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We used data on a national sample of children involved with child welfare systems to compare American Indian caregivers with White, Black, and Hispanic caregivers in their need for, and receipt of, specialty alcohol, drug, and mental health treatment. American Indian caregivers were significantly less likely to receive services than were Hispanic caregivers (P doi:10.2105/AJPH.2004.059436)

Data from the National Survey of Child and Adolescent Well-Being show that approximately 1 in 8 (12.5%) children who are subjects of reports of maltreatment investigated by child welfare services (CWS) agencies have parents who were recently arrested. Compared with other children who come to the attention of CWS agencies, those with arrested parents are younger, disproportionately African American, and significantly more likely to be in out-of-home care. Approximately 2 in 5 children age 2 and older with arrested parents had a clinically significant emotional or behavioral problem, yet only 1 in 10 received mental health care. Although parent characteristics varied by race, rates of substance abuse, serious mental illness, domestic violence, and problems meeting basic needs were higher among arrested parents than among other parents.

This article reviews the empirical literature on psychosocial, psychopharmacological, and adjunctive treatments for children between the ages of 6 and 12 with internalizing disorders. The aim of this review was to identify interventions that have potential to prevent substance use disorders in adolescence by treating internalizing disorders in childhood. Results suggest that a variety of behavioral, cognitive-behavioral, and pharmacological interventions are effective in reducing symptoms of childhood depression, phobias, and anxiety disorders. None of the studies reviewed included substance abuse outcomes. Thus, little can be said about the relationship between early treatment and the prevention of later substance use. The importance of evaluating the generalizability of research-supported interventions to community settings is highlighted and recommendations for future research are offered.

This article reviews controlled research on treatments for childhood externalizing behavior disorders. The review is organized around 2 subsets of such disorders: disruptive behavior disorders (i.e., conduct disorder, oppositional defiant disorder) and attention-deficit/hyperactivity disorder (ADHD). The review was based on a literature review of nonresidential treatments for youths ages 6-12. The pool of studies for this age group was limited, but results suggest positive outcomes for a variety of interventions (particularly parent training and community-based interventions for disruptive behavior disorders and medication for ADHD). The review also highlights the need for additional research examining effectiveness of treatments for this age range and strategies to enhance the implementation of effective practices.

Data from the NIMH-Epidemiologic Catchment Area Project were used to predict differential use of private versus public outpatient mental health services, a salient concern in integrating public and private services in market-based health care reform efforts. Having a recent psychiatric disorder, being age 25-44, female, white, of higher educational level, and unmarried increase the odds of any mental health service use. However, odds of treatment in the public sector are increased for males, African Americans, those with low educational and income levels, and odds are markedly decreased for the elderly, suggesting significant barriers to care for these mentally ill subpopulations.

Recent evaluations of ACT programs have produced equivocal findings, often leading to the invocation of methodological problems as responsible for the lack of positive results. This paper discusses issues of theory and methodology as they pertain to improving research of ACT, with particular attention paid to issues of sampling, process evaluation, measurement, and data analysis.

Objectives. This study examined prevalence of psychiatric disorders, social and family risk factors for disorders, and met and unmet needs for mental health care among Appalachian youth. Methods. All 9-, 11-, and 13-year-old American Indian children in an 11-county area of the southern Appalachians were recruited, together with a representative sample of the surrounding population of White children. Results. Three-month prevalences of psychiatric disorders were similar (American Indian, 16.7%; White, 19.2%). Substance use was more common in American Indian children (9.0% vs 3.8% in White children), as was comorbidity of substance use and psychiatric disorder (2.5% vs 0.9%). American Indian poverty, family adversity (e.g., parental unemployment, welfare dependency), and family deviance (parental violence, substance abuse, and crime) rates were higher, but the rate of family mental illness, excluding substance abuse, was lower. Child psychiatric disorder and mental health service use were associated with family mental illness in both ethnic groups but were associated with poverty and family deviance only in White children. Despite lower financial barriers, American Indian children used fewer mental health services. Conclusions. This study suggests that poverty and crime play different roles in different communities in the etiology of child psychiatric disorder. (Am J Public Health. 1997;87:827-832)