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Patterns of Child Mental Health Service Delivery in a Public System: Rural Children and the Role of Rural Residence

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Abstract

This study uses existing data from Hawaii’s public mental health system for children and youth as an example of a state-level examination of service use patterns and health care disparities. The purpose of this study was to compare differences in mental health service utilization between rural and non-rural children, especially use of residential services. This study used a performance measure approach to conduct multi-level modeling on existing administrative data to examine the impact of community factors on service utilization. Rural children were found to have the most serious levels of mental health problems at intake, more likely to be placed in out-of-home care, more likely to receive only out-of-home care, more likely to in stay out-of-home longer, and less likely to receive follow-up care than their non-rural counterparts. Practice, policy, and research implications are discussed.

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Notes

  1. The term “school district” is used throughout this paper to refer to what the state of Hawaii terms “school complexes,” in order to conform with nationally used terms for school governance entities below the level of the state department of education.

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Acknowledgments

The authors thank Robert Saunders, Ph.D., for his early work on the dataset. At the time the data for this study were pulled, Dr. Higa-McMillan was working for the Hawaii Department of Health, and Dr. Brannan was affiliated with Vanderbilt University. This research was supported by a grant from the National Institute of Mental Health (R01MH70680). The opinions contained in this document are those of the authors and do not necessarily reflect those of the funding source or the Hawaii Department of Health.

Conflict of Interest

There are no conflicts of interest or disclosures.

Author information

Authors and Affiliations

  1. Vanderbilt University, Nashville, TN, USA

    Craig Anne Heflinger PhD & Laurel Lunn PhD

  2. Hawaii Department of Health, Child and Adolescent Mental Health Division, Maui Family Guidance Center, Kahalui, HI, USA

    Virginia Shaw PhD

  3. University of Hawaii, Hilo, HI, USA

    Charmaine Higa-McMillan PhD

  4. Indiana University, Bloomington, IN, USA

    Ana Maria Brannan PhD

Authors
  1. Craig Anne Heflinger PhD
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  2. Virginia Shaw PhD
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  3. Charmaine Higa-McMillan PhD
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  4. Laurel Lunn PhD
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  5. Ana Maria Brannan PhD
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Corresponding author

Correspondence to Craig Anne Heflinger PhD.

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Heflinger, C.A., Shaw, V., Higa-McMillan, C. et al. Patterns of Child Mental Health Service Delivery in a Public System: Rural Children and the Role of Rural Residence. J Behav Health Serv Res 42, 292–309 (2015). https://doi.org/10.1007/s11414-015-9464-9

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  • DOI: https://doi.org/10.1007/s11414-015-9464-9

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