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Related Experiment Videos

Functioning mediates between symptoms and provider assessment.

Catherine Woodstock Striley1, Arlene Rubin Stiffman, Edward L Spitznagel

  • 1Department of Psychiatry, School of Medicine, Washington University, St. Louis, Missouri, USA. strileyc@epi.wustl.edu

Mental Health Services Research
|July 1, 2004
PubMed
Summary
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Youth behavioral health needs often go unmet. This study found that while youth functioning may link symptoms to provider assessment, organizational and provider factors ultimately explain service use better.

Area of Science:

  • Child and Adolescent Psychiatry
  • Health Services Research
  • Behavioral Health

Background:

  • A significant gap exists between service needs and service utilization for adolescents with behavioral health issues.
  • Provider perceptions of need influence service access, yet youth self-reports and provider perceptions show weak correlations.

Purpose of the Study:

  • To investigate whether provider perception of functioning mediates the relationship between youth symptoms and provider assessment of need.
  • To determine the role of functioning and contextual factors in explaining service use variance.

Main Methods:

  • Structural equation modeling was used to analyze data from 792 adolescents (ages 14-18) and 222 of their providers.
  • Data included interviews on service need/use and provider surveys.

Related Experiment Videos

Main Results:

  • Functioning mediated the link between symptoms and assessment when contextual variables were excluded.
  • Including contextual factors rendered functioning non-significant in predicting assessment and reduced overall service variance explained (46% vs. 55%).
  • Organizational and individual provider variables were stronger predictors of service variance than functioning.

Conclusions:

  • While youth functioning may partially explain the symptom-assessment link, it does not fully account for service use.
  • Provider and organizational factors are critical determinants of service access and utilization for youth behavioral health.
  • Future interventions should consider these broader contextual influences to improve service delivery.