Social Disparities in Mental Health Service Use Among Children and Youth in Ontario: Evidence From a General, Population-Based Survey.

OBJECTIVES To examine differences in mental health-related service contacts between immigrant, refugee, racial and ethnic minoritized children and youth, and the extent to which social, and economic characteristics account for group differences. METHODS The sample for analyses includes 10,441 children and youth aged 4-17 years participating in the 2014 Ontario Child Health Study. The primary caregiver completed assessments of their child's mental health symptoms, perceptions of need for professional help, mental health-related service contacts, experiences of discrimination and sociodemographic and economic characteristics. RESULTS Adjusting for mental health symptoms and perceptions of need for professional help, children and youth from immigrant, refugee and racial and ethnic minoritized backgrounds were less likely to have mental health-related service contacts (adjusted odds ratios ranged from 0.54 to 0.79), compared to their non-immigrant peers and those who identified as White. Group differences generally remained the same or widened after adjusting for social and economic characteristics. Large differences in levels of perceived need were evident across non-migrant and migrant children and youth. CONCLUSION Lower estimates of mental health-related service contacts among immigrant, refugee and racial and ethnic minoritized children and youth underscore the importance and urgency of addressing barriers to recognition and treatment of mental ill-health among children and youth from minoritized backgrounds.

[1]  R. Khanam,et al.  The gap between perceived mental health needs and actual service utilization in Australian adolescents , 2022, Scientific Reports.

[2]  D. Finkelhor,et al.  Receipt of Behavioral Health Services Among US Children and Youth With Adverse Childhood Experiences or Mental Health Symptoms , 2021, JAMA network open.

[3]  M. Boyle,et al.  The 2014 Ontario Child Health Study—Methodology , 2019, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[4]  M. Boyle,et al.  Six-Month Prevalence of Mental Disorders and Service Contacts among Children and Youth in Ontario: Evidence from the 2014 Ontario Child Health Study , 2019, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[5]  M. Straiton,et al.  Perceived discrimination, health and mental health among immigrants in Norway: the role of moderating factors , 2019, BMC Public Health.

[6]  Harriet L. MacMillan,et al.  The 2014 Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS) Part I: A Checklist for Dimensional Measurement of Selected DSM-5 Disorders , 2018, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[7]  Cindy D Chang,et al.  Social Determinants of Health and Health Disparities Among Immigrants and their Children. , 2019, Current problems in pediatric and adolescent health care.

[8]  S. Vigod,et al.  Use of the emergency department as a first point of contact for mental health care by immigrant youth in Canada: a population-based study , 2018, Canadian Medical Association Journal.

[9]  T. Stukel,et al.  Trends in mental health service utilisation in immigrant youth in Ontario, Canada, 1996–2012: a population-based longitudinal cohort study , 2018, BMJ Open.

[10]  Kara E. Rudolph,et al.  Prevalence of Mental Disorder and Service Use by Immigrant Generation and Race/Ethnicity Among U.S. Adolescents. , 2018, Journal of the American Academy of Child and Adolescent Psychiatry.

[11]  A. I. Hijas-Gómez,et al.  A systematic review of the use of health services by immigrants and native populations , 2016, Public Health Reviews.

[12]  A. S. Derr Mental Health Service Use Among Immigrants in the United States: A Systematic Review. , 2016, Psychiatric services.

[13]  Anthony F Jorm,et al.  Factors Associated With Service Use for Young Adolescents With Mental Health Problems , 2014 .

[14]  R. Kessler,et al.  Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey-Adolescent. , 2014, Psychiatric services.

[15]  T. Postmes,et al.  The consequences of perceived discrimination for psychological well-being: a meta-analytic review. , 2014, Psychological bulletin.

[16]  R. Turner,et al.  Understanding Health Disparities , 2013 .

[17]  R. Kessler,et al.  School mental health resources and adolescent mental health service use. , 2013, Journal of the American Academy of Child and Adolescent Psychiatry.

[18]  Joseph H. Puyat,et al.  Is the Influence of Social Support on Mental Health the Same for Immigrants and Non-Immigrants? , 2013, Journal of Immigrant and Minority Health.

[19]  B. Druss,et al.  Racial/ethnic differences in mental health service use among adolescents with major depression. , 2011, Journal of the American Academy of Child and Adolescent Psychiatry.

[20]  Mark Olfson,et al.  Service utilization for lifetime mental disorders in U.S. adolescents: results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). , 2011, Journal of the American Academy of Child and Adolescent Psychiatry.

[21]  C. Borrell,et al.  Migration-related health inequalities: showing the complex interactions between gender, social class and place of origin. , 2010, Social science & medicine.

[22]  K. Merikangas,et al.  Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). , 2010, Journal of the American Academy of Child and Adolescent Psychiatry.

[23]  Kathleen R. Merikangas,et al.  Prevalence and Treatment of Mental Disorders Among US Children in the 2001–2004 NHANES , 2010, Pediatrics.

[24]  R. Kessler,et al.  Perceived need for mental health care and service use among adults in Western Europe: results of the ESEMeD project. , 2009, Psychiatric services.

[25]  P. Burgess,et al.  Perceived Need for Mental Health Care: Findings from the 2007 Australian Survey of Mental Health and Wellbeing , 2009, The Australian and New Zealand journal of psychiatry.

[26]  D. Logan,et al.  Parental Facilitation of Adolescent Mental Health Service Utilization: A Conceptual and Empirical Review , 2006 .

[27]  J. Sareen,et al.  Perceived Need for Mental Health Treatment in a Nationally Representative Canadian Sample , 2005, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[28]  T. Hassard,et al.  The Relation between Perceived Need for Mental Health Treatment, DSM Diagnosis, and Quality of Life: A Canadian Population-Based Survey , 2005, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[29]  K. Wells,et al.  Unmet need for mental health care among U.S. children: variation by ethnicity and insurance status. , 2002, The American journal of psychiatry.

[30]  C. Hoven,et al.  Factors associated with use of mental health services for depression by children and adolescents. , 2001, Psychiatric services.

[31]  C. Hoven,et al.  Depressive and disruptive disorders and mental health service utilization in children and adolescents. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[32]  David R. Williams,et al.  The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. , 1999, Journal of health and social behavior.

[33]  David R. Williams,et al.  Racial Differences in Physical and Mental Health , 1997, Journal of health psychology.

[34]  R. Andersen Revisiting the behavioral model and access to medical care: does it matter? , 1995, Journal of health and social behavior.

[35]  D. Offord,et al.  Factors predicting use of mental health and social services by children 6-16 years old: findings from the Ontario Child Health Study. , 1995, The American journal of orthopsychiatry.

[36]  D. Offord,et al.  Immigrant children: psychiatric disorder, school performance, and service utilization. , 1989, The American journal of orthopsychiatry.

[37]  P. Szatmari,et al.  Ontario Child Health Study. II. Six-month prevalence of disorder and rates of service utilization. , 1987, Archives of general psychiatry.