Abstract
This paper explores the use, persistence, andintensity of services for children's mental healthproblems across a variety of service sectors during aone year period. Data come from the Great SmokyMountains Study. Analyses focus on children's psychiatricsymptomatology and impairment, service use, and factorsthat may influence the relationship between psychiatricproblems and service use across a one year period. Findings show that approximately 20% ofchildren used some mental health services from somesector during the year. Child's symptomatology andcharacteristics of parents were associated with use and persistence of services. Parent'sperceptions of impact on the family were associated withservice use, persistence, and intensity.
Similar content being viewed by others
REFERENCES
Achenbach, T.M. & Edelbrock, C. (1983). Manual for-the Child Behavior Checklist and Child Behavior Profile. Burlington, VT: University of Vermont.
Aday, L.A. & Andersen, R. (1974). A framework for the study of access to medical care. Health Services Research, 208–220.
Andersen, R. & Newman, J.R. (1973). Societal and individual determinants of medical care utilization in the United States. Millbank Memorial Fund Quarterly, 51, 95–124.
Andersen, R.M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36, 1–10.
Angold, A. & Costello, E.J. (1995). A test-retest reliability study of child-reported psychiatric symptoms and diagnoses using the child and adolescent psychiatric assessment (CAPA-C). Psychological Medicine, 25, 755–762.
Angold, A., Messer, S.C., Stangl, D.K., Farmer, E.M.Z., Costello, E.J. & Burns, B.J. (1997). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, in press.
Angold, A., Predergast, M., Cox, A., Harrington, A., Simonoff, E. & Rutter, M. (1995). The Child and Adolescent Psychiatric Assessment (CAPA). Psychological Medicine, 25, 739–753.
Ascher, B.H., Farmer, E.M.Z., Burns, B.J. & Angold, A. (1996). The Child and Adolescent Services Assessment (CASA): Description and psychometrics, Journal of Emotional and Behavioral Disorders, 4, 12–20.
Bird, H.R., Canino, G., Rubio-Stipec, M., Gould, M.S., Ribera, J., Sesman, M, Woodbury, M., Suertas-Goldman, S., Pagan, A., Sanchez-Lacay, A., & Moscoso, M. (1988). Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico: The use of combined measures. Archives of General Psychiatry, 45, 1120–1126.
Brandenburg, N., Friedman, R., & Silver, S. (1990). The epidemiology of childhood psychiatric disorders: Prevalence findings from recent studies, Journal of the American Academy of Child and Adolescent Psychiatry, 29, 76–83.
Bruns, E.J., Burchard, J.D. & Yoe, J.T. (1995). Evaluating the Vermont system of care: Outcomes associated with community-based wraparound services. Journal of Child and Family Studies, 4, 321–339.
Burns, B.J., Costello, E.J., Angold, A., Tweed, D.L., Stangl, D.K., Farmer, E.M.Z. & Erkanli, A. (1995). Children's mental health service use across service sectors. Health Affairs, 14, 147–159.
Burns, B.J., Farmer, E.M.Z., Angold, A., Costello, E.J. & Behar, L.B. (1996). A randomized trial of case management for youths with serious emotional disturbance. Journal of Clinical Child Psychology, 25, 476–486.
Cohen, P. & Hesselbart, C.S. (1993). Demographic factors in the use of children's mental health services. American Journal of Public Health, 83, 49–52.
Costello, E.J., Angold, A, Burns, B.J., Erkanli, A., Stangl, D.K. & Tweed, D.L. (1996a). The Great Smoky Mountains Study of Youth: Functional impairment and severe emotional disturbance. Archives of General Psychiatry, 53, 1137–1143.
Costello, E.J., Angold, A., Burns, B.J., Stangl, D.K., Tweed, D.L., Erkanli, A. & Worthman, C.M. (1996b). The Great Smoky Mountains Study of Youth: Goals, design, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry, 53, 1129–1136.
Costello, E.J., Pescosolido, B.A., Angold, A., & Burns, B.J. (1997). A family network-based model of access to child mental health services. In J.P. Morrissey (Eds.), Social Networks and Mental Illness, Research in Community Mental Health (in press). Greenwich, CT: JAI.
Farmer, E.M.Z., Angold, A., Burns, B.J. & Costello, E.J. (1994). Reliability of self-reported service use: Test-retest consistency of children's responses to the Child and Adolescent Services Assessment (CASA). Journal of Child and Family Studies, 3, 307–325.
Jensen, P.S., Bloedau, L. & Davis. H. (1990). Children at risk: II. Risk factors and clinic utilization. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 804–812.
John, L.H., Offord, D.R., Boyle, M.H. & Racine, Y.A. (1995). Factors predicting use of mental health and social services by children 6–16 years old: Findings from the Ontario Child Health Study. American Journal of Orthopsychiatry, 65, 76–86.
Johnsen, M.C., Morrissey, J.P., & Calloway, M.O. (1996). Structure and change in child mental health service delivery networks. Journal of Community Psychology, 24, 275–289.
Little, R.J.A. & Rubin, D.B. (1987). Statistical Analysis with Missing Data. New York, NY: John Wiley & Sons.
Messer, S.C., Angold, A., Costello, E.J., Burns, B.J., Farmer, E.M.Z. & Patrick, MKS. (1996). The Child and Adolescent Burden Assessment (CABA): Measuring the family impact of emotional and behavioral problems. International Journal of Methods in Psychiatric Research, 261–284.
Offord, D.R., Boyle, M.H., Szatmari, P., Rae-Grant, N.I., Links, P.S., Cadman, D.T., Byles, J.A., Crawford, J.W., Munroe-Blum, H., Byrne, C., Thomas, H. & Woodward, C.A. (1987). Ontario Child Health Study: II. Six-month prevalence of disorder and rates of service utilization. Archives of General Psychiatry, 44, 832–836.
Pescosolido, B. & Kronenfeld, J.J. (1996). Health, illness, and healing in an uncertain era: Challenges from and for medical sociology. Journal of Health and Social Behavior.
Silver, S.E., Duchnowski, A., Kutash, K., Friedman, R.M., Eisen, M., Prange, M.E., Brandenburg, N.A. & Greenbaum, P.E. (1992). A comparison of children with serious emotional disturbances served in residential and school settings. Journal of Child and Family Studies, 1, 43–59.
Staghezza-Jaramillo, B., Bird, H.R., Gould, M.S. & Canino, G. (1995). Mental health service utilization among Puerto Rican children ages 4 through 16. Journal of Child and Family Studies, 4, 399–418.
Rights and permissions
About this article
Cite this article
Farmer, E.M., Stangl, D.K., Burns, B.J. et al. Use, Persistence, and Intensity: Patterns of Care for Children's Mental Health Across One Year. Community Ment Health J 35, 31–46 (1999). https://doi.org/10.1023/A:1018743908617
Issue Date:
DOI: https://doi.org/10.1023/A:1018743908617