Understanding gender differences in children referred to mental health services

Abstract

In an effort to understand why young girls tend to be overlooked for referral to mental health sen/ices, this dissertation examined the referral process at the point at which it usually begins: with teachers in the elementary school system. One hundred and thirty-five first-, second-, and third-grade teachers read vignettes describing boys and girls with externalizing and internalizing disorders. Teachers rated whether the child described in each vignette needed to be referred for mental health treatment, whether each child would improve with maturity, and whether their referral decisions would change if the child's academic standing changed. Finally, they rated each symptom In the vignettes according to the degree to which It influenced them to refer. Teachers rated children with externalizing disorders as needing referral significantly more often than children with internalizing disorders. Girls and children with internalizing disorders were referred significantly less often if their academic standing was good and were rated as significantly more likely than boys and children with externalizing disorders to improve with maturity. Finally, externalizing symptoms and symptoms typically found in boys were rated as significantly more likely to influence a teacher to refer than internalizing symptoms and symptoms typically found in girls. The results of this dissertation Indicate that several factors may cause a teacher to overlook girls for referral. Girls tend to have good academic standing and to have the type of disorder and symptoms that are believed to improve with maturity and believed to be less In need of referral.