title: Cross-Sectional Study of Unmet Mental Health Need in 5- to 7-Year Old Latino Children in the United States: Do Teachers and Parents Make a Difference in Service Utilization?
abstract: The aim of the study is to examine the rates of mental health service utilization in young Latino children of immigrants in relation to maternal and teacher reports of child mental health need. Specific knowledge is lacking about gaps in service utilization among young Latino children, the fastest growing and possibly the most underserved segment of the US child population. The associations of mental health service utilization (Service Assessment for Children and Adolescents) and mental health need (clinical levels of internalizing, externalizing, or total problems reported by mothers [Child Behavior Checklist] and teachers [Teacher's Report Form]) were examined in a community sample of young Latino children of immigrants (n= 228; mean age = 6) and compared across mothers' and teachers' responses. Mother-teacher agreement was also studied. Sixty-five children (28.5 %) had a mental health need; most (76.9 %) of these received no services. For all types of mental health need, service utilization was more likely when need was reported by mothers rather than teachers (p= .03). Teachers' reports were not associated with service utilization. Mother-teacher agreement was low for externalizing (r= .23;p≤ 0.01) and total problems (r= .21;p≤ 0.05), and nonsignificant for internalizing problems. This study is the first in the United States to document, in such a young Latino group, high rates of unmet need comparable to those among older Latino youth; low or no mother-teacher agreement on which children had a mental health need; low utilization of school-based services; and a lack of association between service utilization and teacher-reported mental health need-both for externalizing and internalizing problems. These findings suggest that schools are not effectively leveraging mental health services for young Latino children. Potential factors responsible for the findings are discussed.
authors.affiliation: Judge Baker Children's Center, Children's Hospital Boston, Harvard Medical School, 53 Parker Hill Avenue, Boston, MA 02120, USA topi@hms.harvard.edu.
authors.forename: Claudio O
authors.initials: CO
authors.lastname: Toppelberg
authors.forename: Marisa O
authors.initials: MO
authors.lastname: Hollinshead
authors.forename: Brian A
authors.initials: BA
authors.lastname: Collins
authors.forename: Alfonso
authors.initials: A
authors.lastname: Nieto-Castañon
keywords: Child; Immigrant; Latino; Mental health; Service utilization