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Understanding Barriers to Initial Treatment Engagement among Underserved Families Seeking Mental Health Services

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Abstract

This mixed method study examined factors associated with parents not attending their child’s mental health treatment after initially seeking help for their 2–5 year old child. It was part of a larger study comparing two evidence-based treatments among low-income racial/ethnic minority families seeking child mental health services. Of 123 parents who initiated mental health treatment (71 % African American or multi-racial; 97.6 % low-income), 36 (29.3 %) never attended their child’s first treatment session. Socio-demographic characteristics, parenting stress, depression, severity of child behavior problems, and length of treatment delay from intake to first scheduled treatment session were compared for families who did and did not attend their first treatment session. Parents who never attended their child’s first treatment session were more likely to live with more than four adults and children (p = .007) and have more depressive symptoms (p = .003). Median length of treatment delay was 80 days (IQR = 55) for those who attended and 85 days (IQR = 67.5) for those who did not attend their child’s first treatment session (p = .142). Three themes emerged from caregiver interviews: (a) expectations about the treatment, (b) delays in getting help, and (c) ambivalence about research participation. Findings suggest the need to develop better strategies for addressing risk factors early in the treatment process and reducing the length of time families with adverse psychosocial circumstances must wait for child mental health treatment.

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Acknowledgments

Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under award #R01 NR012444. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors give special thanks to the families and children who participated in this study, Jasmine Gilmore for her assistance with the qualitative data analysis, and Melissa Kurtz and Kellie Miller for their assistance with data collection.

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Authors and Affiliations

  1. Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, 1750 East Fairmount Avenue, Baltimore, MD, 21231, USA

    Mirian E. Ofonedu & Harolyn M. E. Belcher

  2. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA

    Harolyn M. E. Belcher

  3. Johns Hopkins University School of Nursing, Baltimore, MD, 21205, USA

    Chakra Budhathoki & Deborah A. Gross

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  1. Mirian E. Ofonedu
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  2. Harolyn M. E. Belcher
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  3. Chakra Budhathoki
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  4. Deborah A. Gross
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Correspondence to Mirian E. Ofonedu.

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Ofonedu, M.E., Belcher, H.M.E., Budhathoki, C. et al. Understanding Barriers to Initial Treatment Engagement among Underserved Families Seeking Mental Health Services. J Child Fam Stud 26, 863–876 (2017). https://doi.org/10.1007/s10826-016-0603-6

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