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Mental health service use among young children receiving pediatric primary care
J V Lavigne1, R Arend, D Rosenbaum
1Northwestern University Medical School, Chicago, USA.
Insights
Young children with more behavioral issues and family conflict are more likely to receive mental health services. Pediatricians play a key role in connecting these children to care.
Area of Science:
- Child Psychology
- Pediatric Mental Health
- Healthcare Services Research
Background:
- Mental health service utilization in early childhood is crucial for long-term outcomes.
- Understanding factors influencing access to care for young children is essential.
Purpose of the Study:
- To identify factors associated with mental health service use in preschool-aged children.
- To examine predictors of service utilization among children with diagnosed mental health conditions.
Main Methods:
- Longitudinal study of 510 preschool children (ages 2-5) with data collected at two waves.
- DSM-III-R diagnoses assigned using best-estimate procedures.
- Utilized Child Behavior Checklist, developmental evaluations, and parent surveys on service use.
Main Results:
- Older age, existing diagnosis, higher behavior problems, and family conflict predicted service use.
- Among diagnosed children, older age, white race, greater impairment, family conflict, and pediatric referral were associated with more services.
- Pediatric referral was a significant predictor of service utilization.
Conclusions:
- Children with greater impairment and family conflict are more likely to access mental health treatment.
- Disparities in service access exist among different racial groups of children with diagnoses.
- Pediatric referrals are critical for facilitating mental health service use in young children.
Objective:
To investigate the factors associated with mental health service use among young children.
Method:
Five hundred ten preschool children aged 2 through 5 years were enrolled through 68 primary care physicians, with 388 (76% of the original sample) participating in a second wave of data collection, 12 to 40 months later. Consensus DSM-III-R diagnoses were assigned using best-estimate procedures. The test battery included the Child Behavior Checklist, a developmental evaluation, the Rochester Adaptive Behavior Inventory, and a videotaped play session (preschool children) or structured interviews (older children). At wave 2, mothers completed a survey of mental health services their child had received.
Results:
In logistic regression models, older children, children with a wave 1 DSM-III-R diagnosis, children with more total behavior problems and family conflict, and children receiving a pediatric referral were more likely to receive mental health services. Among children with a DSM-III-R diagnosis, more mental health services were received by children who were older, white, more impaired, experiencing more family conflict, and referred by a pediatrician.
Conclusions:
Young children with more impairment and family conflict are more likely to enter into treatment. Services among young children of different races with diagnoses are not equally distributed. Pediatric referral is an important predictor of service use.