Factor structure, internal consistency, and construct validity of the Caregiver strain questionnaire in Latinx families.

Caregiver strain or stress directly related to caring for a youth with emotional and/or behavioral problems may be an important and understudied cultural factor associated with mental health disparities among Latinx families. Caregiver strain is a highly relevant construct for research questions focused on the identification of youth's mental health needs, family-level impacts of youth mental health problems, and utilization of youth mental health services. Unfortunately, there is a dearth of research on measures of caregiver strain and the psychometric properties of existing measures in Latinx samples. This study examined the structural and construct validity of the English version of the Caregiver Strain Questionnaire (CGSQ) with a sample of United States-based Latinx caregivers of youths ages 6-18 (N = 598). Confirmatory factor analysis showed that the original three-factor model of caregiver strain was evidenced in this sample. Internal consistency analyses and a poor factor loading led to the elimination of one item. The factor structure held after item removal. Significant associations between each dimension of caregiver strain with youth internalizing/externalizing symptom severity and utilization of youth mental health services provided evidence of construct validity (i.e., psychological counseling, telepsychology, parenting classes). Results provide important evidence of the psychometric properties of the English CGSQ in a Latinx sample and support its use in future research aimed at unpacking mental health disparities among Latinx youth and families. Researchers should translate and validate the CGSQ in Spanish to increase the utility of this measure for research with Latinx families.

Juntos hacemos la diferencia [together we make the difference]: A network analysis of Latinx caregivers' use of youth support services.

Latinx families face unique barriers to accessing traditional youth mental health services and may instead rely on a wide range of supports to meet youth emotional or behavioral concerns. Previous studies have typically focused on patterns of utilization for discrete services, classified by setting, specialization, or level of care (e.g., specialty outpatient, inpatient, informal supports), yet little is known about how youth support services might be accessed in tandem. This analysis used data from the Pathways to Latinx Mental Health study - a national sample of Latinx caregivers (N = 598) from across the United States collected at the start of the coronavirus pandemic (i.e., May-June 2020) - to describe the broad network of available supports that are used by Latinx caregivers. Using exploratory network analysis, we found that the use of youth psychological counseling, telepsychology, and online support groups was highly influential on support service utilization in the broader network. Specifically, Latinx caregivers who used one or more of these services for their child were more likely to report utilizing other related sources of support. We also identified five support clusters within the larger network that were interconnected through specific sources of support (i.e., outpatient counseling, crisis, religious, informal, and non-specialty). Findings offer a foundational look at the complex system of youth supports available to Latinx caregivers, highlighting areas for future study, opportunities to advance the implementation of evidence-based interventions, and channels through which to disseminate information about available services.

Understanding Latinx youth mental health disparities by problem type: The role of caregiver culture.

Latinx youth are less likely to receive mental health services (MHS) than their non-Hispanic White counterparts. Disparities in MHS use have also been shown to vary by type of mental health problem and indices of caregiver culture even within Latinx samples, suggesting the need to go beyond cross-group racial/ethnic comparisons. However, much of the current research examining these within-group disparities has failed to directly measure the extent to which these differences are associated to specific culture. The present study utilized data from the Patterns of Care Study to examine the ways in which caregiver acculturation or enculturation is related to the MHS use of Latinx youth (N = 308) over a 2- year period. Results demonstrated that caregiver acculturation significantly moderated the relationship between caregiver ratings of internalizing need and MHS use, such that the likelihood that Latinx youth with internalizing need would receive MHS increased as caregiver acculturation increased. Furthermore, the influence of caregiver acculturation appeared to be specific to youth with internalizing need. The relationship between externalizing need and MHS utilization was not moderated by either caregiver acculturation nor enculturation. This research provides evidence that ethnic disparities in service use among Latinx families cannot be explained by race/ethnicity alone, and that additional explanatory factors need to be considered in order to gain a better understanding of the factors that drive MHS disparities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Problem-specific racial/ethnic disparities in pathways from maltreatment exposure to specialty mental health service use for youth in child welfare.

The authors examined racial/ethnic differences in pathways from maltreatment exposure to specialty mental health service use for youth in contact with the Child Welfare system. Participants included 1,600 non-Hispanic White, African American, and Latino youth (age 4-14) who were the subjects of investigations for alleged maltreatment and participated in the National Survey of Child and Adolescent Well-Being. Maltreatment exposure, internalizing, and externalizing problems were assessed at baseline and subsequent specialty mental health service use was assessed 1 year later. Maltreatment exposure predicted both internalizing and externalizing problems across all racial/ethnic groups, but non-Hispanic White youth were the only group for whom maltreatment exposure was linked with subsequent service use via both internalizing and externalizing problem severity. Only externalizing problems predicted subsequent service use for African American youth and this association was significantly stronger relative to non-Hispanic White youth. Neither problem type predicted service use for Latinos. Future research is needed to understand how individual-, family-, and system-level factors contribute to racial/ethnic differences in pathways linking maltreatment exposure to services via internalizing/externalizing problems.

Mental health service use by youths in contact with child welfare: racial disparities by problem type.

OBJECTIVE: This study examined racial disparities in mental health service use by problem type (internalizing versus externalizing) for youths in contact with the child welfare system. METHODS: Participants included 1,693 non-Hispanic white, African-American, and Hispanic youths (ages four to 14) from the National Survey of Child and Adolescent Well-Being, a national probability study of youths who were the subject of investigations of maltreatment by child welfare agencies. Mental health need, assessed at baseline, was considered present if the youth had internalizing or externalizing scores in the clinical range on either the Child Behavior Checklist or the Youth Self-Report. Out patient mental health service use in the subsequent year was assessed prospectively. RESULTS: Children who were removed from the home and those investigated for abuse (versus neglect) were more likely to receive services in the year after the child welfare investigation. Overall, African-American youths were less likely than non-Hispanic white youths to receive mental health services. However, race-ethnicity moderated the association between externalizing need and service use such that African Americans were more likely to receive services when externalizing need was present (26% versus 4%) compared with non-Hispanic white youths (30% versus 14%). Race and ethnicity did not moderate the association between youth internalizing need and service use, but internalizing need was associated with increased probability of service use only for non-Hispanic white youths. CONCLUSIONS: Examinations of overall racial disparities in service use may obscure important problem specific disparities. Additional research is needed to identify factors that lead to disparities and to develop strategies for reducing them.