Skip to main content
Log in

Concordance Between Parent Reports of Children's Mental Health Services and Service Records: The Services Assessment for Children and Adolescents (SACA)

  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

The concordance between parent reports of children's mental health services and medical and administrative service records were assessed in a field test of the Services Assessment for Children and Adolescents (SACA) interview instrument. Service use reports from primary caregivers, usually mothers, for their child's emotional or behavioral problems were compared against inpatient, outpatient, and school records in St. Louis, one of the pilot sites for the Multi-Site Study of Service Use, Need, Outcomes and Costs in Child and Adolescent Populations (UNOCCAP). A global “any use” service variable, comprised of inpatient, outpatient, and school reports, yielded an overall service use concordance kappa of .76 between parent reports and records. Parent reports of inpatient hospitalization services using the SACA yielded the highest agreement with medical records, with kappa statistics of 1.00 for use of any inpatient hospital care and for medication use. Parent reports of specific inpatient services concurred with medical records more moderately, yielding kappas from .50 to .66. Reports of any outpatient mental health services yielded variable rates of agreement, with kappas ranging from .67 for any use of outpatient care, to .66 for medication use, to negligible kappas for specific treatments. Parent reports of school services were weakly related to records for most services, except for moderate agreement (.48) on placement in special classrooms for emotional or behavioral problems. Family burden or impact discriminated more powerfully than other variables between respondents who concurred with records and those who did not.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Angold, A., Messer, S.C., Stangl, D., Farmer, E.M.Z., Costello, E.J., & Burns, B.J. (in press). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health.

  • Ascher, B.H., Farmer, E.M.Z., Burns, B.J., & Angold, A. (1996). The Child and Adolescent Services Assessment (CASA): Description and psychometrics. Journal of Emotional and Behavioral Disorders, 4, 12–20.

    Google Scholar 

  • Bean, D.L., Leibowitz, A., Rotheram-Borus, M.D., Duan, N., Horwitz, S.M., Jordan D., & Hoagwood, K. False negative reporting and mental health services utilization: Parents' reports about child and adolescent services. (Under review).

  • Breda, C.S. (1996). Parent and institutional agreement on children's use of mental health services. Evaluation and Program Planning, 19, 165–173.

    Google Scholar 

  • Burns, B.J., Costello, E.J., Angold, A., Tweed, D., Stangl, D., Farmer, E.M.Z., & Erkanli, A. (1995). Children's mental health service use across service sectors. Health Affairs, 14, 147–159.

    Google Scholar 

  • Costello, E.J., Angold, A., Burns, B.J., Stangl, D.K., Tweed, D.L., Erkanli, A., & Worthman, C.M. (1996). The Great Smoky Mountains Study of Youth: Goals, design, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry, 53, 1129–1136.

    Google Scholar 

  • Costello, E.J. (1989). Developments in child psychiatric epidemiology. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 836–841.

    Google Scholar 

  • Farmer, E.M.Z., Angold, A., Burns, B.J., & Costello, E.J. (1994). Reliability of self-reported service use: Test-retest consistency and children's responses to the child and adolescent services assessment. Journal of Child and Family Studies, 3, 307–325.

    Google Scholar 

  • Fendrich, M., Johnson, T., Wislar, J.S., & Jageotte, C. (1999). Accuracy of parent mental health service reporting: results from a reverse record-check study. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 147–155.

    Google Scholar 

  • Friedman, R.M., Katz-Leavy, J.W., Manderscheid, R.W., & Henderson, M. (1996). Prevalence of serious emotional disturbance in children and adolescents. In R.W. Manderscheid & M.A. Sonnenschein (Eds). Mental Health, United States, 1996, (pp 32–54). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Friesen, B.J. & Koroloff, N.M. (1990). Family-centered services: Implications for mental health administration and research. Journal of Emotional and Behavioral Disorders, 17, 13–25.

    Google Scholar 

  • Golding, J.M., Gongla, P., & Brownell, A. (1988). Feasibility of validating survey self-reports of mental health service use. American Journal of Community Psychology, 16, 39–51.

    Google Scholar 

  • Goldstein, K.P., Kviz, F.J., & Daum, R.S. (1993). Accuracy of immunization histories provided by adults accompanying preschool children to a pediatric emergency department. Journal of the American Medical Association, 270, 2190–2194.

    Google Scholar 

  • Gross, R., Bentur, N., Elhayany, A., Sherf, M., & Epstein, L. (1996). The validity of self-reports on chronic disease: Characteristics of underreporters and implications for the planning of services. Public Health Review, 24, 167–182.

    Google Scholar 

  • Hayes, M.V., Taylor, S.M., Bayne, L.R., & Poland, B.D. (1990). Reported versus recorded health service utilization in Grenada, West Indies. Social Science Medicine, 31, 455–460.

    Google Scholar 

  • Horwitz, S.M., Hoagwood, K., Stiffman, A.R., Summerfelt, T., Weisz, J.R., & Costello, E.J. (in press). Measuring youth's use of mental health services: Reliability of the Services Assessment for Children and Adolescents (SACA). Psychiatric Services.

  • Jensen, P.S., Hoagwood, K., Arnold, L.E., & Odbert, C. (1999). Services for Children and Adolescents: Parent Interview (SCA-PI). Available from K. Hoagwood, NIMH, Rockville, MD.

    Google Scholar 

  • Kleinman, A. & Goode, B. (1990). Culture and Depression. Harvard University Press.

  • Lahey, B., Flagg, E.W., Bird, H.R., Schwab-Stone, M.E., Canino, G., Dulcan, M.K., Leaf, P.J., Davies, M., Brogan, D., Bourdon K., Horwitz, S.M., Rubio-Stipec, M., Freeman, D. H., Lichtman, J.H., Shaffer, D., Goodman, S.H., Narrow, W.E., Weissman, M.M., Kandel, D.B., Jensen, P.S., Richters, J.E., & Regier, D.A. (1996). The NIMH methods for the epidemiology of child and adolescent mental disorders (MECA) study: Background and methodology. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 855–877.

    Google Scholar 

  • Leaf, P.J., Alegria, M., Cohen, P., Goodman S.H., Horwitz, S.M., Hoven, C.W., Narrow, W.E., Vaden-Kierman, M., & Regier, D.A. (1996). Mental health service use in the community and schools: Results from the four-community MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 889–897.

    Google Scholar 

  • Roberts, R.E., Attkisson, C., & Rosenblatt, A. (1998). Prevalence of psychopathology among children and adolescents. American Journal of Psychiatry, 155, 715–725.

    Google Scholar 

  • Roberts, R.O., Bergstrahl, E.J., Schmidt, L., & Jacobsen, S.J. (1996). Comparison of self-reported and medical record health care utilization measures. Journal of Clinical Epidemiology, 49, 989–995.

    Google Scholar 

  • Stiffman, A.R., Horwitz, S.M., Hoagwood, K., Compton, W., Cottler, L., & Bean, D.L. (in press). Adult and child reports of mental health services in the Service Assessment for Children and Adolescents (SACA). Journal of the American Academy of Child and Adolescent Psychiatry.

  • Weissman, J.S., Levin, K., Chasan-Taber, S., Massagli, M.P., Seage, G.R., & Scampini, L. (1996). The validity of self-reported health-care utilization by AIDS patients. AIDS, 10, 775–783.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hoagwood, K., Horwitz, S., Stiffman, A. et al. 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, 315–331 (2000). https://doi.org/10.1023/A:1026492423273

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1026492423273

Navigation