Barriers to seeking mental health services among adolescents in military families.

Abstract

Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (non-enlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: four internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and three external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population.

Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies

“… 75% No information School MH in general No previous MH problems b Any professional help 0% current, 25% previous contact with professional help. Interviews 17 (high) Becker et al [ 50 ] 13 12–17 USA Majority Caucasian 38% No information Community—outreach and support programmes for military families MH in general Not assessed MH services No information Interviews and focus groups 16 (high) Breland-Noble et al [ 51 ] 29 11–17 USA African American No information Rural, urban and suburban No information. Depression Not assessed Any professional help No information Interviews and focus groups 12 (moderate) Bullock et al [ 52 ] 15 14–18 Canada 100% Canadian with heterogeneous ethnicities (i.e.…”

“…The latter was reported in all studies that included male-only samples. Young people commonly (in 39% of the studies) endorsed the barrier of refusing to seek help because of a desire to cope with their problems on their own [ 20 , 21 , 24 , 26 – 28 , 33 , 34 , 37 , 40 – 42 , 45 – 47 , 50 , 54 , 56 , 61 , 68 , 73 ]. This subtheme was reported in nearly all studies that included young people with elevated levels of depression symptoms or experiences of self-harm, and mostly in quantitative studies with high rates of endorsement.…”

“…Factors associated with commitment to the process of help-seeking were usually endorsed with a high frequency within quantitative studies. Around a quarter of studies reported the perceived effectiveness of professional help to be the reason for (not) seeking professional help, with most studies reporting that young people were doubtful about the effectiveness of professional help [ 31 – 35 , 37 , 40 , 42 , 44 – 46 , 48 , 50 , 67 , 72 ]. This reason was endorsed by young people with or without previous experience of professional help.…”

“…The vast majority of studies reported barriers (76% of studies) related to perceived stigma [ 19 – 21 , 26 , 27 , 31 , 32 , 49 , 50 , 54 – 62 , 64 , 68 , 69 , 72 , 73 ] and young people’s experienced and/or anticipated embarrassment as a consequence of negative public attitudes [ 20 , 22 , 27 , 28 , 32 , 33 , 36 , 37 , 40 – 42 , 44 , 47 – 49 , 58 , 61 , 64 , 69 ], and these barriers were usually reported by a high percentage of young people within studies. Reduced public stigma and public normalisation of help-seeking were reported as related facilitators in four (13%) qualitative studies [ 57 , 63 , 72 , 74 ].…”

“…Issues related to perceived confidentiality were reported as barriers in 28% and facilitators in 6% of the studies [ 19 , 29 , 33 , 36 , 37 , 39 , 45 , 47 , 50 , 56 , 57 , 59 , 62 , 64 – 66 , 69 , 73 , 74 ]. Young people also reported concerns regarding disclosing personal information to a person they do not know well [ 22 , 26 , 28 , 32 , 33 , 35 , 42 , 57 , 58 , 65 , 68 , 72 , 74 ].…”