Mental Health Services Research

, Volume 6, Issue 2, pp 75–92 | Cite as

Racial/Ethnic Disparities in Parent Perception of Child Need for Mental Health Care Following School Disciplinary Events

  • Eric P. SladeEmail author


Disciplinary problems at school potentially affect parent perception of child need for mental health care. This article explores effects of a child's first school suspension or expulsion on parent perception of child need for services in three racial–ethnic subgroups. Subjects were mothers participating in a national longitudinal study and their children. First-time school suspension or expulsion positively affected service use and parent-reported service need among white non-Hispanic children, but had little or no effect for African American and Hispanic children. These results suggest that information on child behavior provided to parents by teachers and school administrators can influence parent perception of child service need, but that racial–ethnic differences may exist in parent interpretation of and response to this information. Culturally appropriate approaches to relaying information to parents about child service need may help reduce these differences.

children mental health services suspension behavior problems race disparities 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Achenbach, T. M., Bird, H. R., Canino, G., Phares, V., Gould, M. S., & Rubio-Stipec, M. (1990). Epidemiological comparisons of Puerto Rican and U.S. mainland children: Parent, teacher, and self-reports. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 84-93.Google Scholar
  2. Achenbach, T. M., & Edelbrock, C. S. (1983). Manual for the Child Behavior Checklist and Revised Child Behavior Profile. Burlington: University of Vermont.Google Scholar
  3. Anglin, T. M., Naylor, K. E., & Kaplan, D. W. (1996). Comprehensive school-based health care: High school students' use of medical, mental health, and substance abuse services. Pediatrics, 97(3), 318-330.Google Scholar
  4. Angold, A., Costello, E. J., Burns, B. J., Erklani, A., & Farmer, E. M. Z. (2000). Effectiveness of nonresidential specialty mental health services for children and adolescents in the “real world.” Journal of the American Academy of Child and Adolescent Psychiatry, 39(2), 154-175.Google Scholar
  5. Angold, A., Messer, S. C., Stangl, D., Farmer, E. M., Costello, E. J., & Burns, B. J. (1998). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, 88(1), 75-80.Google Scholar
  6. Bennett, R., Gottesman, R., Rock, D., & Cerullo, F. (1993). Influence of behavior perceptions and gender on teachers' judgments of students' academic skill. Journal of Educational Psychology, 85, 347-356.Google Scholar
  7. Bradley, R. H., Corwyn, R. F., Burchinal, M., McAdoo, H. P., & Coll, C. G. (2001). The home environments of children in the United States Part II: Relations with behavioral development through age thirteen. Child Development, 72(6), 1868-1886.Google Scholar
  8. Brier, N. (1995). Predicting antisocial behavior in youngsters displaying poor academic achievement: A review of risk factors. Developmental and Behavioral Pediatrics, 16(4), 271-276.Google Scholar
  9. Bussing, R., Zima, B. T., & Belin, T. R. (1998). Differential access to care for children with ADHD in special education programs. Psychiatric Services, 49(9), 1226-1229.Google Scholar
  10. Center for Health and Health Care in Schools. (2002). 2002 State survey of school-based health center initiatives, Washington, DC: The George Washington University.Google Scholar
  11. Center for Human Resource Research. (1999). The National Longitudinal Surveys, NLSY79 User's Guide, 1999. Columbus: The Ohio State University. Retrieved from Scholar
  12. Center for Human Resource Research. (2002). NLSY79 Child & Young Adult Data User's Guide. Columbus: The Ohio State University. Retrieved from Scholar
  13. Chase-Lansdale, P. L., Cherlin, A. J., & Kiernan, K. E. (1995). The long-term effects of parental divorce on the mental health of young adults: A developmental perspective. Child Development, 66(6), 1614-1634.Google Scholar
