Caregiver Strain, Social Support, and Mental Health Service Use Among Urban African American Mothers

Ané M. Maríñez-Lora, Grace Cua, Stacy L. Frazier, Elisa S. Shernoff, Marc S. Atkins

Research output: Contribution to journalArticlepeer-review


Caregiver strain and social support have been identified as both facilitators and deterrents to parental mental health service use on behalf of their children. This study focused on the relationship between caregiver strain, social support, and mental health service use among African American mothers of children at-risk or meeting criteria for a disruptive behavioral disorder and living in urban communities of concentrated poverty. Mothers (n = 89), participating in a five-year NIMH funded study of school-based community mental health services, completed measures at baseline of caregiver strain and both perceived and received social support. Service use was calculated as the sum total of services (sessions) received. Associations between caregiver strain and service use were examined, and perceived and received social support were explored as potential moderators. Baseline covariates included child’s age, gender, symptom severity, and maternal employment status. Findings highlighted child symptom severity as the strongest predictor of caregiver strain and perceived social support as moderating the association between caregiver strain and service use. Mothers were more likely to utilize services when experiencing relatively high levels of perceived support or high caregiver strain but not both, highlighting the importance of their interrelationship. Received support did not moderate the association between strain and service use. In addition, mothers utilized services more often for sons than daughters and when unemployed. Implications for research and practice are discussed.

Original languageEnglish (US)
Pages (from-to)1633-1649
Number of pages17
JournalJournal of Child and Family Studies
Issue number7
StatePublished - Jul 2021

All Science Journal Classification (ASJC) codes

  • Developmental and Educational Psychology
  • Life-span and Life-course Studies


  • African American mothers
  • Caregiver strain
  • Mental health service use
  • Perceived social support
  • Urban poverty


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