title: Mental health service use among 18-year-old adolescent boys: a prospective 10-year follow-up study.
abstract: OBJECTIVE
  To study prevalence and factors associated with mental health service use among 18-year-old adolescent boys.
  
  
  METHODS
  Predictors at age 8 and factors at age 18 associated with mental health service use during the preceding 12 months were studied in a general population sample of 2,316 Finnish boys born in 1981 attending military call-up (79% of the original sample).
  
  
  RESULTS
  Within the preceding 12 months, 2.1% of the boys had used mental health services. At age 18, internalizing, anxious-depressive, and withdrawal symptoms; health problems; not living with parents; use of illicit drugs; high level of alcohol use; and regular smoking were independently associated with service use. At age 8, a high level of emotional and behavioral symptoms, need for referral, and low school performance according to teacher evaluations predicted service use 10 years later.
  
  
  CONCLUSIONS
  Only a minority of adolescents with severe problems had used mental health services. Because of the wide range of problems and comorbidity among service users, there is a need for integration of different services. Education services have a central role in the early detection of those who will later use mental health services.
authors.affiliation: Department of Child Psychiatry, Turku University Hospital, Finland. andre.sourander@utu.fi
authors.forename: Andre
authors.initials: A
authors.lastname: Sourander
authors.forename: Petteri
authors.initials: P
authors.lastname: MultimAki
authors.forename: Päivi
authors.initials: P
authors.lastname: Santalahti
authors.forename: Kai
authors.initials: K
authors.lastname: Parkkola
authors.forename: Antti
authors.initials: A
authors.lastname: Haavisto
authors.forename: Hans
authors.initials: H
authors.lastname: Helenius
authors.forename: Georgios
authors.initials: G
authors.lastname: Nikolakaros
authors.forename: Jorma
authors.initials: J
authors.lastname: Piha
authors.forename: Tuula
authors.initials: T
authors.lastname: Tamminen
authors.forename: Irma
authors.initials: I
authors.lastname: Moilanen
authors.forename: Kirsti
authors.initials: K
authors.lastname: Kumpulainen
authors.forename: Eeva T
authors.initials: ET
authors.lastname: Aronen
authors.forename: Sirkka-Liisa
authors.initials: SL
authors.lastname: Linna
authors.forename: Kaija
authors.initials: K
authors.lastname: Puura
authors.forename: Fredrik
authors.initials: F
authors.lastname: Almqvist
mesh_terms: D000293:Adolescent; D015897:Comorbidity; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index