The authors examined racial/ethnic disparities in mental health service use based on problem type (internalizing/externalizing). A diverse sample of youth in contact with public sectors of care and their families provided reports of youth's symptoms and functional impairment during an initial interview. Specialty and school-based mental health service use during the subsequent 2 years was assessed prospectively. Greater disparities in mental health service receipt were evident for internalizing problems, with non-Hispanic White youth more likely to receive services in response to internalizing symptoms than minority youth. Fewer disparities in rates of unmet need emerged for externalizing problems, but minority youth were more likely to have need for externalizing problems met and African American youth were particularly likely to receive services in response to such problems. Findings highlight the importance of considering problem type when examining racial disparities in mental health services and underscore concerns about the responsiveness of mental health services for minority youth with internalizing disorders.
Achenbach, T.M. (1991a). Manual for the Child Behavior Checklist/4-18 and 1991 profile. Burlington: University of Vermont, Department of Psychiatry.
2.
Achenbach, T.M. (1991b). Manual for the YSR and 1991 profile. Burlington: University of Vermont, Department of Psychiatry .
3.
Allensworth, D., Lawson, E., Nicholson, L., & Wyche, J. (1997). Schools and health: Our nation's investment. Washington, DC: National Academy Press.
4.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
5.
Bebbington, P.E., Brewin, C.R., Marsden, L., Lesage, A.D., & Lesage, A. (1996). Measuring the need for psychiatric treatment in the general population: The community version of the MRC needs for care assessment . Psychological Medicine, 26(2), 229-236.
6.
Bird, H.R., & Gould, M.S. (1995). The use of diagnostic instruments and global measures of functioning in child psychiatry epidemiological studies. In F. C. Verhulst & H. M. Koot (Eds.), The epidemiology of child and adolescent psychopathology (pp. 86-103). Oxford, UK: Oxford University Press.
7.
Bird, H.R., Shaffer, D., Fisher, P., & Gould, M.S. (1993). The Columbia Impairment Scale (CIS): Pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research, 3(3), 167-176.
8.
Burns, B.J., Costello, E.J., Angold, A., Tweed, D., Stangl, D., Farmer, E.M., et al. (1995). Children's mental health service use across service sectors. Health Affairs, 14(3), 147-159.
9.
Bussing, R., Schoenberg, N.E., Rogers, K.M., Zima, B.T., & Angus, S. (1998). Explanatory models of ADHD: Do they differ by ethnicity, child gender, or treatment status?Journal of Emotional and Behavioral Disorders, 6(4), 233-242.
10.
Bussing, R., Zima, B.T., Gary, F.A., & Garvan, C.W. (2003). Barriers to detection, help-seeking, and service use for children with ADHD symptoms. Journal of Behavioral Health Services & Research, 30(2), 176-189.
11.
Cantwell, D.P., Lewinsohn, P.M., Rohde, P., & Seeley, J.R. (1997). Correspondence between adolescent report and parent report of psychiatric diagnostic data. Journal of the American Academy of Child & Adolescent Psychiatry, 36(5), 610-619.
12.
Chang, D.F., & Sue, S. (2003). The effects of race and problem type on teachers' assessments of student behavior. Journal of Consulting and Clinical Psychology, 71(2), 235-242.
13.
Coutinho, M.J., & Oswald, D.P. (2000). Disproportionate representation in special education: A synthesis and recommendations. Journal of Child and Family Studies, 9(2), 135-156.
14.
Crane, K.D., & Ellis, R.A. (2004). Benevolent intervention or oppression perpetuated: Minority overrepresentation in children's services. Journal of Human Behavior in the Social Environment, 9(1-2), 19-38.
15.
Cullinan, D., & Kauffman, J.M. (2005). Do race of student and race of teacher influence ratings of emotional and behavioral problem characteristics of students with emotional disturbance? Behavioral Disorders , 30(4), 393-402.
16.
Downey, D.B., & Pribesh, S. (2004). When race matters: Teachers' evaluations of students' classroom behavior. Sociology of Education, 77(4), 267-282.
17.
