Caregiver Impact On The Relationship Between Need And Utilization For Child And Adolescent Mental Health: An Examination Of Factors Influencing Utilization Of Mental Health Services
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Type of WorkText
DepartmentPublic Health and Policy
ProgramDoctor of Public Health
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According to the Centers for Disease Control and Prevention, mental health is an important public health issue and without early diagnosis and treatment, children can experience problems at home, at school and forming friendships. Researchers have explored a few barriers that relate to utilization of mental health service however other factors that possibly influence whether or not their child will utilize services have not been greatly studied. Caregivers are the primary means by which children and adolescents enter treatment, and they are responsible for ensuring their physical and emotional well-being. The objectives of this dissertation are to examine barriers as they relate to the influence caregivers have on children's and adolescents' mental health service utilization. Specifically, to explore the relationship between utilization of mental health services and caregiver influences, including burden, caregiver mental health status and caregiver type. This study is a cross-sectional, secondary analysis that utilizes the 2003 National Survey of Children's Health of 3,986 children and adolescents ages 6-17 with need. Bivariate and multivariate analyses were conducted to understand the influences that caregiver characteristics have on the relationship between need and utilization of mental health services. Results show that caregivers who experienced any level of burden were more likely to utilize mental services than those who indicated no burden. Specifically, caregivers who experience a great deal of burden were almost 14 times more likely to utilize mental health services (OR =13.70; 95% CI 10.58-17.74, p<0.001). Caregivers who observed severe indicators of depression or anxiety in their child or adolescent (OR=1.55; 95% CI 1.21-1.98; p<0.05) were more likely to use services than caregivers who observed mild to no indicators of depression or anxiety. Mental health status of the caregiver was not significant and had no influence on need and utilization. Young people between the ages of 14 to 17 were significant and were found to utilize mental health services than their younger counterparts (OR=1.48; 95% CI1.16-1.89; p<0.05). Black children used mental health services more than White or Other children (OR=0.59; 95% CI 0.38-0.91; p<0.05). Income and caregiver type had no influence on utilization. Children and adolescents with insurance coverage used mental health services more than children with no coverage (OR=1.88; 95% CI 1.22-2.64; p<0.05). The findings of this study suggest that caregivers are essential in obtaining mental health treatment for their child or adolescent and also how a caregiver could possibly be a barrier to children and adolescents with need. In addition, this study promotes the need for more studies including qualitative research, in order to understand the additional barriers and challenges that caregivers and youth face in obtaining mental health treatment.