Association for Public Policy Analysis & Management

Neighborhood provides a critical context for families to flourish and for parents to care for their children. Behavioral health services in the neighborhood is a crucial component of the local environment for families to gain support and access services. Essentially, behavioral health services in the neighborhood serves as an entity that responds to the demand of the population health need in local areas, but also needs sufficient supply of resources (e.g. staff, volunteers, rent) to sustain the operation and programming of certain type of services. This tension between population demand and needs for more resources for behavioral health services agency survival could lead to the spatial mismatch in that the location of services is not necessarily driven by the need of families they intend to serve in an area. Therefore, behavioral health services do not necessarily locate in areas where the need for services is high. Thus, services resources are unlikely to equally distribute across the geographical landscape due to a variety of factors (e.g. land price) independent of families’ need. This unequal distribution in behavioral health services across neighborhoods could lead to differential family outcomes. However, there is limited research that examines the links between neighborhood behavioral health services and family outcomes. This study contributes to the literature by examining the temporal relationship among neighborhood behavioral health services, maternal depressive symptoms and use of punitive discipline. Data from two sources were analyzed, including Early Childhood Longitudinal Studies Kindergarten Class of 1998-1999 (ECLS-K, 1998/99), and a historical database on behavioral health services locations in U.S. Two datasets were merged, and analyzed using longitudinal structural equation modelling approach. Geographical availability of behavioral health services is measured by the number of behavioral health services divided by population size and land area. Maternal psychological well-being was measured using twelve 4-point scale, with “1” for “never, “2” for “some of the time”, “3” for “a moderate amount of the time”, and “4” for “most of the time”. Punitive discipline was measured using three dichotomous items, (1) make fun of the child, (2) yell at or threaten child, and (3) hit, slap the child or hit the child back. Analysis are based on a sample of 5,730 mothers with available data on study variables across three waves (Kindergarten, Spring 1999 as T1; Third Grade, Spring 2002 as T2; and Eighth Grade, Spring 2007 as T3). Preliminary analysis show that neighborhood behavioral health resources are positively related to poor maternal mental health outcomes and increased use of punitive disciplinary acts during one single point of time, but neighborhood behavioral health services at an earlier time point (e.g. T1) is negatively associated with maternal mental health outcomes and decreased use of punitive disciplinary acts. Results from this study suggest that neighborhood behavioral health services could help prevent negative mental health and parenting outcomes for families. It is crucial to invest in social services resources in communities as long-term preventive measure to strengthen at-risk families.