Skip to main content

Advertisement

Log in

Socioeconomic Status, Race and Parental Initial Response to Children’s Mental Illness

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

To examine how socioeconomic status (SES) and race affect parents' initial response (IR) to their child’s mental illness (MI) including 1. Parental confidant(s); 2. Lag time in professional help-seeking; and 3. Referral source. 70 parents of patients new to a Child Psychiatry clinic completed a survey to assess their IR to their child’s MI. SES was determined using the United States Census Bureau median income by zip codes. Summary statistics are frequencies and percentages for categorical data, and medians and quartiles for continuous data. Twenty-five percent of parents reported low SES and 31% Non-Caucasian Children (NCC). Confidants of Caucasian and NCC were Pediatrician (77% vs 50%, p = 0.03), and family (73% vs 32%, p = 0.002). Comparing help-seeking Lag Times 66% reported a delay of 1 year or more (p = 0.040). Overall Pediatricians were the leading confidant. Lag times were one year or more with stronger trends in NCC.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Whitney DG, Peterson MD. US national and state-level prevalence of mental health disorders and disparities of mental health care use in children. JAMA pediatrics. 2019;173(4):389–91.

    Article  Google Scholar 

  2. Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003;60(8):837–44.

    Article  Google Scholar 

  3. Kessler RC, Angermeyer M, Anthony JC, De Graaf RON, Demyttenaere K, Gasquet I, Kawakami N. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World psychiatry. 2007;6(3):168–76.

    PubMed  PubMed Central  Google Scholar 

  4. Thomas CR, Holzer CE. The continuing shortage of child and adolescent psychiatrists. J Am Acad Child Adolesc Psychiatry. 2006;45(9):1023–31.

    Article  Google Scholar 

  5. Owens PL, Hoagwood K, Horwitz SM, Leaf PJ, Poduska JM, Kellam SG, Ialongo NS. Barriers to children's mental health services. J Am Acad Child Adolesc Psychiatry. 2002;41(6):731–8.

    Article  Google Scholar 

  6. Farmer EM, Burns BJ, Phillips SD, Angold A, Costello EJ. Pathways into and through mental health services for children and adolescents. Psychiatric services. 2003;54(1):60–6.

    Article  Google Scholar 

  7. Kataoka SH, Zhang L, Wells KB. Unmet need for mental health care among US children: Variation by ethnicity and insurance status. Am J Psychiatry. 2002;159(9):1548–55.

    Article  Google Scholar 

  8. Angold A, Erkanli A, Farmer EM, Fairbank JA, Burns BJ, Keeler G, Costello EJ. Psychiatric disorder, impairment, and service use in rural African American and white youth. Arch Gen Psychiatry. 2002;59(10):893–901.

    Article  Google Scholar 

  9. Boydell KM, Pong R, Volpe T, Tilleczek K, Wilson E, Lemieux S. Family perspectives on pathways to mental health care for children and youth in rural communities. The Journal of Rural Health. 2006;22(2):182–8.

    Article  Google Scholar 

  10. Harrison ME, McKay MM, Bannon WM Jr. Inner-city child mental health service use: The real question is why youth and families do not use services. Community Ment Health J. 2004;40(2):119–31.

    Article  Google Scholar 

  11. Cummings JR. Contextual socioeconomic status and mental health counseling use among US adolescents with depression. J Youth Adolesc. 2014;43(7):1151–62.

    Article  Google Scholar 

  12. Rogler LH, Cortes DE. Help-seeking pathways: a unifying concept in mental health care. The American Journal of Psychiatry. 1993;150(4):554.

    Article  CAS  Google Scholar 

  13. Young AS, Rabiner D. Racial/ethnic differences in parent-reported barriers to accessing children’s health services. Psychological Services. 2015;12(3):267.

    Article  Google Scholar 

  14. Godoy L, Carter AS, Silver RB, Dickstein S, Seifer R. Mental health screening and consultation in primary care: The role of child age and parental concerns. Journal of developmental and behavioral pediatrics: JDBP. 2014;35(5):334.

    Article  Google Scholar 

  15. Godoy L, Mian ND, Eisenhower AS, Carter AS. Pathways to service receipt: Modeling parent help-seeking for childhood mental health problems. Administration and Policy in Mental Health and Mental Health Services Research. 2014;41(4):469–79.

    Article  Google Scholar 

  16. Bussing R, Zima BT, Gary FA, Garvan CW. Barriers to detection, help-seeking, and service use for children with ADHD symptoms. J Behav Health Serv Res. 2003;30(2):176–89.

    Article  Google Scholar 

  17. Zwaanswijk M, Verhaak PF, Bensing JM, Van der Ende J, Verhulst FC. Help seeking for emotional and behavioural problems in children and adolescents. Eur Child Adolesc Psychiatry. 2003;12(4):153–61.

