Mental Health Service Use by Young People: The Role of Caregiver Characteristics

Abstract

AimsMany children and adolescents experiencing mental health problems do not receive appropriate care. Strategies to encourage appropriate access to services might be improved by a more detailed understanding of service use determinants within this group. In view of caregivers’ key role in young people’s pathways to care, this study aimed to advance understanding of caregiver-related characteristics that influence service use among young people.MethodsWe interviewed 407 primary caregivers of young people aged 9-18 years, recruited from a Greater London (United Kingdom) community sample. Caregivers reported on young people’s service use in health care sector and/or education settings, and caregivers’ intended stigmatising behaviours, help-seeking attitudes, and personal service use. Logistic regression analyses examined the relationship between these caregiver characteristics and young people’s service use, controlling for young people’s clinical and socio-demographic factors.ResultsCaregivers’ intended stigmatising behaviours in particular exerted a strong influence on young people’s service use within each service setting. The impact of this characteristic interacted with caregivers’ service use in influencing young people’s service use across health care and education settings and health care settings specifically. For young people’s service use within education settings, caregivers’ intended stigmatising behaviours score had a main effect.ConclusionsThis study highlights the key role caregivers’ attitudes and experiences hold in young people’s service use. The findings indicate that strategies aiming to bridge the gap between young people’s service needs and utilisation might be improved by targeting stigma amongst caregivers.

Seeking and accessing professional support for child anxiety in a community sample

“…One possible interpretation of this finding is that many parents may feel they would benefit from some support, but this is not enough to prompt actual help-seeking behaviour; or it may relate to a belief that seeking professional help for a child's anxiety may facilitate access to direct support for a child rather than for a parent. In line with previous studies, our findings also indicate that parents' own mental health plays a role in help-seeking for child anxiety [14,15], but we found that it was parents' prior use of mental health services, not their mental health symptoms, that was uniquely associated with help-seeking for a child. We did not find evidence that parents' perceptions surrounding the helpfulness of their mental health support was associated with help-seeking for their child, but it is possible this is a reflection of the limited variability in perceived helpfulness reported in this sample.…”

“…Parents were asked if they had spoken to a professional about their own mental health using an item sourced from similar surveys [15,32]. Where applicable, parents also indicated the professional they had spoken to and rated the helpfulness of the support they received (not at all helpful = 0 to extremely helpful = 4).…”

“…For example, if parents perceive a child's difficulties to be problematic, and perceive a negative impact on family life, and need for professional help, a child is more likely to access mental health services than if parents do not recognise a child's difficulties, associated impact or need for help [14]. Parents' own experience of mental health problems and use of mental health services, and a child's symptom severity are also associated with child mental health service use [15,16]. However, few studies have explored help-seeking, specifically in the context of child anxiety disorders; given that reported rates of treatment access are lower for anxiety disorders compared to behavioural disorders, there may be barriers to help-seeking that are unique to anxiety difficulties.…”

Conditional Disclosure on Pathways to Care: Coping Preferences of Young People at Risk of Psychosis

“…Further, purposive sampling was used to achieve a balanced sample amongst those who met inclusion criteria in terms of the following individual and family-characteristics: gender, age, ethnicity, and caregivers' reports of stigma. Data on the first three characteristics were collected during the initial screening assessment (2005)(2006)(2007)(2008)(2009)(2010), and data on caregivers' intended stigmatizing behaviors were collected using the Reported and Intended Behaviour Scale (Evans-Lacko et al, 2011) during subsequent data collection (2011)(2012) (Gronholm et al, 2015).…”

Child and adolescent psychiatry: which knowledge and skills do primary care physicians need to have? A survey in general practitioners and paediatricians

“…Moreover, access to mental health care for adolescents is often impeded by the design of the relevant health system (e.g. CAP specialists are working primarily in a consulting function, or treat only severely mentally ill patients) [1,18,59]. However, early identification (when combined with effective treatment) is one of the main predictors of functional outcome and social adaptation in many patients with mental health disorders [12,51].…”