Skip to main content
SpringerLink
Log in

Cross-Sectional Study of Unmet Mental Health Need in 5- to 7-Year Old Latino Children in the United States: Do Teachers and Parents Make a Difference in Service Utilization?

  • Original Paper
  • Published:
School Mental Health Aims and scope Submit manuscript

Abstract

The aim of the study is to examine the rates of mental health service utilization in young Latino children of immigrants in relation to maternal and teacher reports of child mental health need. Specific knowledge is lacking about gaps in service utilization among young Latino children, the fastest growing and possibly the most underserved segment of the US child population. The associations of mental health service utilization (Service Assessment for Children and Adolescents) and mental health need (clinical levels of internalizing, externalizing, or total problems reported by mothers [Child Behavior Checklist] and teachers [Teacher’s Report Form]) were examined in a community sample of young Latino children of immigrants (n = 228; mean age = 6) and compared across mothers’ and teachers’ responses. Mother–teacher agreement was also studied. Sixty-five children (28.5 %) had a mental health need; most (76.9 %) of these received no services. For all types of mental health need, service utilization was more likely when need was reported by mothers rather than teachers (p = .03). Teachers’ reports were not associated with service utilization. Mother–teacher agreement was low for externalizing (r = .23; p ≤ 0.01) and total problems (r = .21; p ≤ 0.05), and nonsignificant for internalizing problems. This study is the first in the United States to document, in such a young Latino group, high rates of unmet need comparable to those among older Latino youth; low or no mother–teacher agreement on which children had a mental health need; low utilization of school-based services; and a lack of association between service utilization and teacher-reported mental health need—both for externalizing and internalizing problems. These findings suggest that schools are not effectively leveraging mental health services for young Latino children. Potential factors responsible for the findings are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Achenbach, T. M., & Rescorla, L. (2001). Manual for the ASEBA school-age forms & profiles: Child behavior checklist for ages 6–18, teacher’s report form, youth self-report: An integrated system of multi-informant assessment. ASEBA.

  • Alegria, M., Canino, G., Lai, S., Ramirez, R. R., Chavez, L., & Rusch, D. (2004). Understanding caregivers’ help-seeking for Latino children’s mental health care use. Medical Care, 42(5), 447–455.

    Article  PubMed  Google Scholar 

  • Alegria, M., Vallas, M., & Pumariega, A. (2010). Racial and ethnic disparities in pediatric mental health. Child and Adolescent Psychiatric Clinics of North America, 19(4), 759–774.

    Article  PubMed  Google Scholar 

  • Bean, D. L., Rotheram-Borus, M. J., Leibowitz, A., Horwitz, S. M., & Weidmer, B. (2003). Spanish-language services assessment for children and adolescents (SACA): reliability of parent and adolescent reports. Journal of the American Academy of Child and Adolescent Psychiatry, 42(2), 241–248.

    Article  PubMed  Google Scholar 

  • Bird, H. R. (1996). Epidemiology of childhood disorders in a cross-cultural context. Journal of Child Psychology and Psychiatry and Allied Disciplines, 37(1), 35–49.

    Article  Google Scholar 

  • Bird, H. R., Gould, M. S., Rubio-Stipec, M., Staghezza, B. M., & Canino, G. (1991). Screening for childhood psychopathology in the community using the child behavior checklist. Journal of the American Academy of Child and Adolescent Psychiatry, 30(1), 116–123.

    Article  PubMed  Google Scholar 

  • Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., & Farmer, E. M. (1995). Children’s mental health service use across service sectors. Health Affairs (Millwood), 14(3), 147–159.

    Article  Google Scholar 

  • Burns, B. J., Phillips, S. D., Wagner, H. R., Barth, R. P., Kolko, D. J., & Campbell, Y. (2004). Mental health need and access to mental health services by youths involved with child welfare: A national survey. Journal of the American Academy of Child and Adolescent Psychiatry, 43(8), 960–970.

    Article  PubMed  Google Scholar 

  • Canino, G., Shrout, P. E., Alegria, M., Rubio-Stipec, M., Chavez, L. M., & Ribera, J. C. (2002). Methodological challenges in assessing children’s mental health services utilization. Mental Health Services Research, 4(2), 97–107.

    Article  PubMed  Google Scholar 

  • Collins, B. A., O’Connor, E., Suárez-Orozco, C., Nieto-Castañon A., & Toppelberg, C. O. (in press). Dual language profiles of Latino children of immigrants: Stability and change over the early school years. Applied Psycholinguistics.

  • De Los Reyes, A., & Kazdin, A. E. (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131(4), 483–509.

    Article  PubMed  Google Scholar 

  • Edgington, E. (1995). Randomization tests (3rd ed.). New York, NY: Dekker.

