Among African American parents of children with mental health challenges, is support from family and friends associated with children staying in care?

Objective: African American children with mental health needs are less likely to get services and to stay in services than white children. Pescosolido's Network Episode Model (NEM) emphasizes social support for service use. The present study applied the NEM to examine the association between social support and staying in care among African American children with mental health needs.

Methods: This investigation used data from the Teaching Advocacy Skills for Kids (TASK) study, a survey of 316 African American parents of children with mental health needs living in North Carolina during the winter of 2010-2011. Following descriptive and bivariate analysis, logistic regression was used to model the probability of staying in care as a function of receiving social support, controlling for sociodemographic factors, illness severity, and beliefs and attitudes about the healthcare system.

Variables of interest: Staying in care was operationalized as continuing services or ceasing services only after completion. The primary predictor was availability of friend and family support, and encouragement to seek care was considered a covariate.

Results: The ability to turn to friends and family for help was associated with staying in care [OR = 4.43 (2.02,9.72)]. Being encouraged was associated with lower odds of staying in care [OR = 0.46 (0.23,0.92)]. These findings remained robust following adjustment with controls.

Conclusions: For African Americans, relationships matter in providing the support parents need to obtain and retain help for children with mental illness. Thus, interventions that aim to improve healthcare utilization should emphasize building supportive connections with others.