Community Mental Health Journal

, Volume 32, Issue 4, pp 353–361 | Cite as

Addressing the barriers to mental health services for inner city children and their caretakers

  • Mary McKernan McKay
  • Kathleen McCadam
  • J. Jude Gonzales


This paper will outline a series of three research studies meant to identify factors related to child mental health service usage and barriers to help seeking for urban minority children and their caretakers. In addition, this paper will describe the systematic development and evaluation of a telephone intervention strategy aimed towards increasing overall attendance at initial intake appointments at an urban child serving agency. The first study explores differences in demographic variables, for two groups of children (n=450), those that came to an initial intake interview and those that requested child mental health services, but failed to come to any scheduled appointments. The second study evaluates a telephone engagement intervention meant to increase initial attendance (n=54). Finally, the third study, more rigorously evaluates the impact of an intensive telephone intervention on initial attendance rates by randomly assigning families to the more focused telephone intervention or a “business as usual” telephone screening (n=108).


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  1. Anderson, C. (1983).Mastering Resistance. New York: Guilford Press.Google Scholar
  2. Acosta, F.X. (1980). Self described reasons for premature termination of psychotherapy by Mexican American, Black American and Anglo American patients.Psychological Reports, 47, 435–443.PubMedGoogle Scholar
  3. Aponte, H.J., Zarski, J., Bixenstene, C. & Cibik, P. (1991). Home/community based services: A two-tier approach.American Journal of Orthopsychiatry, 61, 3, 403–408.PubMedGoogle Scholar
  4. Armstrong, H.E., Ishiki, D., Heiman, J., Mundt, J. & Womack, W. (1984). Service utilization by Black and White clientele in an urban community mental health center: Revised assessment of an old problem.Community Mental Health Journal, 20, 4, 269–280.CrossRefPubMedGoogle Scholar
  5. Boyd-Franklin, N. (1993). Black families in Walsh, F. (Ed.).Normal Family Process. New York: Guilford Press.Google Scholar
  6. Brandenburg, N.A., Friedman, R.M. & Silver, S.E. (1987). The epidemiology of childhood psychiatric disorders: Prevalence findings from recent studies.Journal of the American Academy of Child and Adolescent Psychiatry, 29, 76–83.Google Scholar
  7. Bronfenbrenner, U. (1979).The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.Google Scholar
  8. Bui, C.T. & Takeuchi, D.T. (1992). Ethnic minority adolescents and the use of community mental health care services.American Journal of Community Psychology, 20, 4, 403–417.CrossRefPubMedGoogle Scholar
  9. Burns, B.J., Angold, A., Magruder-Habib, Costello, E.J., Patrick, (1989).The Child and Adolescent Services Assessment. Developmental Epidemiology Program, Department of Psychiatry, Duke University.Google Scholar
  10. Burns, B.J., Angold, A. & Costello, E.J. (1992). Measuring child, adolescent, and family service use: In L. Bickman & D. Rog (Eds.).Evaluating Mental Health Services for Children. San Francisco: Jossey-Bass, 17–30.Google Scholar
  11. Cheung, F.K. & Snowden, L.R. (1989). Utilization of inpatient services by members of ethnic minority groups. Paper presented at Oklahoma Mental Health Research Institute Professional symposium, Tulsa, OK.Google Scholar
  12. Cohen, P. & Hesselbart, C.S. (1993). Demographic factors in the use of children's mental health service.American Journal of Public health, 83, 1, 49–52.PubMedGoogle Scholar
  13. Flaskerud, J.H. (1986). The effects of culture-compatible intervention on the utilization of mental health services by minority clients.Community Mental Health Journal, 22, 2, 127–140.CrossRefPubMedGoogle Scholar
  14. Gary, L.E. (1982). Attitudes toward human service organization: Perspectives from an urban Black community.Journal of Applied Behavioral Sciences, 21, 445–458.Google Scholar
  15. Germain, C. (1980).The life model of social work practice. New York: Columbia University Press.Google Scholar
  16. Guerra, N., Huessmann, R., Tolan, P.H., VanAcker, R. & Eron, L. (1990). Metropolitan Area Child Study. National Institute for Mental Health Research Proposal.Google Scholar