Finkelhor, D., Wolak, J., & Berliner, L. (2001). Police reporting and professional help seeking for child crime victims: A review. Child Maltreatment: Journal of the American Professional Society on the Abuse of Children, 6(1), 17-30.
18.
Garland, A.F., Hough, R.L., McCabe, K.M., Yeh, M., Wood, P.A., & Aarons, G.A. (2001). Prevalence of psychiatric disorders in youths across five sectors of care. Journal of the American Academy of Child & Adolescent Psychiatry, 40(4), 409-418.
19.
Garland, A.F., Lau, A.S., Yeh, M., McCabe, K.M., Hough, R.L., & Landsverk, J.A. (2005). Racial and ethnic differences in utilization of mental health services among high-risk youths. American Journal of Psychiatry, 162(7), 1336-1343.
20.
Garrison, E.G., Roy, I.S., & Azar, V. (1999). Responding to the mental health needs of Latino children and families through school-based services. Clinical Psychology Review, 19(2), 199-219.
21.
Gottlieb, J., Gottlieb, B.W., & Trongone, S. (1991). Parent and teacher referrals for a psychoeducational evaluation. Journal of Special Education, 25(2), 155-167.
22.
Henry, G.T. (1990). Practical sampling. Newbury Park, CA: Sage.
23.
Hoagwood, K., Horwitz, S., Stiffman, A., Weisz, J., Bean, D., Rae, D., et al. (2000). Concordance between parent reports of children's mental health services and service records: The Services Assessment for Children and Adolescents (SACA). Journal of Child and Family Studies , 9(3), 315-331.
24.
Horwitz, S.M., Hoagwood, K., Stiffman, A.R., Summerfeld, T., Weisz, J.R., Costello, E.J., et al. (2001). Reliability of the Services Assessment for Children and Adolescents. Psychiatric Services, 52(8), 1088-1094.
25.
Hough, R.L., Hazen, A.L., Soriano, F.I., Wood, P., McCabe, K., & Yeh, M. (2002). Mental health care for Latinos: Mental health services for Latino adolescents with psychiatric disorders. Psychiatric Services, 53(12), 1556-1562.
26.
Institute of Medicine. (2002). Unequal treatment: Confronting racial and ethnic disparities in health care . Washington, DC: National Academy Press.
27.
Kataoka, S.H., Zhang, L., & Wells, K.B. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159(9), 1548-1555.
28.
Kazdin, A.E., & Weisz, J.R. (2003). Introduction: Context and background of evidence-based psychotherapies for children and adolescents. In A. E. Kazdin & J. R. Weisz (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 3-20). New York: Guilford Press.
29.
Kodjo, C.M., & Auinger, P. (2004). Predictors for emotionally distressed adolescents to receive mental health care. Journal of Adolescent Health , 35(5), 368-373.
30.
Lau, A.S., Garland, A.F., Yeh, M., McCabe, K.M., Wood, P.A., & Hough, R.L. (2004). Race/ethnicity and inter-informant agreement in assessing adolescent psychopathology. Journal of Emotional and Behavioral Disorders, 12(3), 145-156.
31.
Leaf, P.J., Alegría, M., Cohen, P., & Goodman, S.H. (1996). Mental health service use in the community and schools: Results from the four-community MECA study. Journal of the American Academy of Child & Adolescent Psychiatry, 35(7), 889-897.
32.
Losen, D.J., & Orfield, G. (2002). Racial inequity in special education. Cambridge, MA: Harvard Education Publishing Group.
33.
Marwit, S.J. (1982). Students' race, physical attractiveness and teachers' judgments of transgressions: Follow-up and clarification. Psychological Reports, 50(1), 242.
34.
McCabe, K.M. (2002). Factors that predict premature termination among Mexican-American children in outpatient psychotherapy. Journal of Child and Family Studies, 11(3), 347-359.
35.
McMiller, W.P., & Weisz, J.R. (1996). Help-seeking preceding mental health clinic intake among African-American, Latino, and Caucasian youths. Journal of the American Academy of Child & Adolescent Psychiatry, 35(8), 1086-1094.
36.
