MENTAL-HEALTH-SERVICE USE AMONG YOUNG-CHILDREN RECEIVING PEDIATRIC PRIMARY-CARE

Objective: To investigate the factors associated with mental health se rvice use among young children. Method: Five hundred ten preschool chi ldren aged 2 through 5 years were enrolled through 68 primary care phy sicians, with 388 (76% of the original sample) participating in a seco nd wave of data collection, 12 to 40 months later. Consensus DSM-NI-R diagnoses were assigned using best-estimate procedures. The test batte ry included the Child Behavior Checklist, a developmental evaluation, the Rochester Adaptive Behavior Inventory, and a videotaped play sessi on (preschool children) or structured interviews (older children). At wave 2, mothers completed a survey of mental health services their chi ld had received. Results: In logistic regression models, older childre n, children with a wave 1 DSM-III-R diagnosis, children with more tota l behavior problems and family conflict, and children receiving a pedi atric referral were more likely to receive mental health services. Amo ng children with a DSM-III-R diagnosis, more mental health services we re received by children who were older, white, more impaired, experien cing more family conflict, and referred by a pediatrician. Conclusions : Young children with more impairment and family conflict are more lik ely to enter into treatment. Services among young children of differen t races with diagnoses are not equally distributed. Pediatric referral is an important predictor of service use.