    Article  Google Scholar 

  18. Thurston IB, Hardin R, Decker K, Arnold T, Howell KH, Phares V. Black and white parents’ willingness to seek help for children’s internalizing and externalizing symptoms. J ClinPsychol. 2018;74(1):161–77.

    Google Scholar 

  19. McMiller WP, Weisz JR. Help-seeking preceding mental health clinic intake among African-American, Latino, and Caucasian youths. J Am Acad Child Adolesc Psychiatry. 1996;35(8):1086–94.

    Article  CAS  Google Scholar 

  20. Alegría M, Canino G, Lai S, Ramirez RR, Chavez L, Rusch D, Shrout PE. Understanding caregivers’ help-seeking for Latino children’s mental health care use. Med Care. 2004;42(5):447–55.

    Article  Google Scholar 

  21. Zimmerman FJ. Social and economic determinants of disparities in professional help-seeking for child mental health problems: Evidence from a national sample. Health Serv Res. 2005;40(5 pt 1):1514–33.

    Article  Google Scholar 

  22. Ascher BHZ, Farmer EM, Burns BJ, Angold A. The child and adolescent services assessment (CASA) description and psychometrics. Journal of Emotional and Behavioral Disorders. 1996;4(1):12–20.

    Article  Google Scholar 

  23. United States Census Bureau / American FactFinder. “S1903 : Median Household Income.” 2011–2016 American Community Survey. U.S. Census Bureau’s American Community Survey Office, 2017. Web. 31 May 2018

  24. Bourdon KH, Goodman R, Rae DS, Simpson G, Koretz DS. The strengths and difficulties questionnaire: US normative data and psychometric properties. J Am Acad Child Adolesc Psychiatry. 2005;44(6):557–64.

    Article  Google Scholar 

  25. Goodman R. The extended version of the strengths and difficulties questionnaire as a guide to child psychiatric caseness and consequent burden. The Journal of Child Psychology and Psychiatry and Allied Disciplines. 1999;40(5):791–9.

    Article  CAS  Google Scholar 

  26. Yeh M, McCabe K, Hurlburt M, Hough R, Hazen A, Culver S, Landsverk J. Referral sources, diagnoses, and service types of youth in public outpatient mental health care: A focus on ethnic minorities. J Behav Health Serv Res. 2002;29(1):45–60.

    Article  Google Scholar 

  27. Loades ME, Mastroyannopoulou K. Teachers’ recognition of children’s mental health problems. Child Adolesc Mental Health. 2010;15(3):150–6.

    Article  Google Scholar 

  28. Dowdy E, Doane K, Eklund K, Dever BV. A comparison of teacher nomination and screening to identify behavioral and emotional risk within a sample of underrepresented students. Journal of Emotional and Behavioral Disorders. 2013;21(2):127–37.

    Article  Google Scholar 

  29. Flores G. Racial and ethnic disparities in the health and health care of children. Pediatrics. 2010;125(4):e979–e1020.

    Article  Google Scholar 

  30. Flores G, Lin H. Trends in racial/ethnic disparities in medical and oral health, access to care, and use of services in US children: Has anything changed over the years? International Journal for Equity in Health. 2013;12(1):10.

    Article  Google Scholar 

  31. Reinke WM, Stormont M, Herman KC, Puri R, Goel N. Supporting children’s mental health in schools: Teacher perceptions of needs, roles, and barriers. School Psychology Quarterly. 2011;26(1):1.

    Article  Google Scholar 

  32. Walter HJ, Gouze K, Lim KG. Teachers’ beliefs about mental health needs in inner city elementary schools. J Am Acad Child Adolesc Psychiatry. 2006;45(1):61–8.

    Article  Google Scholar 

  33. Gowers S, Thomas S, Deeley S. Can primary schools contribute effectively to tier I child mental health services? Clinical Child Psychology and Psychiatry. 2004;9(3):419–25.

    Article  Google Scholar 

  34. Breslau J, Cefalu M, Wong EC, Burnam MA, Hunter GP, Florez KR, Collins RL. Racial/ethnic differences in perception of need for mental health treatment in a US national sample. Soc Psychiatry PsychiatrEpidemiol. 2017;52(8):929–37.

    Article  Google Scholar 

Download references

Acknowledgements

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shirley Alleyne.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alleyne, S., Smotherman, C., Lukens-Bull, K. et al. Socioeconomic Status, Race and Parental Initial Response to Children’s Mental Illness. J Immigrant Minority Health 23, 463–469 (2021). https://doi.org/10.1007/s10903-020-01098-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-020-01098-z

Keywords

Navigation