Recurring mental health service utilization for preschool-aged, high-risk children

Few high-risk preschoolers receive needed mental health services and almost half terminate after one session, which is likely insufficient. It is critical to explore the factors associated with repeated mental health service utilization for high-risk preschool-aged children. Prior work has focused on older children and initiation of services, rather than recurring service use. Among the few studies investigating recurrent service use, only demographic factors, symptom severity, and maltreatment type have been explored. It is unclear how other potentially critical variables, including cumulative maltreatment and caregiver and neighborhood factors may be implicated. The current study examined recurring service use among 250 preschoolers from the Longitudinal Studies in Child Abuse and Neglect study who utilized at least one mental health service at age 4 (50.8% females; 42.0% Black). Child's gender, externalizing symptoms, and caregivers' developmental expectations were tied to recurring service use; cumulative maltreatment was unrelated. Emotional abuse and domestic violence were tied to recurring service use. Ongoing service use among at-risk preschoolers may be tied to child, caregiver, and maltreatment factors, indicating the value of comprehensively examining service use. Children's symptoms, maltreatment exposure, and caregivers' attitudes should be considered to help address mental health needs among this population.