Utilizing a validated screening instrument to identify and reduce mental health disparities among school age children and youth

Objective: In the present study, low-income racial and ethnic minority children and youth received school-based referrals to psychiatric services provided by the South Region Children\u27s Mental Health Collaborative (SRCMHC) project in a large urban area in the southern United States. During the referral process, parents and caregivers were asked to complete the Strengths and Difficulties Questionnaire (SDQ) in order for the researchers to obtain systematic information on the psychological difficulties the child or youth may have been experiencing. As part of the study, the SDQ was validated for the SRCMHC sample. The overall purpose of this study was to identify the predictors of mental health problems among the referral sample and to identify the predictors of engagement with and retention in psychiatric services. ^ Methods: Using confirmatory factor analysis, Goodman\u27s original five factor structure (1999) was replicated in the sample of low income minority children and adolescents referred to SRCMH services. Cronbach alpha statistics were calculated for each SDQ subscale, and SDQ scores from the referral population will be compared with SDQ scores from US national surveys. Descriptive and multivariate statistics were used to examine the clinical and socio-demographic characteristics of a population of children and youth referred, engaged, and retained in psychiatric services. ^ Results: The results of the validation study indicated that the SDQ is able to adequately identify mental and emotional difficulties among high-risk, low income racial and ethnic minority children and youth referred to mental health services. In the present study, Goodman\u27s original five factor structure (1999) was replicated in the sample of low income minority children and adolescents referred to SRCMH services. The findings in validation study demonstrate that the SDQ is a good choice for systematically identifying mental health problems among children and youth referred to mental health services in low income racial and ethnic minority communities. An examination of the determinants of mental health problems among SRCMHC children and youth referred for mental health services in the present study found that children and youth with an elevated SDQ TDS score (\u3e=17) were more likely to be African/American black, be reported by their parents/caregivers as having chronic mental health symptoms that were a burden on their families, and to be reported by their schools as having more presenting behaviors of concern. In contrast, children and youth with parent reported serious overall difficulties were more likely to be female and were more likely to be reported by their parents/caregivers as having mental health symptoms that placed a burden on their families. Children and youth with both an elevated SDQ TDS score and parent reported serious overall difficulties were more likely to be female, to be reported by their parents/caregivers as having chronic mental health symptoms that were a burden on their families, and to be reported by their schools as having more presenting behaviors of concern. The results of an examination of the predictors of engagement and retention in psychiatric services among children and youth referred to SRCMHC services confirmed the difficulty of engaging high risk children with mental health problems in mental health services and identified parent/caregiver and whole family burden as a significant factor affecting attendance at the initial psychiatric intake appointment and retention in services over time.