Caregiver Mental Health, Neighborhood, and Social Network Influences on Mental Health Needs among African American Children

Abstract

In this study, the authors examined the combined effects of caregiver mental health, alcohol use, and social network support/satisfaction on child mental health needs among African American caregiver--child dyads at risk of maltreatment. The sample included 514 eight-year-old African American children and their caregivers who participated in the Longitudinal Studies of Child Abuse and Neglect. A structural equation model was created with caregiver mental health/alcohol use and caregiver social network support/satisfaction as the exogenous variables and child mental health need as the endogenous variable. Caregivers with less-supportive networks and whose capacity to parent was challenged by alcohol, depression, or other mental health problems had children with elevated mental health needs. These findings confirm the need to examine the effects of caregiver influences (for example, caregiver mental health and social network support/satisfaction) on mental health among African American children at risk of maltreatment and to further explain how the social networks of caregivers are accessed when caregivers and children have mental health problems. Implications for identifying mental health needs among this vulnerable group and improving their connections to formal mental health services through social network-level interventions are discussed. KEY WORDS: African American children; child maltreatment; child neglect; mental health; social network ********** Children at risk of maltreatment (child abuse or neglect) also are at increased risk of experiencing mental health problems (Johnson et al, 2002; Manly, Kim, Rogosch, & Ciccheti, 2001). In a nationally representative study, almost half (47.9%) of maltreated children and youths had clinically significant emotional/behavioral problems (Burns et al., 2004). Although such large studies of mental health provide important population norms, the impact that family factors have on the mental health needs of children in particular subpopulations remains virtually unknown (Thompson & May, 2006). African American children are of particular interest because they are disproportionately likely to be reported for maltreatment (Fluke, Yuan, & Curtis, 2003); to live in low-income families and reside in neighborhoods characterized by high violence and drug exposure--factors that may precipitate emotional problems (R. H. Bradley, Corwyn, Pipes-McAdoo, & Garcia-Coll, 2001); and to have mental health needs that go unmet (Lindsey et al., 2006; U.S. Department of Health and Human Services, 2001, 2003). What has not been clear from previous research is the extent to which caregivers, whose psychosocial stressors might also influence their child's mental health problems, rely on their social networks for assistance and whether limitations in these networks might further exacerbate child emotional or behavioral problems. Examining the combined effects of caregiver mental health/alcohol use and caregiver social network support/satisfaction is essential to understanding how mental health symptoms are defined and expressed among maltreated African American children. CAREGIVER MENTAL HEALTH AND CHILD MENTAL HEALTH Cross-sectional and retrospective studies have consistently found that children of parents with psychiatric disorders fare more poorly than do children of parents without these problems (Beardslee, Versage, & Gladstone, 1998; Black & Krishnakumar, 1998). For example, researchers have found that children of depressed parents are at greater risk of psychiatric disorders than are children of nondepressed parents (Beardslee et al., 1998;Hammen & Brennan, 2003; Kim et al., 2003). In their meta-analysis, Lavoie and Hodgins (1994) found that children of depressed parents are four times more likely to develop an affective disorder than are children with nondepressed parents. Maternal depression has also been associated with child delinquency, alcohol problems, academic difficulty, and interpersonal conflict (Davies & Windle, 1997; Lewinsohn, Olino, & Klein, 2005; McCombs-Thomas & Forehand, 1991). …