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Psychiatric Disorder, Impairment, and Service Use in Rural African American and White Youth
Adrian Angold, MRCPsych;
Alaattin Erkanli, PhD;
Elizabeth M. Z. Farmer, PhD;
John A. Fairbank, PhD;
Barbara J. Burns, PhD;
Gordon Keeler, MS;
E. Jane Costello, PhD
Arch Gen Psychiatry. 2002;59:893-901.
Background The Caring for Children in the Community Study examined the prevalence
of DSM-IV psychiatric disorders and correlates of
mental health service use in rural African American and white youth.
Methods Four thousand five hundred youth aged 9 to 17 years from 4 North Carolina
counties were randomly selected from school databases. Parents completed telephone
questionnaires about their children's behavior problems. A second-stage sample
of 1302 was identified for recruitment into the interview phase of the study,
and 920 (70.7%) of these were successfully interviewed at home using the Child
and Adolescent Psychiatric Assessment and related measures of service use.
Results Weighted back to general population estimates, 21.1% of youth had 1
or more DSM-IV psychiatric disorders in the past
3 months. Prevalence was similar in African American (20.5%) and white (21.9%)
youth. The only ethnic difference was an excess of depressive disorders in
white youth (4.6% vs 1.4%). Thirteen percent of participants (36.0% of those
with a diagnosis) received mental health care in the past 3 months. White
youth were more likely than African American youth to use specialty mental
health services (6.1% vs 3.2%), but services provided by schools showed very
little ethnic disparity (8.6% vs 9.2%). The effect of children's symptoms
on their parents was the strongest correlate of specialty mental health care.
Conclusions In this rural sample, African American and white youth were equally
likely to have psychiatric disorders, but African Americans were less likely
to use specialty mental health services. School services provided care to
the largest number of youths of both ethnic groups.
From the Center for Developmental Epidemiology, Department of Psychiatry
and Behavioral Sciences, Duke University Medical Center, Durham, NC.
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