Barriers to mental health service use among hematopoietic SCT survivors

Abstract

Summary This study examined barriers to mental health service use and their demographic, medical, and psychosocial correlates among hematopoietic stem cell transplant (HSCT) survivors. A sample of 253 HSCT survivors who were 1- to 3-years post-transplant completed measures of demographic, physical, psychological, and social characteristics as well as a newly modified measure of barriers to mental health service use. Only 50% of distressed HSCT survivors had received mental health services. An exploratory factor analysis of the barriers to mental health service use scale yielded four factors: Scheduling Barriers, Knowledge Barriers, Emotional Barriers, and Illness-related Barriers. Patients with higher social constraints (perceived problems discussing the illness experience with significant others) reported higher levels of all four types of barriers. General distress and transplant-related posttraumatic stress symptoms were positively associated with emotional, knowledge, and illness-related barriers to mental health service use, whereas physical and functional well-being were inversely associated with these barriers. Having more knowledge barriers and more emotional barriers predicted a lower likelihood of receiving mental health services, as did lower levels of education and general distress. Results suggest that a significant number of HSCT survivors may benefit from education about mental health services that is tailored to individual barriers.

Barriers to psychological care among primary caregivers of children undergoing hematopoietic stem cell transplantation

“…The Awareness and Barriers to Counseling-Revised (ABC-R)[12] is an 18-item scale assessing awareness of, attitudes about, and barriers to the use of psychological care [12, 25]. Definitions of psychological services, anxiety and distress symptoms, and cognitive-behavioral therapy are provided and then caregivers are asked to rate the extent to which each statement may impact his/her decision to obtain psychological services related to worries or concerns about his/her child’s HCST using a nine-point scale from 0 = Do not agree at all to 8 = Agree extremely .…”

“…Unfortunately, studies have not systematically explored reasons caregivers do not seek out supportive care services. Generally, research about barriers to psychological care has focused on parents seeking family or child-focused services [11], adults with cancer [12], or adults with mental health issues [13]. Research with adult cancer patients has demonstrated underuse of psychological care, with patients endorsing practical and emotional barriers to psychological care [12].…”

Late effects and healthcare needs of survivors of allogeneic stem cell transplantation: a qualitative study

“…25 Scheduling problems, information gaps and negative feelings about care impacted whether SCT survivors take advantage of mental health services. 26 Although SCT survivors reported an average of four medical problems (controls reported two), denial of health insurance may prevent them from seeking care. 27 Since the number of long-term survivors is anticipated to rise given the increasing use of allogeneic SCT, these issues may become more problematic.…”

Challenges for Cancer Care Delivery to Adolescents and Young Adults: Present and Future

“…Also lacking are centers with peer mentoring, support groups or counseling services for AYAs [9] . From a more patient-centered perspective, emotional barriers, poverty and underemployment due to illness, physical and functional limitations, and lack of knowl- edge can lead to underutilization of psychiatric services [49] .…”