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Doctor of Philosophy


Social Work

First Advisor

Karen Chartier


Adverse childhood experiences (ACEs) are linked to increased mental health problems in children, but their association with mental health services utilization is not well known. This secondary analysis used 2016 National Survey of Children’s Health data from two samples: children aged 6-17-years-old with a mental or behavioral condition in need of treatment or counseling (N = 5,723); and a subsample of children who experienced at least one ACE (n = 3,812). Multiple logistic regression and latent class analysis (LCA) were performed to examine the association between ACEs and mental health services utilization. Multiple logistic regressions also examined the associations of parent/caretaker vulnerability, school-system, and medical-system factors on mental health services utilization for children with ACEs using the Gelberg-Andersen Behavioral Model for Vulnerable Populations and a Systems of Care approach as the framework for model building. Children with increased ACE scores did not have higher odds of utilizing mental health services compared to children at lower levels of or no ACEs. For children who experienced adversity, increased parent/caretaker vulnerability was associated with lower odds and the current receipt of special education services with increased odds of mental health services utilization in adjusted models. Strengths of this study included the large dataset and generalizability to the U.S. population. There were limitations to the measurement of ACEs and other key variables. The current study identified children who experienced adversity as an underserviced population for mental health services.


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