Understanding ethnic differences in mental health service use for adolescent's internalizing problems: the role of emotional problem identification - Verhulp et. al - 2013 - Article

Generally, adolescents are at an increased risk of developing internalizing problems. However, only a small percentage of these adolescents receives mental health care. Furthermore, although immigrant adolescents are at least at equal risk of developing internalizing problems as their non-immigrant peers, they are even less likely to use mental health care. Why do immigrant adolescents make so little use of mental health care? The present study is the first to examine ethnic differences in problem identification as a possible explanation for this disparity in mental health service use.

To examine the ethnic differences in problem identification as a possible source of seeking less help, this study examined data of 349 parents and adolescents living in the Netherlands. One group of native Dutch people was examined (95 participants) and three different immigrant populations: Surinamese (85 participants), Turkish (87 participants) and Moroccan (82 participants). To avoid language difficulties, Turkish and Morrocan immigrant parents were interviewed by an interviewer from their own ethnic group in their own language.

Information was gathered regarding: (1) internalizing problem symptoms; (2) emotional problem identification; (3) mental health service use; (4) ethnicity, and; (5) educational level. A mediation model was developed in which emotional problem identification was tested as a mediator for the relationship between ethnicity and mental health service use.

The results indicated that mental health service use for internalizing problems is far lower among immigrant adolescents than among native Dutch adolescents. It should be noted, however, that there were substantial differences between immigrant groups. More specifically, the percentage of participants using mental health services is: Dutch (22%), Surinamese (18%), Turkish (15%), Moroccan (9%). Thus, especially the Moroccan adolescents are making far less use of mental health care service. Next, the mediating role of problem identification was confirmed in this study. That is, a lack of emotional problem identification seemed to be an essential mediator in the relationship between immigrant status and mental health service use. More specifically, immigrant parents seem to be less likely to identify their children's internalizing problems. And this offers an important explanation as to why their children do not receive mental health care.