  14. Conoley, J. C., & Conoley, C. W. (1991). Collaboration for child adjustment: Issues for school-and clinic-based child psychologists. Journal of Consulting and Clinical Psychology, 59, 821-829.Google Scholar
  15. Costello, E. J., Angold, A., & Keeler, G. P. (1999). Adolescent outcomes of childhood disorders: The consequences of severity and impairment. Journal of the American Academy of Child and Adolescent Psychiatry, 38(2), 121-128.Google Scholar
  16. Costello, E. J., Costello, A. J., Edelbrock, C., Burns, B. J., Dulcan, M. K., Brent, D., et al. (1988). Psychiatric disorders in primary care: Prevalence and risk factors. Archives of General Psychiatry, 45, 1107-1116.Google Scholar
  17. Crowley, S. L., Worchel, F. F., & Ash, M. J. (1992). Self-report, peer-report, and teacher-report measures of child depression: An analysis by item. Journal of Personality Assessment, 59, 189-203.Google Scholar
  18. Cuffe, S. P., Waller, J. L., Cuccaro, M. L., Pumariega, A. J., & Garrison, C. Z. (1995). Race and gender differences in the treatment of psychiatric disorders in young adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34(11), 1536-1542.Google Scholar
  19. Cunningham, P. J., & Freiman, M. P. (1996). Determinants of ambulatory mental health services use for school-age children and adolescents. Health Services Research, 31(4), 409-427.Google Scholar
  20. Dishion, T. J., Loeber, R., Stouthamer-Loeber, M., & Patterson, G. R. (1984). Skill deficits and male adolescent delinquency. Journal of Abnormal Child Psychology, 12(1), 37-54.Google Scholar
  21. Evans, S. W. (1999). Mental health services in schools: Utilization, effectiveness, and consent. Clinical Psychology Review, 19(2), 165-178.Google Scholar
  22. Flisher, A. J., Kramer, R. A., Grosser, R. C., Alegria, M., Bird, H. R., Bourdon, K. H., et al. (1997). Correlates of unmet need for mental health services by children and adolescents. Psychological Medicine, 27(5), 1145-1154.Google Scholar
  23. Garrison, E. G., Roy, I. S., & Azar, V. (1999). Responding to the mental health needs of Latino children and families through school-based services. Clinical Psychology Review, 19(2), 199-219.Google Scholar
  24. Glied, S., Garrett, A. B., Hoven, C., Rubio-Stipec, M., Regier, D., Moore, R. E., et al. (1998). Child outpatient mental health service use: Why doesn't insurance matter? The Journal of Mental Health Policy and Economics, 1, 173-187.Google Scholar
  25. Greene, W. H. (2000). Econometric analysis (4th ed., pp. 813-818). Upper Saddle River, NJ: Prentice-Hall.Google Scholar
  26. Heneghan, A. M., & Malakoff, M. E. (1997). Availability of school health services for young children. Journal of School Health, 67(8), 327-332.Google Scholar
  27. Hobbs, F., & Stoops, N. (2002). Demographic trends in the 20th century (U.S. Census Bureau, Census 2000 Special Reports, Series CENSR-4). Washington, DC: U.S. Government Printing Office.Google Scholar
  28. Hofstra, M. B., van der Ende, J., & Verhulst, F. C. (2002). Child and adolescent problems predict DSM-IV disorders in adulthood: A 14-year follow-up of a Dutch epidemiological sample. Journal of the American Academy of Child and Adolescent Psychiatry, 41(2), 182-189.Google Scholar
  29. Holzer, C. E., Goldsmith, H. F., & Ciarlo, J. A. (1998). Effects of rural–urban county type on the availability of health and mental health care providers. In R. W. Manderscheid & M. J. Henderson (Eds.), Mental Health, United States (pp. 204-213, DHHS Publication No. SMA 99-3285). Washington, DC: Center for Mental Health Services.Google Scholar
  30. Huber, P. J. (1967). The behavior of maximum likelihood estimates under non-standard conditions. In Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability (pp. 221-233). Berkeley: University of California Press.Google Scholar
  31. Johnston, J. R. (1994). High-conflict divorce. The Future of Children, 4(1), 165-182.Google Scholar
  32. Jones, D., Dodge, K. A., Foster, E. M., Nix, R., & Conduct Problems Prevention Research Group. (2002). Early identification of children at risk for costly mental health service use. Prevention Science, 34, 247-256.Google Scholar
