Predictors of outpatient mental health service use by American youth.

Abstract

Among American children and adolescents aged 1 to 17 years, the 12-to 17-year-olds represent the largest users of outpatient mental health services. This study utilizes a nationally representative sample of this age group from the 2005 National Survey on Drug Use and Health to illuminate predictors of services use from three treatment settings: day treatment programs, mental health clinics/centers, and private/in-home settings. Univariate analyses were used to calculate the percentages of the study sample that used mental health services in these settings. In bivariate analyses, the authors estimated the strength of the associations between available predisposing, need, and enabling factors and the outcomes. Multiple logistic regressions estimated the independent effects of each covariate on the outcomes. Lifetime depression, lifetime general anxiety, delinquent behaviors, drug dependence, and Medicaid were consistent predictors of services use in the three treatment settings. Several other factors were associated with services use in bivariate analyses but lost most of their statistical significance when the authors adjusted for other confounders. Interpreted in light of its potential limitations, this study has important research and policy significance.

Factors Associated with Mental Health Services Use among Disconnected African-American Young Adult Population

“…In a recent study on predictors of mental health services, both depression and anxiety were found to be important predictors of service use. 23 Although data on past depressive and anxiety symptoms were not collected, this study used current symptoms as a proxy for past symptoms, given data suggesting moderate stability in depressive and anxious symptomatology during adolescence. 24,25 Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale.…”

“…5 However, provision of mental health services to adolescents and young adults in the US has proven challenging. For instance, among [18][19][20][21][22][23][24] year old African-Americans in the CPES, only 25% used any service for sadness lasting more than 2 weeks (e.g., medical doctor, psychiatrist, other mental health professional, spiritual leader, or healer), with this percentage dropping to 19% among unemployed [18][19][20][21][22][23][24] year old African-Americans. 4 Using 10-year follow-up data from a school-based study, Cuffe et al 6 found that among seventh to tenth graders, there was a significant drop in outpatient mental health service use as they grew older.…”

“…Perhaps as a result of these different sources of stress, adolescents and young adults between the ages of 16 and 24 in the USA are particularly vulnerable to certain mental disorders and emotional problems. The National Comorbidity Survey found that 25% of young adults in the [16][17][18][19][20][21][22][23][24] year age group experience depressive disorders by the age of 24, 2,3 and the Collaborative Psychiatric Epidemiology Surveys (CPES) found that about 13% of 18-24-year-old African-American youths had a depressive disorder. 4 The increased susceptibility to mental health problems among emerging adults is best addressed by provision of appropriate mental health services.…”

“…While there is some literature on mental health services use by African-American adolescents and young adults, there is no known previous research examining mental health service use among a particularly vulnerable population of African-American adolescents and young adults-i.e., those who are disconnected from school and enrolled in employment training programs. A Center for Labor Market Studies analysis estimated that in 2001 there were 5.2 million [16][17][18][19][20][21][22][23][24] year olds in the US who were disconnected from school and the labor force. 11 The mental health needs of such a population are potentially unique and need to be ascertained in order to provide appropriate services.…”

Caregiver Factors Predicting Service Utilization Among Youth Participating in a School-based Mental Health Intervention

“…Although large numbers of children and adolescents experience a diagnosable psychiatric disturbance (Costello et al 1996;Cuffe et al 1995;Leaf et al 1996) the majority of those with need do not utilize mental health services (Alexandre et al 2008;Cuffe et al 1995). Additionally, even among those who do access services, rates of service use tend to decrease over time.…”