Service use for mental disorders and unmet need: results from the Israel Survey on Mental Health Among Adolescents.
OBJECTIVE
The first nationwide Israel Survey of Mental Health Among Adolescents was conducted in 2004-2005 with a representative sample of 957 adolescents aged 14-17 and their mothers to assess 12-month mental health service use, unmet needs, and associated factors.


METHODS
Need for services was assessed by presence of a psychiatric disorder diagnosed with the Development and Well-Being Assessment inventory, plus clinicians' verification and additional questions on service use.


RESULTS
In the past year, 22% of adolescents and 11% of their mothers consulted a service provider. Adolescents' help seeking in school was associated with residing in an Arab locality (odds ratio [OR]=1.6, 95% confidence interval [CI]=1.1-2.4) and with having single, divorced, or widowed parents (OR=2.9, CI=1.8-4.8); an employed father (OR=1.7, CI=1.0-2.8); and an internalizing disorder (OR=2.2, CI=1.2-3.9). Mothers' consultation was associated with residing in a Jewish or mixed locality (OR=18.1, CI=3.4-96.1); being single, divorced, or widowed (OR=3.1, CI=1.6-6.0); and having a child with an internalizing disorder (OR=6.4, CI=3.2-13.0), an externalizing disorder (OR=8.2, CI=2.9-23.0), or a learning disability (OR=4.5, CI=2.4-8.4). Overall, unmet needs were 66% and 60%, according to adolescents' and mothers' reports, respectively. According to mothers' reports, unmet needs were higher in Arab (91%) than in Jewish or mixed localities (54%).


CONCLUSIONS
Adolescents and their mothers reported distinct service use patterns with particular implications for policy makers and health service providers. High rates of unmet needs, particularly among Arab-Israeli adolescents, need to be addressed.
Mansbach-Kleinfeld
Ivonne
I
Department of Mental Health Services, Ministry of Health, 2 Ben Tabai, Jerusalem, Israel. ivonne.mansbach@moh.health.gov.il
Farbstein
Ilana
I
Levinson
Daphna
D
Apter
Alan
A
Erhard
Rachel
R
Palti
Hava
H
Geraisy
Nabil
N
Brent
David A
DA
Ponizovsky
Alexander M
AM
Levav
Itzhak
I
D000293:Adolescent; D000296:Adolescent Psychiatry; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D007557:Israel; D008297:Male; D001523:Mental Disorders; D008605:Mental Health Services / Q000706:statistics & numerical data*