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Objective: To identify barriers to seeking help for preschool behavior problems and understand the pattern of service utilization.

Method: Altogether, 320 preschool children from eight preschool centers were studied using a two-stage design. After the initial screening, a more detailed assessment was carried out in the second stage involving semistructured interviews with parents and children. Parents also completed a service utilization questionnaire during the first stage and General Health Questionnaire, Family Assessment Device, and life events questions during the second stage.

Results: Only 19% of those with preschool behavior disorder crossed all the filters in reaching for help. The most common perceived barriers to help-seeking were that problems would get better by themselves or that parents should be strong enough to handle them. The major blocks to help-seeking were at two levels, in parents recognizing the presence of a problem and in overcoming the perceived barriers by the parents. Parents sought help from the informal agencies more often than from the formal. Help was sought significantly less often by those who had parental separation, low income, or multiple adversities, all of which were known to be significantly associated with behavior disorder.

Conclusion: These findings indicate the need to educate and influence the parents' attitude to help-seeking, target those at risk to develop behavior disorder, and develop better consultation-liaison service with the informal agencies. J. Am. Acad. Child Adolesc. Psychiatry, 1996, 35(2):215-222.

Copyright 1996 (C) American Academy of Child and Adolescent Psychiatry