The Role of Caregiver Strain and Other Family Variables in Determining Children's Use of Mental Health Services

Abstract

This study used a prominent model of family stress and coping to examine whether caregiver and family variables predicted child mental health service utilization patterns, holding constant the child clinical and demographic variables.We were especially interested in the impact of caregiver strain on children's use of mental health services. We found caregiver strain to be associated with the combination of services used, sequencing of services, gaps in care, and cost of services. Other family variables that predicted children's service use included material resources, life events, and family functioning. Child clinical variables improved the explanatory power of the models considerably. When all other variables were included in the model, child's age was the only demographic variable that predicted service use patterns. et al., 1987). Once in services, older children tend to use more services (Realmutto et al., 1992;Roghmann et al., 1982) and experience more restrictive levels of care

Measurement Quality of the Caregiver Strain Questionnaire-Short Form 7 (CGSQ-SF7)

“…A large body of evidence indicates that caregiver strain has important implications for how children use mental health services (e.g., Bussing et al 2003b;Brannan and Heflinger 2005;Brannan et al 2003). In particular, children of caregivers who reported greater strain were more likely to enter mental health services, receive more restrictive services, and incur higher costs of care.…”

The Stigma of Childhood Mental Disorders: A Conceptual Framework

“…23 Furthermore, although it is thought that children suffer many of the consequences of stigma directly, 34, 55 they rarely seek professional help on their own--parents or other family caregivers act as their agents and, thus, play a unique role that must also be acknowledged and examined. Therefore, the traditional tendency to blame child misconduct on poor parenting, 57,58 compounded by vulnerability of children (including insufficient legal protections) 23 and the role of family caregivers in help-seeking, 25,55,59 places children and their families under unique stigmatizing contexts, most of which have not been adequately studied.…”

Use of the Family Resource Scale in Children’s Mental Health: Reliability and Validity among Economically Diverse Samples

“…When operationalized in terms of perceived adequacy of resources, having fewer family resources increased the risk that children would have breaks in care of 30 days or longer in one study (Brannan, Heflinger, & Foster, 2003). As part of an evaluation designed to examine the effectiveness of a continuum of care, some analyses included both perceived adequacy of resources and actual family income.…”