Session: Factors Associated with Mental Health Service Use among School-Aged Children and Adolescents across Service Sectors (Society for Social Work and Research 14th Annual Conference: Social Work Research: A WORLD OF POSSIBILITIES)

Estimates have indicated that about 12%-17% (7.5-14 million) of youth in the United States suffer from an emotional or behavioral disorder that impairs their functioning (Hoberman, 1992; USDHHS, 2001), while only about 20% of all youth with mental health needs receive care (USDHHS, 1999). For many youth, especially ethnic minorities, psychiatric emergency services (PES) are the first contact or entry point into the mental health service system (Sadka, 1995). The majority of youth contacting PES are ultimately dispositioned to community-based services, where their likelihood of having unmet mental health needs persist (Juszczak, Melinkovich, & Kaplan, 2003). Unmet need among youth is particularly concerning given the onset of many psychological disorders during childhood/adolescence, and the increased risk for disrupted developmental trajectories among youth with emotional and behavioral problems. Increasingly, there is a need to examine factors associated with formal service use, across a diversity of service sectors. Once these factors are understood, services researchers and practitioners might design interventions and strategies to improve access to care for youth with serious mental health needs. Proposed are four studies that explore factors underlying mental health service use among school-aged children and adolescents.

The first paper in this symposium examines demographic and diagnostic factors associated with PES use among suicidal adolescents, in particular, factors that predict either outpatient disposition or inpatient treatment for this group. Findings indicate both race and gender differences regarding case disposition for suicidal youth who access PES.

The second paper explores the help-seeking behaviors and service use experiences of maltreated youth and their families; a secondary aim explores how type of placement (e.g. home vs. foster care) facilitates, delays or prohibits entrée into care. Study results suggest that whether maltreated youth access services depended on placement type; caregivers of youth who remained in their homes were more likely to contact community-based services through coercive means.

The third paper examines social network influences (e.g. family and friend support; size of network) on help-seeking and service use among urban youth. Findings from this study indicate that youth accessing treatment, particularly school-based services, were more likely to express positive social network support. Larger network size was associated with school, not community-based mental health service use.

The fourth paper explores the relationship between perceived stigma, diagnosed depression and mental health service utilization among urban adolescents accessing community-based mental health treatment. Findings from this study highlight the influence of depression on perceived stigma among ethnic minority youth, and provide important implications regarding the service use experiences for depressed adolescents.

Discussion across these papers will focus on the importance examining factors associated with formal mental health service use among youth in order to bridge the gap between mental health need and service use. In particular, the symposium will highlight the relative importance of factors influencing treatment among suicidal youth, factors influencing service use among child welfare involved youth, and the social network influences and perceptual barriers that impede mental health service use, particularly among ethnic minority youth.