Depressive and disruptive disorders and mental health service utilization in children and adolescents

Objective: To examine the relationship of depressive and disruptive disorde rs with patterns of mental health services utilization in a community sampl e of children and adolescents. Method: Data were from the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The sample consisted of 1,285 child (ages 9-17 years) and parent/guardian pair s. Data included child psychopathology (assessed by the Diagnostic Intervie w Schedule for Children), impairment, child need and use of mental health s ervices, and family socioeconomic status. Results: After adjusting for pote ntial confounding factors, disruptive disorder was significantly associated with children's use of mental health services, but depressive disorder was not. For school-based services, no difference was found between the 2 type s of disorders. Parents perceived greater need for mental health services f or children with disruptive disorders than for those with depression. Conve rsely, depression was more related to children's perception of mental healt h service need than was disruptive disorder. Conclusions: The findings high light the need for more effective ways to identify and refer depressed chil dren to mental health professionals, the importance of improving school-bas ed services to meet children's needs, and the necessity to better educate p arents and teachers regarding the identification of psychiatric disorders, especially depression.