Agreeing on more than chicken soup: Intra-household decision-making and treatment for child psychopathology

Using a large, U.S. dataset it is shown that children are more likely to receive needed mental health specialty treatment when women have greater decision-making power, as measured by an index of wife-favorable divorce laws and by the sex ratio at the time of marriage. Stratified analyses show that this effect is modified by the degree of marital conflict. Marriages characterized by high conflict conform more closely to the unified household model. The paper then presents a model of household decision-making consistent with these results that incorporates both objective determinants of bargaining power as well as the role of violent coercion in maintaining otherwise unsustainable equilibria. Implications for improving children's access to mental health treatment are offered. © Springer Science+Business Media, LLC 2006.