The Proposed study will examine mental health service use, needs and outcomes of treatment for children from 4 to 17 years of age in the US Commonwealth of Puerto Rico (PR). We offer a conceptual framework which focuses on assessing multiple levels of outcome and provides a guide to integrate epidemiological, utilization and organizational perspectives to study children's mental health. PR is an optimal location for achieving these goals for a number of reasons: boundaries of service systems are defined naturally; different levels of poverty and rural residence y can be studied; a team with a sound epidemiological and health services research history will track children and their families throughout,the longitudinal study; the examination of the family context both as a potential risk and protective as well as an alternative source of care, can be well addressed given the strong family and community supports. Findings thus can contribute to understand the level of family burden when service is provided in the community vs. institutions. The findings can enhance the knowledge about children living in different levels of poverty as well as children living in rural areas in the mainland. The design is based on three probability samples derived from the same units in the island; a sample of organizations (N= 154) from six service sectors (Education, Juvenile Justice, Social Welfare, Primary Health Care, Substance Abuse and Mental Health), a sample of children from these service sectors (N= 1800) and a sample of children from the community (N= 1,800). The survey will obtain information by direct interview with the children and their parents. Information will also be gathered from teachers by telephone interview and from the main provider through self- administered questionnaires. The samples of children in the community and service sectors will be followed with two direct interviews two years apart. Telephone interviews will be done half-way in the intervening period to maintain contact with the sample and obtain information concerning changes in the use of services, symptoms and quality of care. The data will be analyzed in an integrated fashion that ties each child to the family, neighborhood system and the service system. Findings can be generalized to the entire island and permit linkage of child, family, community and service system data, including organizational characteristics o the service systems, to provide a broad picture of the impact of services on children and families in the island.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01MH054827-04
Application #
2675388
Study Section
Special Emphasis Panel (SRCM)
Project Start
1995-09-30
Project End
2000-08-31
Budget Start
1998-09-30
Budget End
1999-08-31
Support Year
4
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of Puerto Rico Med Sciences
Department
Psychology
Type
Schools of Public Health
DUNS #
City
San Juan
State
PR
Country
United States
Zip Code
00936
Jones, Jennifer; Ramirez, Rafael Roberto; Davies, Mark et al. (2008) Suicidal behaviors among adolescents in puerto rico: rates and correlates in clinical and community samples. J Clin Child Adolesc Psychol 37:448-55
Maldonado-Molina, Mildred M; Collins, Linda M; Lanza, Stephanie T et al. (2007) Patterns of substance use onset among Hispanics in Puerto Rico and the United States. Addict Behav 32:2432-7
Bauermeister, Jose J; Shrout, Patrick E; Chavez, Ligia et al. (2007) ADHD and gender: are risks and sequela of ADHD the same for boys and girls? J Child Psychol Psychiatry 48:831-9
Bauermeister, Jose J; Shrout, Patrick E; Ramirez, Rafael et al. (2007) ADHD correlates, comorbidity, and impairment in community and treated samples of children and adolescents. J Abnorm Child Psychol 35:883-98
Dierker, Lisa C; Sledjeski, Eve M; Botello-Harbaum, Maria et al. (2007) Association between psychiatric disorders and smoking stages within a representative clinic sample of Puerto Rican adolescents. Compr Psychiatry 48:237-44
Cabiya, Jose J; Canino, Glorisa; Chavez, Ligra et al. (2006) Gender disparities in mental health service use of Puerto Rican children and adolescents. J Child Psychol Psychiatry 47:840-8
Martinez-Taboas, Alfonso; Canino, Glorisa; Wang, Min Qi et al. (2006) Prevalence and victimization correlates of pathological dissociation in a community sample of youths. J Trauma Stress 19:439-48
Dierker, Lisa C; Ramirez, Rafael R; Chavez, Ligia M et al. (2005) Association between psychiatric disorders and smoking stages among Latino adolescents. Drug Alcohol Depend 80:361-8
Bird, Hector R; Canino, Glorisa J; Davies, Mark et al. (2005) The Brief Impairment Scale (BIS): a multidimensional scale of functional impairment for children and adolescents. J Am Acad Child Adolesc Psychiatry 44:699-707
Gonzalez-Tejera, Gloria; Canino, Glorisa; Ramirez, Rafael et al. (2005) Examining minor and major depression in adolescents. J Child Psychol Psychiatry 46:888-99

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