  17. Hu, T., Snowden, L., Jerrell, J. & Nguyen, T. Ethnic populations in public mental health: Services choice and level of use.American Journal of Public health, 81, 11, 1429–1434.Google Scholar
  18. Jacobs, S.E. (1979). “Our babies shall not die”: A community's response to medical neglect.Human Organization, 38, 120–133.PubMedGoogle Scholar
  19. Kazdin, A. (1993). Premature termination from treatment among children referred for antisocial behavior.Journal of Clinical Child Psychology, 31, 8, 415–425.Google Scholar
  20. Keefe, S.E., Padilla, A.M. & Carlos, M.L. (1979). The Mexican-American extended family as an emotional support system.Human Organization, 38, 144–152.Google Scholar
  21. Landsverk, J., Madsen, J., Litrownik, A., Ganger, W. & Newton, R. (under review). Mental health problems of foster children in three California counties.Google Scholar
  22. Muecke, M.A. (1983). In search of healers.Western Journal of Medicine, 139, 835–840.PubMedGoogle Scholar
  23. Miller & Prinz, R. (1990). Enhancement of social learning family intervention for childhood conduct disorder.Psychological Bulletin, 108, 2, 291–307.CrossRefPubMedGoogle Scholar
  24. Minkler, M., Roe, K.M. & Price, M., (1992). The physical and emotional health of grandmothers raising grandchildren in the crack cocaine epidemic.The Gerontologist, 32, 752–761.PubMedGoogle Scholar
  25. Mull, J.D., Wood, C.S., Gans, L.P. & Mull, D.S. (1989). Culture and “compliance” among leprosy patients in Pakistan.Social Science and Medicine, 29, 799–811.CrossRefPubMedGoogle Scholar
  26. Russell, M., Lang, M. & Brett, B. (1987). Reducing dropout rates through improved intake procedures.Social Casework, 421–425.Google Scholar
  27. Schlosberg, S.B. & Kagan, R.M. (1988). Practice strategies for engaging chronic multiproblem families.Social Casework, 3–9.Google Scholar
  28. Shivack, N. & Sullivan, T. (1991). Use of telephone prompts at an inner city outpatient clinic.Hospital and Community Psychiatry, 40, 8, 851–853.Google Scholar
  29. Stanton, M.D. & Todd, T.C. (1981). Engaging “resistant” families in treatment.Family Process, 20, 3, 261–293.CrossRefPubMedGoogle Scholar
  30. Steffenson, M.S. & Colker, L. (1982). Intercultural misunderstandings about health care: Recall of descriptions of illness and treatment,Social Science Medicine, 16, 1249–1254.Google Scholar
  31. Sue, S. (1977). Community mental health services to minority groups: Some optimism, some pessimism.American Psychologist, 32, 616–624.CrossRefPubMedGoogle Scholar
  32. Sue, S., Fujino, D.C., Hu, L. & Takeuchi, D.T. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis.Journal of Consulting and Clinical Psychology, 59, 4, 533–540.CrossRefPubMedGoogle Scholar
  33. Sue, S. & Morishima, J.K. (1983).The mental health of Asian Americans. San Francisco: Jossey-Bass.Google Scholar
  34. Szapocznik, J., Perez-Vidal, A., Brickman, A.L., Foote, F.H., Santesteban, D., Hervis, O., Kurtines, W.M. (1988). Engaging adolescent drug abusers and their families in treatment: A strategic structural systems approach.Journal of Consulting and Clinical Psychology, 56, 4, 552–557.CrossRefPubMedGoogle Scholar
  35. Tolan, P.H., McKay, M.M., Kohner, K. & Montaini, L. (1995). Engaging Inner City Families in Prevention Research. Manuscript submitted for publication.Google Scholar
  36. Tuma, J.M. (1989). Mental health services for children.American Psychologist, 188–189.Google Scholar
  37. Wahler, R. & Dumas, J. (1989). Attentional problems in dysfunctional mother-child interactions: An interbehavior model.Psychological Bulletin, 105, 116–130.CrossRefPubMedGoogle Scholar
  38. Wallen, J. Providing culturally appropriate mental health services for minorities. TheJournal of Mental Health Administration, 19, 3, 288–295.Google Scholar
  39. Zahner, G., Pawelkiewicz, W., DeFrancesco, J.J. & Adnopoz, J. Children's mental health service needs and utilization patterns in an urban community: An epidemiological assessment.Journal of the American Academy of Child and Adolescent Psychiatry, 31, 5, 951–960.Google Scholar

Copyright information

© Human Sciences Press, Inc. 1996

Authors and Affiliations

  • Mary McKernan McKay
    • 1
  • Kathleen McCadam
    • 1
  • J. Jude Gonzales
    • 1
  1. 1.Institute for Juvenile ResearchUniversity of Illinois at ChicagoChicago

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