title: Factors associated with adolescent mental health service need and utilization.
abstract: OBJECTIVE
  To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization.
  
  
  METHODS
  Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of 1,120 Dutch adolescents aged 11 to 18 years (78% response rate).
  
  
  RESULTS
  3.1% of the sample had been referred for mental health services within the preceding year, and 3.8% reported unmet need. 7.7% of adolescents at risk for psychopathology, and 17.8% of those indicating a need for help, had been referred. Family stress and adolescent's self-reported problems were most strongly associated with service need and utilization. Internalizing problems, female gender, and low education level were associated with self-perceived unmet need. Adolescent ethnicity and competence in activities and school were associated with service use, but did not influence service need, while the opposite effect was found for adolescent age and parental psychopathology.
  
  
  CONCLUSIONS
  In designing intervention programs aimed at increasing adolescent mental health service use, distinctions should be made between efforts focused at adolescents not recognizing their problems, and those with unmet need.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands. M.Zwaanswijk@nivel.nl
authors.forename: Marieke
authors.initials: M
authors.lastname: Zwaanswijk
authors.forename: Jan
authors.initials: J
authors.lastname: Van der Ende
authors.forename: Peter F M
authors.initials: PF
authors.lastname: Verhaak
authors.forename: Jozien M
authors.initials: JM
authors.lastname: Bensing
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D002648:Child; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D020380:Needs Assessment; D009426:Netherlands / Q000453:epidemiology; D012647:Self-Assessment