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Mental health service use in a community head start population
Michelle New1, Brian Razzino, Amy Lewin
1Center for Health Services and Clinical Research, Children's National Medical Center, Washington, DC, USA. mnew@cnmc.org
Insights
Young children in Head Start programs show unmet mental health needs, with parent well-being and home environment impacting service use. Interventions should support parents and children for better outcomes.
Area of Science:
- Child Psychology
- Mental Health Services Research
- Early Childhood Education
Background:
- The Starting Early Starting Smart (SESS) program aimed to evaluate mental health service access for young children.
- This study presents preliminary findings from the SESS program within a Head Start population.
Purpose of the Study:
- To examine family mental health and service utilization in Head Start children at study entry.
- To identify factors associated with child behavior problems and mental health service use.
Main Methods:
- Longitudinal study of 290 Head Start children (mean age 4.3 years) enrolled in 1998-1999.
- Data collected via caregiver and teacher interviews/questionnaires on demographics, child/parent mental health, and service use.
- Assessed concordance between parent and teacher behavior ratings.
Main Results:
- Low agreement between parent and teacher ratings of child behavior problems.
- Teacher-identified problems linked to male sex and home environment; parent-identified problems linked to parent mental health and parent-child relationship.
- Home environment was the only factor associated with child-focused service utilization.
Conclusions:
- Demographic factors did not predict behavior problems or service use in this Head Start cohort.
- Children with behavioral issues appear to have unmet mental health service needs.
- Interventions addressing parent mental health and child developmental needs may improve service utilization.
Background:
Evaluating access to and delivery of mental health services for young children was a primary objective of the national research demonstration program Starting Early Starting Smart (SESS).
Objective:
To present preliminary findings on family mental health and use of services in a community Head Start population at time of entry into a longitudinal study as part of the SESS program.
Subjects:
Children enrolled for Head Start entry in 1998 and 1999 (N = 290; mean age, 4.3 years). Of these children, 52% were boys.
Methods:
Data on demographic factors, child and parent mental health, and service use were collected from the sample at baseline. Information was gathered from primary caregivers and teachers using standardized questionnaires and structured interviews.
Results:
There was low concordance between parent and teacher ratings of child behavior. Factors predicting behavior problems in young children varied according to whether the parent or teacher rated the child as having behavior problems. Sex (male) and home environment were associated with teachers rating the child as having a behavior problem. Parent mental health problems and problems in the parent-child relationship were associated with parent ratings. Only home environment was associated with child-focused service utilization (services that help parents manage children's behavior).
Conclusions:
Demographic risk factors were not associated with child behavior problems or use of mental health services in this group of Head Start children. Findings suggest that children with behavioral problems have unmet mental health service needs. Interventions designed to address both parent mental health needs and sensitivity to the developmental needs of children may increase child-focused mental health service utilization.