ARTICLES
Factors Associated With Adolescent Mental Health Service Need and Utilization

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ABSTRACT

Objective

To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization.

Method

Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of 1,120 Dutch adolescents aged 11 to 18 years (78% response rate).

Results

3.1% of the sample had been referred for mental health services within the preceding year, and 3.8% reported unmet need. 7.7% of adolescents at risk for psychopathology, and 17.8% of those indicating a need for help, had been referred. Family stress and adolescent's self-reported problems were most strongly associated with service need and utilization. Internalizing problems, female gender, and low education level were associated with self-perceived unmet need. Adolescent ethnicity and competence in activities and school were associated with service use, but did not influence service need, while the opposite effect was found for adolescent age and parental psychopathology.

Conclusions

In designing intervention programs aimed at increasing adolescent mental health service use, distinctions should be made between efforts focused at adolescents not recognizing their problems, and those with unmet need.

Section snippets

Participants

The sample used in this article is part of a larger study on psychopathology and mental health service use in a Dutch national sample of children and adolescents. We will describe the selection of the original sample (involving subjects aged 4–18 years) before describing the sample used in the present study.

The target population for the original study consisted of all 4- to 18-year-olds who were of Dutch nationality and living in the Netherlands. Respondents were recruited using a stratified

RESULTS

Thirty-five adolescents (54% boys; 46% girls) reported a referral for mental health services in the 12 months preceding the assessment. This represents 3.1% of the total sample. Of the 209 adolescents who scored in the deviant range of the YSR Total Problems scale, only 7.7% had been referred for mental health services. However, of the 35 adolescents who were referred, 45% were in the deviant range on the YSR Total Problems scale.

Of the total sample, 425 adolescents (37.9%) perceived themselves

DISCUSSION

Of our total sample of Dutch adolescents, 3.1% were referred for mental health services. This figure is lower than the 5.8% reported by Saunders et al. (1994) and the 7% reported by Sourander et al. (2001). These differences may be ascribed to differences in definitions of mental health service use, differences in prevalence rates for adolescent psychopathology between nations (Verhulst et al., 1993; Verhulst et al., unpublished, 2002), or differences in the organization of mental health

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    Supported by the Dutch Ministry of Welfare and Health, Rijswijk, the Netherlands, and the Sophia Foundation of Medical Research, Rotterdam, the Netherlands.

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