title: Barriers to children's mental health services.
abstract: OBJECTIVE
  To examine the characteristics associated with barriers to children's mental health services, focusing on the effect of children's psychosocial problems on parents.
  
  
  METHODS
  Data come from a first-grade, prevention-intervention project conducted in Baltimore, Maryland. Analyses were restricted to 116 families who participated in seventh-grade interviews and indicated the index child needed services. The Services Assessment for Children and Adolescents was used to measure barriers to children's mental health services.
  
  
  RESULTS
  More than 35% of parents reported a barrier to mental health services. Types of barriers included those related to structural constraints, perceptions of mental health, and perceptions of services (20.7%, 23.3%, and 25.9%, respectively). Although parenting difficulties were associated with all barriers (structural: OR = 10.63, 95% CI: 2.37, 47.64; mental health: OR = 8.31, 95% CI: 1.99, 34.79; services: OR = 5.22, 95% CI: 1.56, 17.51), additional responsibilities related to attendance at meetings was associated only with structural barriers (OR = 5.49, 95% CI: 1.22, 24.59).
  
  
  CONCLUSIONS
  Researchers and policymakers interested in increasing children's access to mental health services should consider strategies to reduce barriers related to perceptions about mental health problems and services, in addition to structural barriers. Particular attention should be given to programs that focus on the needs of families who are most affected by their child's psychosocial problems.
authors.affiliation: Department of Mental Hygiene, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Owens
authors.forename: Kimberly
authors.initials: K
authors.lastname: Hoagwood
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Horwitz
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Leaf
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Poduska
authors.forename: Sheppard G
authors.initials: SG
authors.lastname: Kellam
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Ialongo
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D001294:Attitude to Health; D015142:Baltimore / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D020380:Needs Assessment; D010290:Parents / Q000523:psychology*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000517:prevention & control / Q000523:psychology; D014505:Urban Population / Q000706:statistics & numerical data*