This article examines problem recognition across ethnic groups by focusing on parental reports of mental health problems in adolescents. Data were collected from 1 youth (aged 11-17) and 1 caregiver from a community-based sample of households in the Houston metropolitan area. The sample was 4175 youths and their caregivers (37.8% European, 35.00% African, 25.4% Latino, and 1.8% other American). Indicators of mental health were perceived mental health, life dissatisfaction, and whether adolescents had a mental health problem in the past year. European Americans were more likely to rate the mental health of adolescents as fair or poor, were about twice as likely to report that adolescents were dissatisfied with their lives, and that adolescents had a mental health problem in the past year. Interventions to help minority families in the identification of youth's mental health problems may need to address cultural differences in the definition of mental health problems or in the benefit of labeling mental health problems that may serve as barriers to help-seeking.
"Asian parents may expect children to overcome their psychological problems on their own and discourage them from continuing services . This may be partly due to cultural influences to assess normative development and recognize emotional and behavioral problems in children (Roberts et al., 2005). It may also reflect a lack of knowledge of the mental health problems and the benefits of the treatment (Bussing, Schoenberg, & Perwien, 1998). "
[Show abstract][Hide abstract] ABSTRACT: This paper explores the role of English proficiency, ethnicity, and California's threshold language policy in the rates of discontinuing mental health services among Asian-American children. We used data from the 2001-2006 Client and Services Information (CSI) System, which contains county-level information about service users in public mental health systems. Our data included 59,218 service users under the age of 18. We used logistic regression to determine the likelihood of discontinuing services, while controlling for sociodemographic and clinical characteristics. English-speaking Asians were 11% more likely than English-speaking Whites to discontinue mental health services. Non-English-speaking Asians were 50% significantly more likely to stay in services. The results also revealed some inter-ethnic variations in the discontinuation patterns; however, the patterns of mental health service utilization appear to be driven by the availability of mental health services in Asian-ethnic languages in county of residence. Further research is needed to understand the intake and referral processes that Asian children go through within the mental health service system.
"Children who are recent immigrants may experience problems in adjusting to their new environment, and school staff, for example, may judge their behaviour as deviant and consequently refer them to the mental healthcare . Socio-cultural differences may also manifest themselves in ethnic differences in families' perceptions of whether or not a problem should be defined as mental health-related, and of whether the problem warrants a mental health care referral [16,25-28]. Previous research has found ethnic differences in parental recognition of mental health problems in their children [28,29], indicating differences in tolerance thresholds for mental health problems. "
[Show abstract][Hide abstract] ABSTRACT: In the Swedish society, as in many other societies, many children and adolescents with mental health problems do not receive the help they need. As the Swedish society becomes increasingly multicultural, and as ethnic and economic residential segregation become more pronounced, this study utilises ethnicity and neighbourhood context to examine referral pathways to child and adolescent psychiatric (CAP) clinics.
The analysis examines four different sources of referrals: family referrals, social/legal agency referrals, school referrals and health/mental health referrals. The referrals of 2054 children aged 11-19 from the Stockholm Child-Psychiatric Database were studied using multilevel logistic regression analyses.
Results indicate that ethnicity played an important role in how children and adolescents were referred to CAP-clinics. Family referrals were more common among children and adolescents with a Swedish background than among those with an immigrant background. Referrals by social/legal agencies were more common among children and adolescents with African and Asian backgrounds. Children with Asian or South American backgrounds were more likely to have been referred by schools or by the health/mental health care sector. A significant neighbourhood effect was found in relation to family referrals. Children and adolescents from neighbourhoods with low levels of socioeconomic deprivation were more likely to be referred to CAP-clinics by their families in comparison to children from other neighbourhoods. Such differences were not found in relation in relation to the other sources of referral.
This article reports findings that can be an important first step toward increasing knowledge on reasons behind differential referral rates and uptake of psychiatric care in an ethnically diverse Swedish sample. These findings have implications for the design and evaluation of community mental health outreach programs and should be considered when developing measures and strategies intended to reach and help children with mental health problems. This might involve providing information about the availability and accessibility of health care for children and adolescents with mental health problems to families in certain neighbourhoods and with different ethnic backgrounds.
Child and Adolescent Psychiatry and Mental Health 03/2011; 5(1):6. DOI:10.1186/1753-2000-5-6
"Reports in the literature identify several obstacles that prevent minorities from using routine outpatient treatment. These obstacles include avoidance of defining personal distress as mental illness due to stigma and a preference for culturally sanctioned alternatives (Pumariega et al. 2005; Roberts et al. 2005), mistrust of providers and of the mental health treatment system (Thompson et al. 2004), and limited proficiency in English (Fiscella et al. 2002). By preventing them from seeking other forms of mental health treatment, and in so doing, by entering the mental health treatment system via non-emergency care routes, these obstacles appear to channel minorities into crisis care. "
[Show abstract][Hide abstract] ABSTRACT: For children and youth making a mental health crisis visit, we investigated ethnic disparities in whether the children and youth were currently in treatment or whether this crisis visit was an entry or reentry point into mental health treatment. We gathered Medicaid claims for mental health services provided to 20,110 public-sector clients ages 17 and younger and divided them into foster care and non-foster care subsamples. We then employed logistic regression to analyze our data with sociodemographic and clinical controls. Among children and youth who were not placed in foster care, African Americans, Latinos, and Asian Americans were significantly less likely than Caucasians to have received mental health care during the three months preceding a crisis visit. Disparities among children and youth in foster care were not statistically significant. Ethnic minority children and youth were more likely than Caucasians to use emergency care as an entry or reentry point into the mental health treatment, thereby exhibiting a crisis-oriented pattern of care.
Journal of Child and Family Studies 11/2009; 18(5):512-519. DOI:10.1007/s10826-008-9253-7 · 1.42 Impact Factor
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