  33. Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159(9), 1548-1555.Google Scholar
  34. Knitzer, J., Steinberg, Z., & Fleisch, B. (1991). Schools, children's mental health, and the advocacy challenge. Journal of Clinical Child Psychology, 20(1), 102-111.Google Scholar
  35. Laitinen-Krispijn, S., van der Ende, J., Wierdsma, A. I., & Verhulst, F. C. (1999). Predicting adolescent mental health service use in a prospective record-linkage study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(9), 1073-1080.Google Scholar
  36. Leslie, L. K., Landsverk, J., Ezzet-Lofstrom, R., Tschann, J. M., Slyman, D. J., & Garland, A. F. (2000). Children in foster care: Factors influencing outpatient mental health service use. Child Abuse and Neglect, 24(4), 465-476.Google Scholar
  37. Loeber, R. (1991). Antisocial behavior: More enduring than changeable? Journal of the American Academy of Child and Adolescent Psychiatry, 30(3), 393-396.Google Scholar
  38. Loeber, R., & Farrington, D. P. (2000). Young children who commit crime: Epidemiology, developmental origins, risk factors, early interventions, and policy implications. Development and Psychopathology, 12, 737-762.Google Scholar
  39. Loeber, R., Stouthamer-Loeber, M., & White, H. R. (1999). Developmental aspects of delinquency and internalizing problems and their association with persistent juvenile substance use between ages 7 and 18. Journal of Clinical Child Psychology, 28(3), 322-332.Google Scholar
  40. McGee, R., Partridge, F., Williams, S., & Silva, P. A. (1991). A twelve-year follow-up of preschool hyperactive children. Journal of the American Academy of Child and Adolescent Psychiatry, 30(2), 224-232.Google Scholar
  41. McMiller, W. P., & Weisz, J. R. (1996). Help-seeking preceding mental health clinic intake among African-American, Latino, and Caucasian youths. Journal of the American Academy of Child and Adolescent Psychiatry, 35(8), 1086-1094.Google Scholar
  42. Morgan-D'Atrio, C., Northup, J., LaFleur, L., & Spera, S. (1996). Toward prescriptive alternatives to suspensions: A preliminary evaluation. Behavioral Disorders, 21, 190-200.Google Scholar
  43. Najman, J. M., Williams, G. M., Nikles, J., Spence, S., Bor, W., O'Callaghan, M., et al. (2000). Mothers' mental illness and child behavior problems: Cause–effect association or observation bias? Journal of the American Academy of Child and Adolescent Psychiatry, 39(5), 592-602.Google Scholar
  44. Owens, P. L., Hoagwood, K., Horwitz, S. M., Leaf, P. J., Poduska, J. M., Kellam, S., et al. (2002). Barriers to children's mental health services. Journal of the American Academy of Child and Adolescent Psychiatry, 41(6), 731-738.Google Scholar
  45. Padgett, D. K., Patrick, C., Burns, B. J., Schlesinger, H. J., & Cohen, J. (1993). The effect of insurance benefit changes on use of child and adolescent outpatient mental health services. Medical Care, 31(2), 96-110.Google Scholar
  46. Peterson, B. D., West, J., Tanielian, T. L., Pion, G. M., Wicherski, M. M., Vandihort-Warren, R. E., et al. (1998). Mental health practitioners and trainees. In R. W. Manderscheid & M. J. Henderson (Eds.), Mental health, United States (pp. 214-246, DHHS Publication No. SMA 99-3285). Washington, DC: Center for Mental Health Services.Google Scholar
  47. Peterson, J. L., & Zill, N. (1986). Marital disruption, parent–child relationships, and behavioral problems in children. Journal of Marriage and the Family, 48(2), 295-307.Google Scholar
  48. Roberts, R. E., Roberts, C., & Chen, Y. R. (1997). Ethnocultural differences in prevalence of adolescent depression. American Journal of Community Psychology, 25, 95-110.Google Scholar
  49. Roberts, R. E., & Sobhan, M. (1992). Symptoms of depression in adolescence: A comparison of Anglo, African, and Hispanic Americans. Journal of Youth and Adolescence, 21, 639-651.Google Scholar
  50. Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Review, 3(4), 223-241.Google Scholar
