Abstract Economic hardship and poor parenting behaviors are associated with increased risk for mental health problems in community adolescents. However, less is known about the impact of socioeconomic status (SES) and
parenting behaviors on youth at elevated risk for mental health problems, such as teens seeking outpatient psychiatric care. This study examined whether family SES and parent positive communication were directly and indirectly
associated with mental health symptoms 6 months later in urban teens seeking outpatient treatment, after accounting for baseline levels of symptoms. At baseline, adolescent participants (N = 346; 42 % female; 61 % African-American) ages 12–19 years old (M = 14.9; SD = 1.8) and their primary caregivers reported on SES and teen internalizing and externalizing symptoms and engaged in a videotaped discussion of a real-life conflict to assess parent positive communication. At 6-month follow-up, 81 % (N = 279) of families were retained and teens and caregivers
again reported internalizing and externalizing symptoms. Structural equation modeling (SEM) was used to test the hypothesized models with a sample of 338, using the full information likelihood method to adjust for missing data.