L., & Santiago, R. (2002). Overview of the national evaluation of the comprehensive community mental health services for children and their families program and summary of current findings. Children’s Services: Social Policy, Research, & Practice, 5, 3–20.
Santelli, J., Morreale, M., Wigton, A., & Grason, H. (1996). School health centers and primary care for adolescents: A review of the literature. Journal of Adolescent Health, 18, 357–366.
Slade, E. (2002). Effects of school-based mental health programs on mental health service use by adolescents at school and in the community. Mental Health Services Research, 4, 151–166.
Teagle, S. (2002). Parental problem recognition and child mental health service use. Mental Health Services Research, 4, 257–266.
Acknowledgments
The writing of this manuscript was supported by the Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs. We would also like to thank Mark Ilgen Ph.D., Zoran Martinovich Ph.D, Gary McClelland, Ph.D., Dana Weiner, Ph.D, and Kara Zivin, Ph.D. for their helpful contributions.
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Burnett-Zeigler, I., Lyons, J.S. Caregiver Factors Predicting Service Utilization Among Youth Participating in a School-based Mental Health Intervention. J Child Fam Stud 19, 572–578 (2010). https://doi.org/10.1007/s10826-009-9331-5
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DOI: https://doi.org/10.1007/s10826-009-9331-5