Pathways Into and Through Mental Health Services for Children and Adolescents
Abstract
OBJECTIVE: This study examined points of entry into the mental health service system for children and adolescents as well as patterns of movement through five service sectors: specialty mental health services, education, general medicine, juvenile justice, and child welfare. METHODS: The data were from the Great Smoky Mountains Study, a longitudinal epidemiologic study of mental health problems and service use among youths. The sample consisted of 1,420 youths who were nine, 11, or 13 years old at study entry. Each youth and a parent were interviewed at baseline and every year thereafter about the use of services for mental health problems over the three-year study period. RESULTS: Population estimates indicated that 54 percent of youths have used mental health services at some time during their lives. The education sector was the most common point of entry and provider of services across all age groups. The specialty mental health sector was the second most common point of entry for youths up to age 13 years, and juvenile justice was the second most common point of entry for youths between the ages of 14 and 16. Youths who entered the mental health system through the specialty mental health sector were the most likely to subsequently receive services from other sectors, and those who entered through the education sector were the least likely to do so. CONCLUSIONS: The education sector plays a central role as a point of entry into the mental health system. Interagency collaboration among three primary sectors-education, specialty mental health services, and general medicine-is critical to ensuring that youths who are in need of mental health care receive appropriate services.
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In the USA, the education sector is the most heavily accessed youth mental health service setting.
“In the USA, studies consistently indicate that the education sector is the most heavily accessed youth mental health service setting, responsible for 50–80% of all mental healthcare [4, 41–45].”
From Leading the charge in the education sector: development and validation of the School Implementation Leadership Scale (SILS) (2022) · cites this paper as [41]
In the USA, the education sector is responsible for 50-80% of all mental healthcare.
“In the USA, studies consistently indicate that the education sector is the most heavily accessed youth mental health service setting, responsible for 50–80% of all mental healthcare [4, 41–45].”
From Leading the charge in the education sector: development and validation of the School Implementation Leadership Scale (SILS) (2022) · cites this paper as [41]
Three-fourths of children who do receive services for mental health problems receive their care through the education sector, with schools being the most common point of entry for accessing mental health services.
“Three-fourths of children who do receive services for mental health problems receive their care through the education sector, with schools being the most common point of entry for accessing mental health services (Farmer, Burns, Phillips, Angold, & Costello, 2003).”
From Evidence-Based Mental Health Programs in Schools: Barriers and Facilitators of Successful Implementation (2010) · cites this paper as Farmer, Burns, Phillips, Angold, & Costello, 2003
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Self-citationIncrease in Untreated Cases of Psychiatric Disorders During the Transition to Adulthood
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- Authors
- Farmer, E. M. Z., Burns, B. J., Phillips, S. D., Angold, A., & Costello, E. J.
- Affiliations
- Duke University (US)
- Venue
- Psychiatric Services
- Published
- 2003-01
- Volume
- 54
- Issue
- 1
- Pages
- 60-66
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2169700036
- Cited by
- 658
- References
- 20
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 17 · 2023: 21 · 2022: 32 · 2021: 34 · 2020: 38 · 2019: 37 · 2018: 36 · 2017: 70 · 2016: 34 · 2015: 40 · 2014: 37 · 2013: 32 · 2012: 38
- FWCI
- 15.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- child and adolescent mental health services, service utilization patterns, specialty mental health services, school-based mental health services, juvenile justice, child welfare, general medical care, inter-agency cooperation, Great Smoky Mountains Study
- MeSH terms
- Adolescent, Adult, Mental Disorders, Child, Child Health Services, Criminal Law, Education, Female, Follow-Up Studies, Humans, Male, Mental Health Services, North Carolina, Adolescent Health Services
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