Parental recognition of depression in adolescents: Implications for adolescent mental health service use.

Abstract

The primary goal of this study was to examine parental awareness of emotional/behavioral distress and parents' ability to identify signs of depression as important precursors to seeking and obtaining mental health services for depressed adolescents. Fifty-nine adolescent-parent pairs (44 families with depressed adolescents and 15 comparison families) were interviewed to determine diagnoses of depression, comorbid psychopathology, the quality of adolescent-parent communication, family history of depression, parents' awareness of emotional problems and ability to identify signs of depression, and reports of adolescent mental health service utilization. The primary assessment instruments employed in the study included the Structured Clinical Interview for DSM-IV, the parent-report version of the Diagnostic Interview Schedule for Children, the Child and Adolescent Functional Assessment Scale, and the Child and Adolescent Services Assessment. Through multiple logistic and linear regression techniques, the influences of hypothesized predictor variables on the outcome variables of parent awareness and depression-identification were examined. Similar techniques measured the influence of parental recognition on service utilization among depressed adolescents. Results reveal that, overall, parents showed a poor ability to recognize general distress and to identify signs of depression in adolescents. Perceived family burden emerged as the most powerful predictor of parental awareness of distress/depression-identification, with comorbid substance use disorders and family history of depression also contributing to the predictive power of the model. Parents' general awareness of adolescent distress and their ability to identify specific signs of depression increased the likelihood of mental health service use. From these findings we conclude that parents play a crucial role in seeking and obtaining services for depressed adolescents. Currently, however, many parents may fail to recognize their adolescents' emotional distress. Efforts to assist parents in learning to identify and understand the signs of depression in their adolescents should be enhanced in order to increase service use among this group of adolescents in need of assistance.