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Mental Health Service Use in a Community Head Start Population
Michelle New, PhD;
Brian Razzino, PhD;
Amy Lewin, PsyD;
Karen Schlumpf, MPH;
Jill Joseph, MD, PhD
Arch Pediatr Adolesc Med. 2002;156:721-727.
Background Evaluating access to and delivery of mental health services for young
children was a primary objective of the national research demonstration program
Starting Early Starting Smart (SESS).
Objective To present preliminary findings on family mental health and use of services
in a community Head Start population at time of entry into a longitudinal
study as part of the SESS program.
Subjects Children enrolled for Head Start entry in 1998 and 1999 (N = 290; mean
age, 4.3 years). Of these children, 52% were boys.
Methods Data on demographic factors, child and parent mental health, and service
use were collected from the sample at baseline. Information was gathered from
primary caregivers and teachers using standardized questionnaires and structured
interviews.
Results There was low concordance between parent and teacher ratings of child
behavior. Factors predicting behavior problems in young children varied according
to whether the parent or teacher rated the child as having behavior problems.
Sex (male) and home environment were associated with teachers rating the child
as having a behavior problem. Parent mental health problems and problems in
the parent-child relationship were associated with parent ratings. Only home
environment was associated with child-focused service utilization (services
that help parents manage children's behavior).
Conclusions Demographic risk factors were not associated with child behavior problems
or use of mental health services in this group of Head Start children. Findings
suggest that children with behavioral problems have unmet mental health service
needs. Interventions designed to address both parent mental health needs and
sensitivity to the developmental needs of children may increase child-focused
mental health service utilization.
From the Center for Health Services and Clinical Research, Children's
National Medical Center, Washington, DC.
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