Racial and Ethnic Disparities in Caregiver Strain and the Use of Child Mental Health Services

A Structural Equation Model

Data from a longitudinal, racially and ethnically stratified study reveals that African-American children were less likely to use mental health services and that their caregivers associated lower levels of strain with the children’s diagnosed mental health disorders.

Why does the use of mental health services vary among children of different races and ethnicities? One explanation may be found in levels of caregiver strain, the perceived stress that a parent or guardian associates with a child’s mental health disorder. Cultural factors could affect caregiver strain; for instance, strong African-American family networks might attenuate the difficulties of coping with a child’s mental health obstacle.

This article presents a secondary data analysis of a longitudinal study of mental health service use among children in a major metropolitan area; the children were found in five public service sectors, including child welfare and juvenile justice. The types of strain experienced by caregivers fell into three categories: objective strain (e.g.,disruption of daily routines);internalized subjective (e.g., sadness); and externalized subjective (e.g., embarrassment).

Key Findings:

  • Youths whose caregivers felt lower levels of strain were less likely to use mental health services.
  • Compared with White caregivers, African-American caregivers had lower levels of caregiver strain; Hispanic caregivers had lower levels of objective but not subjective strain.

How a caregiver copes with the strains of their child’s mental health challenges may determine whether the child receives treatment. This analysis of a longitudinal, racially and ethnically stratified study of child mental health service use supports that theory. The findings are consistent with previous research into the effects of caregiver strain on child mental health service use.

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