Access Type

Open Access Dissertation

Date of Award

January 2020

Degree Type


Degree Name




First Advisor

Douglas Barnett


Mental health among adolescents is widely acknowledged as a significant concern in the United States. Based on a national survey, Merikangas et al. (2010) found that among 13-17 year olds, 42% to 48% reported experiencing mental health concerns. It is estimated that only half of adolescents with mental health problems utilize mental health services (Costello et al., 2014). An initial study found that caregivers of disadvantaged youth appeared to function as the “gatekeepers” to mental health services (Tsang et al., 2020). Also, the results suggested that positive attitude towards professional psychological help, but not stigma, predicted service enrollment. The current study was designed to replicate and extent the original study using a new sample and adapted a longitudinal design to investigate the independent and combined effects of parent and adolescent perceptions of mental health problems, attitudes towards professional help, and stigma on adolescent mental health service utilization. For this dissertation, 69 predominately African American, low-income, urban youth (81.2% African American, 60.9% girls, Age 13–17 years, M = 15.13, SD = 1.45) and their caregivers were interviewed initially and then 6 months later. Remarkable rates (i.e., 23.2% at T1 and 24.6% at T2) of mental health service underutilization and strikingly low awareness (i.e., 21.4% caregivers and 14.5% youth) of confidential mental health care were found in the current sample of urban youth. SEM model suggested that caregiver’s perception of youth mental health problems, but not adolescent-reported variables, was predictive of future youth mental health service enrollment. Contrary to hypothesis, caregiver’s positive attitude towards professional psychological help was not a significant predictor of future mental health service use among adolescents. Implications regarding mental health service utilization and dissemination among adolescents living in an urban community were discussed.