National Research Council. (2002). Representation of minority students in special and gifted education. In M. S. Donovan & C. T. Cross (Eds.), Minority students in special and gifted education (pp. 35-90). Washington, DC: National Academy Press.
37.
Office of Juvenile Justice and Delinquency Prevention. (1999). Minorities in the juvenile justice system. Retrieved August 23, 2006, from http://www.ncjrs.gov/pdffiles1/ojjdp/179007.pdf
38.
Phares, V., & Compas, B.E. (1990). Adolescents' subjective distress over their emotional/behavioral problems. Journal of Consulting and Clinical Psychology, 58(5), 596-603.
39.
Pigott, R.L., & Cowen, E.L. (2000). Teacher race, child race, racial congruence, and ratings of child school adjustment. Journal of School Psychology , 38, 177-196.
40.
Pihlakoski, L., Aromaa, M., Sourander, A., Rautava, P., Helenius, H., & Sillanpää, M. (2004). Use of and need for professional help for emotional and behavioral problems among preadolescents: A prospective cohort study of 3- to 12-year-old children. Journal of the American Academy of Child & Adolescent Psychiatry, 43(8), 974-983.
41.
Roberts, R.E., Alegría, M., Roberts, C.R., & Chen, I.G. (2005). Mental health problems of adolescents as reported by their care-givers: A comparison of European, African, and Latino Americans . Journal of Behavioral Health Services & Research, 32(1), 1-13.
42.
Shaffer, D., Fisher, P., Dulcan, M.K., & Davies, M. (1996). The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): Description, acceptability, prevalence rates, and performance in the MECA study. Journal of the American Academy of Child & Adolescent Psychiatry, 35(7), 865-877.
43.
Shaffer, D., Fisher, P., Lucas, C.P., Dulcan, M.K., & Schwab-Stone, M.E. (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry, 39(1), 28-38.
44.
Skiba, R.J., Michael, R.S., Nardo, A.C., & Peterson, R.L. (2002). The color of discipline: Sources of racial and gender disproportionality in school punishment. Urban Review, 34(4), 317-342.
45.
Slade, E.P. (2004). Racial/ethnic disparities in parent perception of child need for mental health care following school disciplinary events . Mental Health Services Research, 6(2), 75-92.
46.
Stiffman, A.R., Horwitz, S.M., Hoagwood, K., Compton, W., III, Cottler, L., Bean, D.L., et al. (2000). The Service Assessment for Children and Adolescents (SACA): Adult and child reports. Journal of the American Academy of Child & Adolescent Psychiatry, 39(8), 1032-1039.
47.
Taylor, P.B., Gunter, P.L., & Slate, J.R. (2001). Teachers' perceptions of inappropriate student behavior as a function of teachers' and students' gender and ethnic background . Behavioral Disorders, 26(2), 146-151.
48.
Thompson, R. (2005). The course and correlates of mental health care received by young children: Descriptive data from a longitudinal urban high-risk sample. Children and Youth Services Review, 27(1), 39-50.
49.
Wood, P.A., Yeh, M., Pan, D., Lambros, K.M., McCabe, K.M., & Hough, R.L. (2005). Exploring the relationship between race/ethnicity, age of first school-based services utilization, and age of first specialty mental health care for at-risk youth. Mental Health Services Research, 7(3), 185-196.
50.
Yeh, M., Forness, S.R., Ho, J., McCabe, K., & Hough, R.L. (2004). Parental etiological explanations and disproportionate racial/ethnic representation in special education services for youths with emotional disturbance. Behavioral Disorders, 29(4), 348-358.
51.
Yeh, M., McCabe, K., Hough, R.L., Dupuis, D., & Hazen, A. (2003). Racial/ethnic differences in parental endorsement of barriers to mental health services for youth. Mental Health Services Research, 5(2), 65-77.
52.
Yeh, M., McCabe, K., Hough, R.L., Lau, A., Fakhry, F., & Garland, A. (2005). Why bother with beliefs? Examining relationships between race/ethnicity, parental beliefs about causes of child problems, and mental health service use. Journal of Consulting and Clinical Psychology, 73(5), 800-807.
