CONTRIBUTIONS OF SERVICE SECTORS TO MENTAL HEALTH TREATMENT UNDERUTILIZATION
While many service sectors contribute, in one way or another, to the mental health treatment underutilization among young males of color, we focus on two sectors in this chapter, child welfare and juvenile justice. Males of color with mental health needs are often overrepresented in service sectors like child welfare and juvenile justice. It is often the case that mental health problems among young males of color go unrecognized in these systems or, as mentioned earlier, are misinterpreted as behavioral problems or problems that otherwise do not warrant treatment. For example, extant research examining mental health treatment among child welfare-involved youth suggests that youth with sexual abuse histories are more likely to reach mental health treatment than youth with other types of trauma histories (e.g., removal from the family due to neglect; Horwitz, Hulburt, & Zhang, 2010). Girls tend to report higher levels ofsexual abuse histories. Otherwise, gender tends to predict mental health treatment use among child welfare-involved youth, with boys often experiencing higher levels of treatment use (Farmer, Mustillo, Wagner, et al., 2010; Lindsey, Gilreath, Thompson et al., 2012). Age plays an additional important role in mental health treatment underutilization, particularly for young males of color aging out of foster care. Studies by McMillen (2004) and McMillen and Raghavan (2010) found that youth of color have increased levels of mental health needs that go untreated as they age out of the child welfare system. These findings suggest that as child welfare- involved youth gain more volition over their own decision making, some of the individual-level factors related to mental health service use discussed earlier in this chapter (e.g., stigma related to service use, social network influences on service use, greater reliance on informal sources of psychological health) prevail. Indeed, in a study of black males aging out of foster care, Scott (in press) found that young males from this cohort tend to rely more on their family members for support regarding a mental health problem than on professional sources of help. This is the case even in light offederal policies (i.e., the Foster Care Independence Act of 1999) that expanded access to services for older youth (up to age 21) in foster care.