The role of parental burden in child mental health service use: longitudinal study

Area of Science:

• Child and Adolescent Psychiatry
• Health Services Research
• Longitudinal Studies

Background:

• Predicting specialist child mental health service use is crucial for timely intervention.
• Previous studies suggest functional impairment and parental burden are key predictors.
• Longitudinal data are needed to understand the evolving role of different factors.

Purpose of the Study:

• To determine the relative predictive power of symptom severity, functional impairment, and parental burden on specialist child mental health service use.
• To examine these associations over a 4-year period.
• To identify factors influencing referral to child mental health services.

Main Methods:

• A community-based sample of 1,168 children (aged 5-11) in the UK completed Strengths and Difficulties Questionnaires.
• A prospective longitudinal design tracked referrals to specialist mental health services over 4 years.
• Statistical analysis compared referred and non-referred children and examined changes in predictor associations over time.

Main Results:

• Only 5.1% of children were referred to specialist services over the 4-year period.
• Symptom severity was the strongest predictor of future referrals, with increased symptom scores correlating with higher odds of referral.
• Parental burden predicted referrals only in the first year, while conduct and emotional problems predicted later referrals.

Conclusions:

• Contrary to cross-sectional findings, this longitudinal study identifies symptom severity as the primary predictor of specialist child mental health service use.
• Significant delays exist in accessing specialist mental health services for children.
• Understanding predictive factors is essential for improving service accessibility and outcomes.