The proposed project examines help-seeking processes among parents of adolescents with depressive disorders. Its objective is to explore the role of parents in the initial stages of determining whether depressed adolescents do or do not obtain mental health services. The primary importance of this project lies in its potential to increase our understanding of the pathways to service utilization among a group of adolescents who are at risk for continued mental health problems into adulthood, as well as more severe outcomes such as suicide. To explain how depressed adolescents come into contact with mental health services, a three step path is proposed: (1) parental awareness of the adolescent's depression; (2) parental intention to obtain professional help for the adolescent; and (3) actual service utilization. At each step, parent and adolescent variables can operate individually and interactively to facilitate or hinder the help-seeking process. The present study will focus upon the first and second steps of this path. First, we will test the associations of parental depression and parent-adolescent communication to parents' recognition or awareness of depression in their adolescents. Second, we will investigate how parents' intentions to seek services for their adolescents are influenced by family attitudes toward mental health services, family history of service use, referrals by others, and perceived barriers to services. We will also examine the validity of the proposed model as a series of related and sequential steps; that is, we will determine whether families who do recognize adolescents' problems are more likely to profess intentions to seek services, in an effort to lay the groundwork for later investigation of both awareness and intent on actual service utilization patterns in this population. The study is part of a larger project employing a two-stage screening methodology to identify a community sample of 75 adolescents who meet criteria for past or current depressive disorders (i.e., major depression, dysthymia, or depression not otherwise specified). Included in the methodology are a combination of interview and self-report measures administered to adolescents and their parents. These assessment techniques will yield information about the adolescents' depression, adolescents' perceptions of their communication with parents, parental depression, the individual and family attitudes related to service utilization, and the perceived barriers to services. Regression analyses will be used to test the predictive power of the independent variables in the model.
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