Factors associated with use of mental health services for depression by children and adolescents.
OBJECTIVE
This study examined patterns of mental health service use among depressed children and adolescents and factors associated with help seeking and treatment modalities.


METHODS
The sample consisted of 206 children and adolescents aged 9 to 17 years who were assessed as part of a larger survey of mental health service use in five service systems and in the community and who met DSM-III-R criteria for depressive disorders (major depression or dysthymia).


RESULTS
Among the 206 children, 75 (36 percent) never received professional help for depressive symptoms. Among the 131 children who received professional help for depression, antidepressants were prescribed for 40 (31 percent) in the year before the interview. The findings indicate possible undertreatment of depression among children and adolescents, especially among African Americans. Socioeconomic factors, such as the mother's education and the child's health insurance, were not associated with receiving professional help for depressive symptoms but were associated with receiving antidepressants. Parental perception of a child's mental health service need was associated with receiving professional help but not with receiving antidepressants. Also, depressed children were more likely to receive antidepressants when they had life-threatening or severe symptoms, such as a suicide attempt or drug abuse.


CONCLUSIONS
Whether a depressed child receives mental health services and the types of treatment received are influenced by different individual and family factors and by the type of symptoms exhibited. Better understanding of these factors will help in meeting the service needs of depressed children and adolescents.
Wu
P
P
Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, 10032, USA. wup@child.cpmc.columbia.edu
Hoven
C W
CW
Cohen
P
P
Liu
X
X
Moore
R E
RE
Tiet
Q
Q
Okezie
N
N
Wicks
J
J
Bird
H R
HR
D000293:Adolescent; D000928:Antidepressive Agents / Q000008:administration & dosage; D002648:Child; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000628:therapy; D019263:Dysthymic Disorder / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009518:New York; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014600:Utilization Review
D000928:Antidepressive Agents