title: Adolescents referred to specialty mental health care from local services and adolescents who remain in local treatment: what differs?
abstract: BACKGROUND
  The study investigates whether adolescents referred to specialty mental health services from local services differ from adolescents who only have received help for psychiatric problems locally. If so, which factors associate strongest with referral?
  
  
  METHODS
  Adolescents (n = 76) from an adolescent population sample (N = 2,538) who had received help during the last year for mental problems from local services were compared to a clinical sample of adolescents (N = 129) referred to specialty mental health services from such local services. Comparisons were made according to scores on the Youth Self-Report (YSR); depressive symptoms; family functioning; attachment to parents; self-concept; coping styles; response styles; dysfunctional attitudes; negative life events; daily hassles; socio-demographics.
  
  
  RESULTS
  As compared to adolescents receiving help locally, adolescents in specialty mental health care scored higher on YSR internalising syndrome; YSR attention problems; YSR thought problems; suicidality; psychosocial stressors; knowing someone who had attempted suicide; parental divorce; substance use; recent moves; living in lodgings; lost a pal or boy/girlfriend; and lower on attachment to parents. Multivariate logistic regression analysis identified four factors associated with receiving specialty mental health care: low family functioning; moved previous year; knowing someone who had attempted suicide; own suicidality.
  
  
  CONCLUSIONS
  Family functioning as reported by the adolescents, and not mental health problems except for suicidality, was found to be the strongest associated with referral to specialty mental health services. Contrary to findings from many other studies, referral was associated with internalising problems, not externalising ones.
authors.affiliation: Dept. of Child and Adolescent Psychiatry, Nordlandssykehuset, Bodø, Norway. bre@nlsh.no
authors.forename: Bjørn
authors.initials: B
authors.lastname: Reigstad
authors.forename: Kirsti
authors.initials: K
authors.lastname: Jørgensen
authors.forename: Anne Mari
authors.initials: AM
authors.lastname: Sund
authors.forename: Lars
authors.initials: L
authors.lastname: Wichstrøm
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013406:Suicide, Attempted