title: Determinants of mental health service use among depressed adolescents.
abstract: OBJECTIVE
  Evaluate determinants of mental health service use among depressed adolescents.
  
  
  METHODS
  We assessed mental health services use over the 12 months following screening among 113 adolescents (34 males, 79 females) from an integrated healthcare system who screened positive for depression (Patient Health Questionnaire-9 score ≥11). Youth characteristics (demographics, depression severity, and co-morbidity) and parent characteristics (parent history of depression, parent-report of youth externalizing and internalizing problems) were compared among youth who had received mental health services and those who had not. Multivariate regression was used to evaluate the strongest factors associated with mental health service use.
  
  
  RESULTS
  Overall, 52% of adolescents who screened positive for depression received mental health service in the year following screening. Higher parent-reported youth internalizing problems (OR 5.37, CI 1.77-16.35), parental history of depression/anxiety (OR 4.12, CI 1.36-12.48) were significant factors associated with mental health service use. Suicidality and functional impairment were not associated with increased mental health services use.
  
  
  CONCLUSIONS
  Parental factors including recognition of the adolescent's internalizing symptoms and parental experience with depression/anxiety are strongly associated with mental health service use for depressed adolescents. This highlights the importance of educating parents about depression and developing systems to actively screen and engage youth in treatment for depression.
authors.affiliation: Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA. Electronic address: david.breland@seattlechildrens.org.
authors.forename: David J
authors.initials: DJ
authors.lastname: Breland
authors.affiliation: Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: McCarty
authors.affiliation: Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA.
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Seattle Children's Hospital, Seattle, WA, USA; Psychiatry and Behavioral Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McCauley
authors.affiliation: Seattle Children's Hospital, Seattle, WA, USA; Psychiatry and Behavioral Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Rockhill
authors.affiliation: Department of Psychiatry & Behavioral Sciences; UW School of Medicine, Seattle, WA, USA.
authors.forename: Wayne
authors.initials: W
authors.lastname: Katon
authors.affiliation: Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Richardson
mesh_terms: D000293:Adolescent; D003863:Depression / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010290:Parents / Q000523:psychology*
keywords: Adolescent; Depression