  51. Royall, R. M. (1986). Model robust confidence intervals using maximum-likelihood estimators. International Statistical Review, 54, 221-226.Google Scholar
  52. Santelli, J., Morreale, M., Wigton, A., & Grayson, H. (1996). School health centers and primary care for adolescents: A review of the literature. Journal of Adolescent Health, 18, 357-366.Google Scholar
  53. Sheppard, V. B., & Benjamin-Coleman, R. (2001). Determinants of service placements for youth with serious emotional and behavioral disturbances. Community Mental Health Journal, 37(1), 53-65.Google Scholar
  54. Siegel, J. M., Aneshensel, C. S., Taub, B., Cantwell, D. P., & Driscoll, A. K. (1998). Adolescent depressed mood in a multiethnic sample. Journal of Youth and Adolescence, 27, 413-427.Google Scholar
  55. Slade, E. P. (2002). Effects of school-based mental health programs on mental health service use by adolescents at school and in the community. Mental Health Services Research, 4(3), 151-166.Google Scholar
  56. Slade, E. P. (2003). The relationship between school characteristics and the availability of mental health counseling and related health services in middle and high schools in the U.S. Journal of Behavioral Health Services and Research, 30(4), 382-392.Google Scholar
  57. Stiffman, A. R., Horwitz, S. M., Hoagwood, K., Compton, W., Cottler, L., Bean, D. L., et al. (2000). The service assessment for children and adolescents (SACA): Adult and child reports. Journal of the American Academy of Child and Adolescent Psychiatry, 39(8), 1032-1039.Google Scholar
  58. Takeuchi, D., Bui, K., & Kim, L. (1993). The referral of minority adolescents to community mental health centers. Journal of Health and Social Behavior, 34(2), 153-164.Google Scholar
  59. Tuma, J. M. (1989). Mental health services for children: The state of the art. American Psychologist, 44(2), 188-199.Google Scholar
  60. U.S. Bureau of the Census. (1996). Statistical abstract of the United States, 1996, Washington, DC: Author.Google Scholar
  61. U.S. Bureau of the Census. (2003). Health insurance coverage status of children and type of coverage: 1995. Retrieved on August 7, 2003, from Scholar
  62. Vega, W. A., Khoury, E. L., Zimmerman, R. S., Gil, A. G., & Warheit, G. J. (1995). Cultural conflicts and problem behaviors of Latino adolescents in home and school environments. Journal of Community Psychology, 23, 167-179.Google Scholar
  63. Weist, M. D. (1997). Expanded school mental health services: A national movement in progress. In T. H. Ollendick & R. Z. Prinz (Eds.), Advances in Clinical Child Psychology (Vol. 19, pp. 319-352). New York: Plenum.Google Scholar
  64. Weist, M. D., Paskewitz, D. A., Warner, B. S., & Flaherty, L. T. (1996). Treatment outcome of school-based mental health services for urban teenagers. Community Mental Health Journal, 32(2), 149-157.Google Scholar
  65. Weisz, J. R., & Hawley, K. M. (2002). Developmental factors in the treatment of adolescents. Journal of Consulting and Clinical Psychology, 70(1), 21-43.Google Scholar
  66. White, H. (1982). Maximum likelihood estimation of misspecified models. Econometrica, 50, 1-25.Google Scholar
  67. Wu, P., Hoven, C. W., Bird, H. R., Moore, R. E., Cohen, P., Algeria, M., et al. (1999). Depressive and disruptive disorders and mental health service utilization in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38(9), 1081-1092.Google Scholar
  68. Yeh, M., McCabe, K., Hough, R. L., Dupuis, D., & Hazen, A. (2003). Racial/ethnic differences in parental endorsement of barriers to mental health services for youth. Mental Health Services Research, 5(2), 65-77.Google Scholar
  69. Zimmerman, R. S., Khoury, E. L., Vega, W. A., Gil, A. G., & Warheit, G. J. (1995). Teacher and parent perceptions of behavior problems among a sample of African American, Hispanic, and non-Hispanic white students. American Journal of Community Psychology, 23(2), 181-197.Google Scholar

Copyright information

© Plenum Publishing Corporation 2004

Authors and Affiliations

  1. 1.Department of Health Policy and Management, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimore

Personalised recommendations