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Published on: March 27, 2012
Do needs drive services use in young children?
Sarah McCue Horwitz1, Lisa C Gary, Margaret J Briggs-Gowan
1Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06520-8034, USA. sarah.horwitz@uhh.com
Insights
Parental recognition of child mental health issues varies by family factors, but service use is limited, especially for mental health concerns compared to physical or developmental problems. Needs alone do not drive service use.
Area of Science:
- Child and Adolescent Psychiatry
- Health Services Research
- Pediatric Mental Health
Background:
- Parental recognition of child health problems is crucial for timely intervention.
- Understanding factors influencing service utilization is key to improving pediatric care.
- Disparities in service use for mental health versus physical/developmental issues warrant investigation.
Purpose of the Study:
- To identify predictors of parental recognition of children's mental health problems.
- To examine factors associated with service use for these problems.
- To compare how mental health, physical health, and developmental problems influence service use.
Main Methods:
- Survey of parents from a random sample of children in Connecticut.
- Analysis of age- and sex-stratified data from birth records.
- Logistic regression to assess relationships between child/family factors and outcomes.
Main Results:
- Child and family factors predicted problem recognition (e.g., considering services).
- Service use was primarily linked to physical health, developmental problems, parental worry about language, and family conflict.
- Mental health problems were less likely to be discussed with professionals or lead to service receipt compared to physical/developmental issues.
Conclusions:
- Factors influencing problem recognition differ from those driving service use.
- While all problem types affect recognition, mental health issues do not translate to service use at the same rate.
- Service use patterns suggest that factors beyond identified needs influence access to care.
Objective:
To determine whether different factors predicted parental recognition of mental health problems in children and use of services for those problems and to determine whether mental health problems elicit service use in the same way as physical health or developmental problems.
Methods:
Survey of the parents of an age- and sex-stratified random sample of children who were born in 1 Connecticut hospital selected from state birth records.
Results:
Logistic regression results demonstrate that a number of child and family factors are related to problem recognition, defined as thinking about seeking services and/or talking to a professional about a problem. However, factors related to the third outcome of interest-service use-are more limited and include only physical health and developmental problems, parental worry about language, and family conflict. Furthermore, mental health problems were not discussed with professionals, and they were not associated with receipt of services at the same rates as physical health or developmental problems.
Conclusions:
The correlates of problem recognition (defined as thinking about seeking services or actually speaking to a professional about a problem) differ from those of service use, and, whereas mental health, physical health, and developmental problems all affect problem recognition, mental health problems do not result in service use. Furthermore, rates of service use vary dramatically across the 3 categories. These results suggest that needs alone do not drive service use. Rather, other factors may influence which needs are met.
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