Who are we serving? Clinic-based versus school-based services for adolescents

This study was conducted to compare adolescents who received mental health services at on-site, school-based clinics with those who received treatment at one of the city's outpatient clinics. Youth of color and girls tend to underutilize psychological services located in traditional community clinics. The purpose of this study was to examine how well the school-based clinics were serving these underserved populations. Archival data of 586 total subjects, 403 from the community clinics and 183 from the school sites, were analyzed. Demographic data of age, gender, ethnicity, and diagnosis, as well as level of overall functioning as indicated by the Total 5-scale score on The Child and Adolescent Functioning and Assessment Scale (CAFAS), were analyzed using t-tests and Chi-Square analyses. Significant differences between the two samples were found among gender and level of functioning. There were mixed results for the variable of ethnicity, with findings indicating that Chinese-American youth were served in significantly greater numbers by the school clinics, while African-American and other Asian groups are seen at school-based clinics in percentages only slightly higher that what was expected. The opposite of what was anticipated was found for Latino youth that were provided treatment in greater numbers at the community clinics. These results support trends found in other studies regarding the effectiveness of on-site services in reaching underserved adolescents. The results for Chinese-American youth underscore the impact that cultural and language congruence between clinicians and youth can have on reducing barriers to treatment.