TY - JOUR
T1 - Mental Health Services Use among School-Aged Children with Disabilities
T2 - The Role of Sociodemographics, Functional Limitations, Family Burdens, and Care Coordination
AU - Witt, Whitney P.
AU - Kasper, Judith D.
AU - Riley, Anne W.
PY - 2003/12
Y1 - 2003/12
N2 - Objective. To examine the use of mental health services and correlates of receiving services among community-dwelling children with disabilities, ages 6 to 17 years. Study Design. Data are from the 1994 and 1995 National Health Interview Survey Disability Supplements (NHIS-D), conducted by the National Center for Health Statistics. The study sample is 4,939 children with disabilities, representing an estimated eight million children with disabilities nationwide. Parents of children under 16 years of age reported (17-year-olds self-reported) on health, emotional and behavioral problems, mental health services use, and who, if anyone, coordinated the child's health care. Principal Findings. Among disabled children with poor psychosocial adjustment (11.5 percent), only 41.8 percent received mental health services in the past year. Multivariate logistic regression analysis showed service use was associated with poor psychosocial adjustment; communication, social, and learning-related functional impairments; public health insurance; and financial family burdens. Younger and black disabled children were less likely to receive mental health services. The odds of service use were greater with the involvement of a health professional in coordinating care, in contrast to no one or family only. Moreover, children with disabilities were more likely to use outpatient mental health services if their care was jointly coordinated by a family member and a health professional, compared to a health professional working alone. In contrast to inpatient and outpatient care, race and family burden were not associated with the likelihood of mental health counseling in special education school settings. Conclusions. Findings indicate that only two in five disabled children with poor psychosocial adjustment receive mental health services. Differences by age, race, and insurance coverage suggest that inequalities to access exist. However, the school setting may be one in which some barriers to mental health services for disabled children are reduced. The study also shows that the involvement of health professionals in care coordination is associated with greater access to mental health care for disabled children. These findings underscore the importance of engaging both health care professionals and the family in the care process.
AB - Objective. To examine the use of mental health services and correlates of receiving services among community-dwelling children with disabilities, ages 6 to 17 years. Study Design. Data are from the 1994 and 1995 National Health Interview Survey Disability Supplements (NHIS-D), conducted by the National Center for Health Statistics. The study sample is 4,939 children with disabilities, representing an estimated eight million children with disabilities nationwide. Parents of children under 16 years of age reported (17-year-olds self-reported) on health, emotional and behavioral problems, mental health services use, and who, if anyone, coordinated the child's health care. Principal Findings. Among disabled children with poor psychosocial adjustment (11.5 percent), only 41.8 percent received mental health services in the past year. Multivariate logistic regression analysis showed service use was associated with poor psychosocial adjustment; communication, social, and learning-related functional impairments; public health insurance; and financial family burdens. Younger and black disabled children were less likely to receive mental health services. The odds of service use were greater with the involvement of a health professional in coordinating care, in contrast to no one or family only. Moreover, children with disabilities were more likely to use outpatient mental health services if their care was jointly coordinated by a family member and a health professional, compared to a health professional working alone. In contrast to inpatient and outpatient care, race and family burden were not associated with the likelihood of mental health counseling in special education school settings. Conclusions. Findings indicate that only two in five disabled children with poor psychosocial adjustment receive mental health services. Differences by age, race, and insurance coverage suggest that inequalities to access exist. However, the school setting may be one in which some barriers to mental health services for disabled children are reduced. The study also shows that the involvement of health professionals in care coordination is associated with greater access to mental health care for disabled children. These findings underscore the importance of engaging both health care professionals and the family in the care process.
KW - Care coordination
KW - Children
KW - Disabilities
KW - Family burden
KW - Mental health services
KW - Utilization
UR - http://www.scopus.com/inward/record.url?scp=0347651505&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0347651505&partnerID=8YFLogxK
U2 - 10.1111/j.1475-6773.2003.00187.x
DO - 10.1111/j.1475-6773.2003.00187.x
M3 - Article
C2 - 14727782
AN - SCOPUS:0347651505
VL - 38
SP - 1441
EP - 1466
JO - Health Services Research
JF - Health Services Research
SN - 0017-9124
IS - 6 I
ER -