Cited by 658Mental Health Treatment and AccessPsychiatric care and mental health servicesChild and Adolescent Psychosocial and Emotional Development

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Pathways Into and Through Mental Health Services for Children and Adolescents

Farmer, Elizabeth M. Z., Burns, Barbara J., Phillips, Susan D., Angold, Adrian, Costello, E. Jane·2003·Psychiatric Services

DOI 10.1176/appi.ps.54.1.60

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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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Self-citation
Increase in Untreated Cases of Psychiatric Disorders During the Transition to Adulthood
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Self-citation
Factors Associated with Parent–Child Discrepancies in Reports of Mental Health Disorders in Young Children
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Authors: Farmer, E. M. Z., Burns, B. J., Phillips, S. D., Angold, A., & Costello, E. J.
Affiliations: Duke University (US)
ORCID: Farmer, Elizabeth M. Z.
Costello, E. Jane
Venue: Psychiatric Services
Publisher: American Psychiatric Association Publishing
Published: 2003-01
Volume: 54
Issue: 1
Pages: 60-66
ISSN: 0022-1597 (ISSN-L)
1075-2730
1557-9700
DOI: 10.1176/appi.ps.54.1.60
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: Health Sciences › Medicine › Psychiatry and Mental health › 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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Pathways Into and Through Mental Health Services for Children and Adolescents

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