title: Ethnic differences in problem perception and perceived need as determinants of referral in young children with problem behaviour.
abstract: An underrepresentation of ethnic minority children in mental health care settings is consistently reported. Parents of ethnic minority children are, however, less likely to perceive problem behaviour in their children. Our hypothesis was that, as a result of ethnic differences in problem perception, referral to care by a child health professional (CHP) would be lower for 5- to 6-year-old (high-risk) children from ethnic minority backgrounds than for their peers from the ethnic majority (Dutch origin). For 10,951 children in grade two of elementary school, parents and/or teachers completed the Strengths and Difficulties Questionnaire (SDQ) as well as questions on problem perception (PP) and perceived need for professional care (PN). Referral information was obtained from the Electronic Child Records (ECR) for 1,034 of these children. These children had a high (>90th percentile) SDQ score, and were not receiving mental health care. CHP's referred 144 children (14 %) during the routine health assessments. A lower problem perception was reported by parents of ethnic minority children (40-72 %) than by parents of the ethnic majority group (80 %; p < 0.001), but there were no ethnic differences in referral (OR range 0.9-1.9-p > 0.05). No ethnic differences were found for parental PN, nor for teacher's PP or PN. Despite a lower problem perception in ethnic minority parents when compared to ethnic majority parents, no ethnic differences were found in referral of children with problem behaviour in a preventive health care setting.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Centre, University Medical Centre, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.
authors.forename: Floor
authors.initials: F
authors.lastname: Bevaart
authors.forename: Cathelijne L
authors.initials: CL
authors.lastname: Mieloo
authors.forename: Marianne C H
authors.initials: MC
authors.lastname: Donker
authors.forename: Wilma
authors.initials: W
authors.lastname: Jansen
authors.forename: Hein
authors.initials: H
authors.lastname: Raat
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Floor V A
authors.initials: FV
authors.lastname: van Oort
mesh_terms: D001294:Attitude to Health; D002648:Child; D002653:Child Behavior Disorders / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D002675:Child, Preschool; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D010465:Perception; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
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