Inner-city child mental health service use: The real question is why youth and families do not use services

Objective: This study examines pathways to urban child mental health care as well as explores reasons why care was not received. Methods: A single group longitudinal design was used to study initial attendance rates at an outpatient child mental health clinic and identify factors associated with initial service use for urban children and their families. Results: Approximately one-third of families (n = 82) do not follow up with care despite their child being referred and an initial appointment scheduled. Yet, three-quarters of those who did not attend a first session still wanted services when interviewed. Factors most significantly related to service use were social support and parental skill efficacy. Miscommunication between adult caregiver and provider was the most often cited reason for non-attendance. Conclusions: There is a significant unmet need for care along with identification of significant barriers to access. Empirical findings can serve as the basis for modifying urban child mental health service delivery systems.