title: Use of and need for professional help for emotional and behavioral problems among preadolescents: a prospective cohort study of 3- to 12-year-old children.
abstract: OBJECTIVE
  To determine the effect of child-, parent- and family-related factors on the use of and need for mental health services by 12 years of age.
  
  
  METHODS
  A prospective population-based questionnaire study of 1,287 first-born children was launched in Finland in 1985. The Child Behavior Checklist (CBCL) was completed by 1,086 parents when the children were aged 3 years. At the age of 12, the CBCL, the Youth Self-Report, and other potential determinants of service need and use were obtained from 908 parents and 900 children (80% response rate).
  
  
  RESULTS
  Of the total sample, 7.2% had used professional services, and 3.3% had needed services without obtaining them. Elevated scores on the age 3 CBCL Total Problems and Externalizing scale predicted independently later service use but not perceived need of services. In cross-sectional data at age 12, parental ratings of the child's problem behavior were associated with both the need for and use of services. Poor social competence and parental distress were independently associated with use of services.
  
  
  CONCLUSIONS
  Recognizing behavior problems in early childhood and evaluating family stress factors are important in social and health care systems designed for children.
authors.affiliation: Department of Public Health, University of Turku and Turku City Hospital, Turku, Finland. leena.pihlakoski@tyks.fi
authors.forename: Leena
authors.initials: L
authors.lastname: Pihlakoski
authors.forename: Minna
authors.initials: M
authors.lastname: Aromaa
authors.forename: Andre
authors.initials: A
authors.lastname: Sourander
authors.forename: Päivi
authors.initials: P
authors.lastname: Rautava
authors.forename: Hans
authors.initials: H
authors.lastname: Helenius
authors.forename: Matti
authors.initials: M
authors.lastname: SillanpAA
mesh_terms: D000342:Affective Symptoms / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000628:therapy; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010552:Personality Assessment; D011446:Prospective Studies; D014600:Utilization Review / Q000706:statistics & numerical data