Adolescents’ Use of Care for Behavioral and Emotional Problems: Types, Trends, and Determinants

Abstract

ObjectiveWhile adolescents use various types of care for behavioral and emotional problems, evidence on age trends and determinants per type is scarce. We aimed to assess use of care by adolescents because of behavioral and emotional problems, overall and by type, and its determinants, for ages 10–19 years.MethodsWe obtained longitudinal data on 2,230 adolescents during ages 10–19 from four measurements regarding use of general care and specialized care (youth social care and mental healthcare) in the preceding 6 months, the Child Behavior Checklist (CBCL) and Youth Self-Report, and child and family characteristics. We analyzed data by multilevel logistic regression.ResultsOverall rates of use increased from 20.1% at age 10/11 to 32.2% at age 19: general care was used most. At age 10/11 use was higher among boys, at age 19 among girls. Use of general care increased for both genders, whereas use of specialized care increased among girls but decreased among boys. This differential change was associated with CBCL externalizing and internalizing problems, school problems, family socioeconomic status, and parental divorce. Preceding CBCL problems predicted more use: most for mental health care and least for general care. Moreover, general care was used more frequently by low and medium socioeconomic status families, with odds ratios (95%-confidence intervals): 1.52 (1.23;1.88) and 1.40 (1.17;1.67); youth social care in case of parental divorce, 2.07 (1.36;3.17); and of special education, 2.66 (1.78;3.95); and mental healthcare in case of special education, 2.66 (1.60;4.51).DiscussionAdolescents with behavioral and emotional problems use general care most frequently. Overall use increases with age. Determinants of use vary per type.

Differences in care provided to children with behavioral and emotional problems in a delineated region by using the Taxonomy of Care for Youth (TOCFY)

“…'Individual child support' concerned the largest part of the interventions offered, but to a varying degree per provider with its share being largest for MHC. An explanation could be that MHC focuses more on severe mental health problems that require more specialized, individualized support (Reijneveld et al, 2014). In CYC, the share of 'individual child support' was somewhat smaller, which fits with the focus in this type of support being more on the social background of the child (Reijneveld et al, 2014).…”

“…An explanation could be that MHC focuses more on severe mental health problems that require more specialized, individualized support (Reijneveld et al, 2014). In CYC, the share of 'individual child support' was somewhat smaller, which fits with the focus in this type of support being more on the social background of the child (Reijneveld et al, 2014). That may cause the range of types of support provided to be wider.…”

“…Typically, PCHC mainly offered short-term care and treatment aimed at parents, as might be expected due to the relatively mild problems compared to CYC and MHC (Faber, Burgers, & Westert, 2012). CYC offered a much wider range of services, mainly in a home-based or residential setting, which reflects the context-focused approach and the main target group of the provider (Reijneveld et al, 2014). This may also explain the rather surprising finding that girls were more likely to have CYC support, but this definitely requires further study.…”

“…Behavioral and emotional problems can lead to severe restrictions in the functioning of children and as a consequence to an impaired development (Maschi, Hatcher, Schwalbe, & Rosato, 2008;Ormel et al, 2017;Spijkers, Reijneveld, & Jansen, 2013). This makes it of major importance to provide support that adequately addresses children's problems timely, which is currently not always the case (Nanninga, Jansen, Knorth, & Reijneveld, 2017;Reijneveld et al, 2014). The number and types of support increased tremendously over the years (Kazdin, 2000;Loeffen, Ooms, & Wijgergangs, 2004;Veerman, Janssens, & Delicat, 2005).…”

Cost‐effectiveness of multisystemic therapy versus usual treatment for young people with antisocial problems

“…Estimates of rates of behavioural problems among adolescents vary from 10 to 25% (Reijneveld et al, ), with serious consequences, including costs, both for the individual and society (Knuutila, ; Algemene Rekenkamer, ; Cary et al, ; Ter Bogt et al, ). Disruptive and aggressive behaviour during adolescence has been associated with dropping out of school, criminal involvement, incarceration, psychological disorders and low employment (Ogden and Hagen, ; Loeber et al, ; Smith & Smith, ).…”