Help-seeking for child psychopathology: pathways to informal and professional services in the Netherlands.
OBJECTIVE
To devise and test a model describing the process of help-seeking for child psychopathology in professional and informal service settings.


METHODS
Using structural equation modeling, associations between several help-seeking stages, and the influence of child, family, and context characteristics on these stages were investigated in 246 Dutch children (4-11 years old) between April 2000 and July 2002. Children were selected for having emotional or behavioral problems from a representative general practice sample; 68% of the selected children participated.


RESULTS
School personnel played an important role in the process of help-seeking for child psychopathology, in both detecting service need and the provision of and the referral for help. Although Dutch general practitioners are supposed to be gatekeepers of mental health care, their role in help-seeking for child psychopathology was limited. Various family characteristics were shown to influence service need and informal or professional help-seeking. The influence of child characteristics on the help-seeking process was limited.


CONCLUSIONS
Educating parents about child psychopathology and the availability and accessibility of care, improving general practitioners' skills in detecting child psychopathology, and direct contact of mental health professionals with general practitioners and schools may enhance access to care for children in need.
Zwaanswijk
Marieke
M
Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands. M.Zwaanswijk@nivel.nl
van der Ende
Jan
J
Verhaak
Peter F M
PF
Bensing
Jozien M
JM
Verhulst
Frank C
FC
D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010552:Personality Assessment; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors