This paper will outline a series of three research studies meant to identify factors related to child mental health service usage and barriers to help seeking for urban minority children and their caretakers. In addition, this paper will describe the systematic development and evaluation of a telephone intervention strategy aimed towards increasing overall attendance at initial intake appointments at an urban child serving agency. The first study explores differences in demographic variables, for two groups of children (n = 450), those that came to an initial intake interview and those that requested child mental health services, but failed to come to any scheduled appointments. The second study evaluates a telephone engagement intervention meant to increase initial attendance (n = 54). Finally, the third study, more rigorously evaluates the impact of an intensive telephone intervention on initial attendance rates by randomly assigning families to the more focused telephone intervention or a "business as usual" telephone screening (n = 108).

This article presents the results of a study that evaluated the effects of two engagement interventions on the initial attendance and ongoing retention in child mental health services of 109 primarily children of color and their families. Both the combined intervention (telephone and first interview) and the telephone-alone intervention were associated with significant increases in attendance at initial intake appointments over the usual intake procedure, but only the combined intervention was related to the greater ongoing use of services. Implications for future research and recommendations for modifying procedures in outpatient child mental health centers are also presented.

The authors present the results of two studies designed to improve treatment engagement among urban youths with conduct and oppositional behavioral difficulties. In the first study, information on attitudes about mental health treatment was obtained from 159 adult caregivers of children who were referred to an urban child mental health clinic because of disruptive behavioral difficulties. The caregivers listed insufficient time, lack of transportation, the child's not wanting to attend treatment, and the caregiver's concern that treatment might not help as barriers to service use. The data from study 1 were used to design a multiple-family group intervention to be tested in study 2. The families who participated in these groups attended an average of seven sessions during the 16-week study, compared with four sessions for families who participated in family therapy and three for families who participated in individual psychotherapy.

Objective: This article presents an evaluation of a multiple family group intervention (MFG) designed to meet the mental health needs of low-income minority children and families. Method:Children participating in the MFG are compared with children demographically and clinically similar who received individual or family therapy services at an urban mental health center. Results: Of the children referred for MFG, 59% were still in service by the 16th group meeting. Of the children assigned to individual or family therapy, only 39% were in service after 16 weeks. Data from the subsamples that attended 16 weeks of MFG or therapy sessions were analyzed, and significant decreases in total disruptive behavior, conduct problems, learning difficulties, hyperactivity, and impulsivity were associated with MFG participation. Conclusion: Follow-up interviews revealed that 70% of MFG parents noted child improvements, in comparison to 54% of parents whose children received individual family therapy.

This article will focus on increasing the ability of social workers to provide mental health services to urban, low-income children and their caretakers. A conceptual model for understanding the process of engagement will be presented. Further, a protocol for training social workers to conduct first interview/engagement interviews and the results of a study evaluating its impact will be highlighted. One hundred seven children and their families were randomly assigned to one of two conditions: (1) first interviewers trained in specific engagement skills, and (2) other therapists within an urban mental health agency. Of the 33 children assigned to first interviewers, 29 (88%) came for a first appointment and 97% (n = 28) of those returned for a second appointment. In comparison, of the 74 clients assigned to the routine first interview condition, 47 (64%) came for an initial appointment and only 83% (n = 39) returned for a second appointment. The average length of treatment during an 18-week study period for first interview subjects was 7.1 sessions, as opposed to 5.4 sessions for the comparison group. The applications of this model for social work education are discussed.