title: Understanding caregivers' help-seeking for Latino children's mental health care use.
abstract: BACKGROUND
  Latino children have persistent low rates of mental health service use. Understanding the factors that influence caregivers' decisions about whether to use mental health care for their children can help explain why.
  
  
  OBJECTIVE
  The objective of this study was to investigate the factors reported by the primary caregiver that could help classify Puerto Rican children into users versus nonusers of mental health services and mental health versus school sector care, among users.
  
  
  METHODS
  Data were collected from a random Puerto Rican community sample of caregiver-child dyads.
  
  
  METHODS
  Version-IV of the Computerized Diagnostic Interview for Children (DISC) was used to assess psychiatric disorders in children. The Service Assessment for Children and Adolescents (SACA) was used to examine the types of services used for mental health problems.
  
  
  METHODS
  The Classification and Regression Tree (CART) approach was used to develop a simple model simulating caregivers' decision-making around taking children for mental health care and the setting for care.
  
  
  RESULTS
  The classification model of use versus no use of mental health service suggested 3 significant predictors: child's level of impairment, parental concern, and child's difficulty in performing schoolwork. The classification model of sector of care, mental health versus school setting, identified 1 significant predictor, any disruptive disorder diagnosis.
  
  
  CONCLUSIONS
  : Assisting caregivers in linking a child's impairment with need for mental health care might be a mechanism to reduce children's unmet need. Approaches such as CART, used to identify factors predicting consumer choices in marketing, might be useful to select strategies for social campaigns targeted toward decreasing unmet need.
authors.affiliation: Cambridge Health Alliance, Center for Multicultural Mental Health Research, Somerville, Massachusetts, USA. malegria@charesearch.org
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegría
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
authors.forename: Shenghan
authors.initials: S
authors.lastname: Lai
authors.forename: Rafael R
authors.initials: RR
authors.lastname: Ramirez
authors.forename: Ligia
authors.initials: L
authors.lastname: Chavez
authors.forename: Dana
authors.initials: D
authors.lastname: Rusch
authors.forename: Patrick E
authors.initials: PE
authors.lastname: Shrout
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D011647:Puerto Rico / Q000208:ethnology; D012044:Regression Analysis; D014481:United States