Ethnicity, socioeconomic position and severity of problems as predictors of mental health care use in 5- to 8-year-old children with problem behaviour

  • Floor Bevaart
  • Cathelijne L. MielooEmail author
  • André Wierdsma
  • Marianne C. H. Donker
  • Wilma Jansen
  • Hein Raat
  • Frank C. Verhulst
  • Floor V. A. van Oort
Original Paper



Empirical research on mental health care use and its determinants in young school-aged children is still scarce. In this study, we investigated the role of ethnicity, socioeconomic position (SEP) and perceived severity by both parents and teachers on mental health care use in 5- to 8-year-old children with emotional and/or behavioural problems.


Data from 1,269 children with a high score (>P90) on the Strengths and Difficulties Questionnaire (SDQ) in the school year 2008–2009 were linked to psychiatric case register data over the years 2010–2011. Cox proportional hazards models were used to predict mental health care use from ethnicity, SEP and perceived severity of the child’s problems.


During the follow-up period, 117 children with high SDQ scores (9.2 %) had used mental health care for the first time. Ethnic minority children were less likely to receive care than Dutch children (HR Moroccan/Turkish: 0.26; 95 % CI 0.13–0.54, HR other ethnicity: 0.26; 95 % CI 0.12–0.58). No socioeconomic differences were found. After correction for previous care use, ethnicity and parental perceived severity, impact score as reported by teachers was significantly associated with mental health care use (HR 1.58; 95 % CI 1.01–2.46).


Ethnicity is an important predictor of mental health care use in young children. Already in the youngest school-aged children, ethnic differences in the use of mental health care are present. A distinct predictor of care use in this age group is severity of emotional and behavioural problems as perceived by teachers. Therefore, teachers may be especially helpful in the process of identifying young children who need specialist mental health care.


Child mental health care Ethnicity Predictors Socioeconomic position SDQ 



No honorarium, grant or other form of payment was given to anyone to produce the manuscript.

Conflict of interest

No conflicts declared.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Floor Bevaart
    • 1
    • 5
  • Cathelijne L. Mieloo
    • 2
    • 4
    Email author
  • André Wierdsma
    • 3
  • Marianne C. H. Donker
    • 4
  • Wilma Jansen
    • 2
    • 4
  • Hein Raat
    • 4
  • Frank C. Verhulst
    • 1
  • Floor V. A. van Oort
    • 1
  1. 1.Department of Child and Adolescent Psychiatry and PsychologyErasmus MC-University Medical Centre RotterdamRotterdamThe Netherlands
  2. 2.Department of Youth PolicyRotterdam Municipal Health Service (GGD Rotterdam-Rijnmond)RotterdamThe Netherlands
  3. 3.Department of PsychiatryErasmus MC-University Medical Centre RotterdamRotterdamThe Netherlands
  4. 4.Department of Public HealthErasmus MC-University Medical Centre RotterdamRotterdamThe Netherlands
  5. 5.Department of Child and Adolescent PsychiatryVU Medical Centre AmsterdamAmsterdamThe Netherlands

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