Determinants of ambulatory mental health services use for school-age children and adolescents.
OBJECTIVE
To analyze a comprehensive multivariate model of the use of mental health-related ambulatory care services by children ages 6-17.


METHODS
The 1987 National Medical Expenditure Survey, a national probability sample of the U.S. civilian noninstitutionalized population.


METHODS
A cross-sectional survey of a national probability sample of the U.S. population. Key independent variables include person-level mental health status, health care coverage, family income, and use of mental health services by other family members.


METHODS
Four in-person interviews were conducted during 1987 using structured questionnaires. A designated family respondent was used to answer questions for other family members, including children.


RESULTS
Children with poor mental health in high-income families were more than three times as likely to have a mental health-related visit than children with poor mental health in low-income families. The number of mental health-related visits and the likelihood of seeing a mental health specialist also increased along with family income. Mental health use by other family members was strongly associated with use.


CONCLUSIONS
The results from this study provide strong evidence that the socioeconomic status of children is an important factor in explaining unmet need for mental health services.
Cunningham
P J
PJ
Center for Studying Health System Change, Washington, DC 20024, USA.
Freiman
M P
MP
D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000191:economics; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D015233:Models, Statistical; D015999:Multivariate Analysis; D011336:Probability; D012959:Socioeconomic Factors; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data