Predictors of Initial Engagement in Child Anxiety Mental Health Specialty Services
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Child and family mental health services remain largely underutilized despite the relatively high rate of youth suffering from mental, emotional, and behavioral disorders. As such, it is important to address challenges and examine factors related to child mental health service use and engagement, especially when it comes to children in need of services for anxiety.
Informed by the behavioral model of health services use, the present study sought to examine predictors of service use and engagement for families seeking assistance for their anxious children. Initial levels of engagement in culturally tailored services were predicted from predisposing characteristics (e.g., child age, ethnicity), enabling resources (e.g., Spanish services, transportation), and need characteristics (e.g., child clinical severity).
Participants included Latino (n = 126) and Caucasian (n = 116) families who presented to a specialty clinic due to child emotional and behavior problems related to anxiety. Initial service utilization and engagement was assessed along the following levels toward services care: (1) initiated contact and completed a clinical intake, (2) completed a home screen, and (3) completed an on-site diagnostic assessment. All procedures were culturally tailored to the presenting needs of families.
Predisposing characteristics, enabling resources and need characteristics emerged as significant predictors of child mental health service use, with some variations. Child age, ethnicity, referral source, and enabling resources predicted completion of a home screen. Proximity to services predicted completion of the on-site diagnostic assessment.
Knowledge of factors that predict engagement in child mental health services can help identify avenues to promote service utilization, especially among ethnic minority children and families. Our culturally tailored approach to serving families appears to be promising in bridging the cross-ethnic services gap and therefore has implications for practice.
KeywordsMental health service use Anxiety Latino Children and adolescents
This study was supported in part by award numbers K01MH086687 and L60MD001839 from the National Institute of Mental Health and the National Center on Minority Health and Health Disparities, as well as funding from the Institute for Mental Health Research awarded to A. Pina.
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