    Google Scholar 

  • Goodman, S. H., Hoven, C. W., Narrow, W. E., Cohen, P., Fielding, B., & Alegria, M. (1998). Measurement of risk for mental disorders and competence in a psychiatric epidemiologic community survey: The National Institute of Mental Health Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study. Social Psychiatry, 33(4), 162–173.

    Google Scholar 

  • Hoagwood, K. E., Olin, S. S., Kerker, B. D., Kratochwill, T. R., Crowe, M., & Saka, N. (2007). Empirically based school interventions targeted at academic and mental health functioning. Journal of Emotional and Behavioral Disorders, 15(2), 66–92.

    Article  Google Scholar 

  • Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159(9), 1548–1555.

    Article  PubMed  Google Scholar 

  • Kerr, D. C., Lunkenheimer, E. S., & Olson, S. L. (2007). Assessment of child problem behaviors by multiple informants: A longitudinal study from preschool to school entry. Journal of Child Psychology and Psychiatry and Allied Disciplines, 48(10), 967–975.

    Article  Google Scholar 

  • New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Rockville, MD: Final Report.

    Google Scholar 

  • Polanczyk, G., de Lima, M., Horta, B., Biederman, J., & Rohde, L. (2007). The worldwide prevalence of ADHD: A systematic review and metaregression analysis. American Journal of Psychiatry, 164(6), 942–948.

    Article  PubMed  Google Scholar 

  • Richters, J. E., & Saltzman, W. (1990). Survey of children’s exposure to community violence: Self-report. National Institute of Mental Health.

  • Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Psychology Review, 3(4), 223–241.

    Article  PubMed  Google Scholar 

  • Stanger, C., & Lewis, M. (1993). Agreement among parents, teachers, and children on internalizing and externalizing behavior problems. Journal of Clinical Child Psychology, 22(1), 107.

    Article  Google Scholar 

  • Stephan, S. H., Weist, M., Kataoka, S., Adelsheim, S., & Mills, C. (2007). Transformation of children’s mental health services: The role of school mental health. Psychiatric Services (Washington, DC), 58(10), 1330–1338.

    Article  Google Scholar 

  • Thompson, R., & May, M. A. (2006). Caregivers’ perceptions of child mental health needs and service utilization: an urban 8-year old sample. Journal of Behavioral Health Services & Research, 33(4), 474–482. doi:10.1007/s11414-006-9021-7.

    Article  Google Scholar 

  • Toppelberg, C. O., & Collins, B. (2010). Language, culture, and adaptation in immigrant children. Child and Adolescent Psychiatric Clinics of North America, 19(4), 697–717. doi:10.1016/j.chc.2010.07.003.

    Article  PubMed  Google Scholar 

  • U. S. Bureau of the Census. (2000). 2000 Census of population.

  • Vega, W., & Lopez, S. (2001). Priority issues in Latino mental health services research. Mental Health Services Research, 3(4), 189–200.

    Article  PubMed  Google Scholar 

  • Wood, P. A., Yeh, M., Pan, D., Lambros, K. M., McCabe, K. M., & Hough, R. L. (2005). Exploring the relationship between race/ethnicity, age of first school-based services utilization, and age of first specialty mental health care for at-risk youth. Mental Health Services Research, 7(3), 185–196.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by the US National Institute of Mental Health (K01 MH01947-01A2) and an Early Investigator Grant from the American Academy of Child and Adolescent Psychiatry (C.Toppelberg, PI, for both). The first author expresses his special gratitude to Stuart Hauser, MD, PhD (deceased), who provided him with inspiration, insight, and support over many years of work together. The authors also thank the teachers and schools that devoted time, energy, and space for the research; and very specially, the children and families for their generous support and participation.

Author information

Authors and Affiliations

  1. Judge Baker Children’s Center, Children’s Hospital Boston, Harvard Medical School, 53 Parker Hill Avenue, Boston, MA, 02120, USA

    Claudio O. Toppelberg

  2. Judge Baker Children’s Center, Boston, MA, USA

    Marisa O. Hollinshead & Alfonso Nieto-Castañon

  3. Hunter College, New York, NY, USA

    Brian A. Collins

Authors
  1. Claudio O. Toppelberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marisa O. Hollinshead
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brian A. Collins
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alfonso Nieto-Castañon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Claudio O. Toppelberg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Toppelberg, C.O., Hollinshead, M.O., Collins, B.A. et al. Cross-Sectional Study of Unmet Mental Health Need in 5- to 7-Year Old Latino Children in the United States: Do Teachers and Parents Make a Difference in Service Utilization?. School Mental Health 5, 59–69 (2013). https://doi.org/10.1007/s12310-012-9089-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12310-012-9089-6

Keywords

Search

Navigation