FACTORS ASSOCIATED WITH CHILD MENTAL-HEALTH-SERVICE USE IN THE COMMUNITY

Objective: To determine the association of parent, family, and child f actors with mental health services need and utilization. Method: Possi ble determinants of services need and utilization were assessed in a g eneral population sample of 2,227 children aged 4 to 18 years. Results : 3.5% of the total sample had been referred for mental health service s within the past year. The most potent factors associated with servic e need and utilization were the child's problem behaviors (both intern alizing and externalizing) and academic problems and family stress. So cioeconomic factors and the child's sex were not in itself associated with help-seeking factors. Parental psychopathology, life events, and family psychopathology lowered the parents' threshold for evaluating t he child's behavior as problematic but did not increase the likelihood of referral. Conclusion: Referred children are more likely to live in families under stress than are children with the same level of proble ms who live in well-functioning families. Clinicians and researchers w ho make inferences from findings in clinical samples should realize, t herefore, that children from problem families are overrepresented in t heir samples.