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Different treatment thresholds in non-Western children with behavioral problems.

Barbara W C Zwirs1, Huibert Burger, Tom W J Schulpen

  • 1Department of Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands. b.zwirs@wkz.azu.nl

Journal of the American Academy of Child and Adolescent Psychiatry
|April 8, 2006
PubMed
Summary

Non-Western children in the Netherlands receive less treatment for behavioral problems than Western children, even when problem severity is similar. This highlights a need for better detection of behavioral issues in ethnic minority youth.

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Area of Science:

  • Child and Adolescent Psychiatry
  • Public Health
  • Cross-cultural Psychology

Background:

  • Behavioral problems in children are a significant concern.
  • Disparities in healthcare access and treatment exist among ethnic minority groups.
  • Understanding these disparities is crucial for equitable child mental health services.

Purpose of the Study:

  • To investigate treatment disparities for behavioral problems between Western and non-Western children in the Netherlands.
  • To examine if differences in problem behavior or impairment explain treatment gaps.
  • To identify ethnic and gender-specific patterns in treatment access.

Main Methods:

  • A cross-sectional study of 2,185 children (grades 3-5) from Dutch, Moroccan, Turkish, and Surinamese backgrounds.

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  • Teacher-reported Strengths and Difficulties Questionnaire and DSM-IV externalizing problem items were used.
  • Treatment status was assessed by teachers, controlling for age, problem behavior, and impairment.

    • Main Results:

    • Moroccan boys showed more, Turkish boys less, and Surinamese boys similar externalizing problem behavior compared to Dutch boys.
    • No significant differences in problem behavior were found between Western and non-Western girls.
    • Moroccan, Turkish children, and Surinamese girls were less likely to receive treatment, irrespective of problem severity or impairment.

    Conclusions:

    • Treatment thresholds for behavioral problems are higher for non-Western children in the Netherlands.
    • These disparities are not explained by differences in the level of problem behavior or impairment.
    • Increased attention is needed for detecting behavioral problems in non-Western children to ensure timely and equitable care.