Title: Stress and demographic variables as related to mother's referral of children in need of treatment
Description: In this work we examined a series of hypotheses to test whether social class, mother's stress, mother's ethnicity, child's sex, level of child's impairment and the severity of the patterns of the child's symptoms were related to whether mothers brought their children for help with their problems. Each of the variables were examined to ascertain their contribution and the extent to which they intervene in the social process, leading to referral. Using data obtained in a mid-Manhattan longitudinal study of a randomly selected sample of 1,034 families, we focused on 732 mothers seen at Time 1 and Time 2 (1966-67 and 1971-72). Information was gathered by a comprehensive questionnaire. The topics handled can be summarized as follows: What are the similarities or differences in stress for mothers of different socioeconomic levels and how is this related to mother's behavior regarding pursuit of help for her child. Does the degree of stress experienced influence whether or not they will refer their children for help? Does educational background affect the salience of a child's symptoms in the mother's decision concerning seeking help for her child? To what extent do mothers of different socioeconomic levels use different resources to cope with comparable problems with their children? And to what extent does education through media and other informational sources influence a mother's decision to seek help for her child? The findings of a pattern of highly educated mothers referring at a consistently higher percentage than mothers with medium or low education remained consistent for a majority of the childhood disturbances studied.

A child is more likely to be referred if his mother is highly educated for all levels of childhood disorder; whereas children of mothers with medium education have a better chance of receiving help for their problems if they are considered to be in the high category of child disturbances, and much less if they are in the medium or low categories. Mothers of low education seldom refer. Mothers with high education referred twice as frequently as those mothers in the lowest educational category in the earlier time, and almost three times as often at Time 2. We found a greater response to the stress factor by highly educated mothers. Stress was less related to referral at the lowest educational level in contrast to highly educated mothers whose rate of referral increased four-fold as their stress increased from low to medium to high. Ethnic group membership apparently affects help-seeking behavior by mothers of disturbed children. Black mothers and White mothers refer their highly disturbed children at a much higher rate than Spanish mothers (Time 1 and Time 2).

There is a relationship between stress levels, referral and ethnicity. Black mothers who refer most when under high stress, also have the highest proportion of their population in the high stress category. All three ethnic groups respond to greater stress by larger percentages of referrals, however Black mothers and White mothers refer at statistically significant levels while Spanish mothers do not. Educational differences in referral vary with the type of problem and this is reflected in the referral patterns of highly educated mothers who referred at statistically significant levels for mentation problems, delinquency and fighting. In contrast to this, class differences were minimal in relation to conflict with parents, where all three groups referred in similar percentages. The findings indicate that the extent to which one is informed by television, reading, discussion groups, and other media in general, seems to have little effect on whether or not mothers will bring their disturbed children for help.

Upper socioeconomic mothers utilize psychiatrists and psychologists at much higher levels than middle and lower classes both at Time 1 and Time 2. The upper classes utilize social workers least at both times in contrast to middle and lower classes. As compared to the other two classes, lower class mothers refer proportionately less to doctors, school counselors, psychologists and psychiatrists. Teachers and social workers seem to be utilized by them at rates comparable to the middle classes. The police and courts are rarely utilized by any of the three classes. It is interesting to note that within the category of low education, psychiatrists were sought out by them in both times as the resource of choice for help with their disturbed children, a pattern consistent with that of the middle and upper socioeconomic groups. The aim of the paper was to determine if the mothers referred their children appropriately--and if they were indeed cognizant of the various types and degrees of disturbed behavior.

The goals (only suggested in this paper) would be to determine how these patterns might be changed -- as indeed the evidence suggest they should be -- by educators and those in the "helping professions". A major obstacle in attempting to institute viable programs to properly service those in need, has been the relative lack of pertinent information concerning those factors which are central to leading people to seek help. Hopefully these findings can clarify some of these issues.