Factors associated with mental health, general health, and school-based service use for child psychopathology.

Abstract

OBJECTIVES: This study was designed to identify factors associated with service use for child psychopathology in three settings: mental health, general health, and school. METHODS: Subjects were 2519 children, 6 to 11 years of age, assessed in two cross-sectional Connecticut surveys in the late 1980s. Three groups of variables (sociodemographics, child's illness profile, and parental attitudes) were examined through multivariate logistic regression. RESULTS: Most sociodemographics showed moderate associations with all settings, although some previously reported effects (e.g. birth order, sibship size) were not observed. Of the illness profile measures, only Child Behavior Checklist total scores predicted use in the final model (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.1, 2.3). Health problems were associated with increased use in all settings (OR = 1.5, 95% CI = 1.3, 1.9), while academic problems were associated only with increased school service use (OR = 5.2, 95% CI = 3.9, 7.0). Parental belief that the child needed help was most strongly associated with service use (common OR for all settings = 5.3, 95% CI = 4.1, 6.8). CONCLUSIONS: Sociodemographics, parental attitudes, and children's illness profiles independently influence service use for psychopathology in school-aged children.

Help seeking for emotional and behavioural problems in children and adolescents

“…In childhood and early adolescence more help is sought for boys, whereas in late adolescence, girls seek help more frequently [16,19,20,41,50]. This finding may result from the fact that externalising problems, which are more prevalent in boys than girls, tend to decrease with age, whereas internalising problems, which are more typical for girls, tend to increase with age.…”

Help-Seeking for Child Psychopathology: Pathways to Informal and Professional Services in The Netherlands

“…Help-seeking is assumed to be influenced by a child's gender, age, academic problems, family functioning, changes in family structure, single parenthood, and mental health service use by a relative (Briggs-Gowan et al, 2000;Feehan et al, 1994;Gunther et al, 2003;Jensen , 1990;John et al, 1995;Lavigne et al, 1998;Rickwood and Braithwaite, 1994;Verhulst and Van der Ende, 1997;Zahner and Daskalakis, 1997).…”

“…First, based on previous results concerning the importance of the school in the detection of children with coexisting academic problems and the provision of care to these children (Verhulst and Van der Ende, 1997;Zahner and Daskalakis, 1997), academic problems are expected to affect service need through teachers' perceptions of child problems rather than through parents' reports of child symptoms and to be related to school service use only.…”

Incorporating missingness for estimation of marginal regression models with multiple source predictors

“…In the case of two multiple informant predictors, monotone missingness often occurs when one predictor has missingness and the other is complete; for example, a mental health service utilization study had many teacher ratings of children missing but all parents responded about their children [3], [4], [5], [6], [7]. In general, multiple informant data missingness is not necessarily monotone and missing responses are also possible.…”

“…In the Hernández et al [2] study with body mass index (BMI) as response and physical activity reported by the child and the child's mother, 26% of the cases have missingness either in the response, the multiple informant variables or both. In a study of mental health service utilization in children from Connecticut, 43% of cases had missingness [3], [4], [5], [6], [7]. Having a large amount of missingness can lead to inferential problems including bias and efficiency loss [8].…”