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Mental Health Service Use in Schools and Non-school-Based Outpatient Settings: Comparing Predictors of Service Use

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Abstract

Researchers have consistently documented a gap between the large number of US youth meeting criteria for a mental health disorder with significant associated impairment, and the comparatively few youth receiving services. School-based mental health care may address the need-services gap by offering services more equitably to youth in need, irrespective of family economic resources, availability of transportation, and other factors that can impede access to community clinics. However, diagnoses alone do not fully capture the severity of an individual’s mental health status and need for services. Studying service use only in relation to diagnoses may restrict our understanding of the degree to which service use is reflective of service need, and inhibit our ability to compare school and non-school-based outpatient settings on their responsiveness to service need. The present study evaluated predictors of mental health service use in school- and community-based settings for youth who had an active case in one of two public sectors of care, comparing empirically derived dimensional measurements of youth mental health service need and impairment ratings against non-need variables (e.g., ethnicity, income). Three dimensions of youth mental health service need were identified. Mental health service need and non-need variables each played a significant predictive role. Parent-rated impairment was the strongest need-based predictor of service use across settings. The impact of non-need variables varied by service setting, with parental income having a particularly noticeable effect on school-based services. Across time, preceding service use and impairment each significantly predicted future service use.

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Acknowledgments

This research was supported in part by National Institute of Mental Health Grants F31-MH079631 (DAL) and U01-MH55282 (RLH).

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Authors and Affiliations

  1. Department of Psychology, Boston University, 648 Beacon St. 6th Floor, Boston, MA, 02215, USA

    David A. Langer

  2. Graduate School of Education and Information Studies, University of California, Los Angeles, Moore Hall 3132A, 405 Hilgard Avenue, Los Angeles, CA, 90095-1521, USA

    Jeffrey J. Wood

  3. Child and Adolescent Services Research Center, Rady Children’s Hospital, 3020 Children’s Way, MC 5033, San Diego, CA, 92123, USA

    Patricia A. Wood, John Landsverk & Richard L. Hough

  4. Department of School, Family, and Mental Health Professions, University of San Diego, San Diego, USA

    Ann F. Garland

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Langer, D.A., Wood, J.J., Wood, P.A. et al. Mental Health Service Use in Schools and Non-school-Based Outpatient Settings: Comparing Predictors of Service Use. School Mental Health 7, 161–173 (2015). https://doi.org/10.1007/s12310-015-9146-z

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