Parent–adolescent concordance on perceived need for mental health services and its impact on service use

Abstract

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent–adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n=108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.

Predictors of Health Literacy and Numeracy Concordance Among Adolescents With Special Health Care Needs and Their Parents

“…Existing literature suggests that when adolescents and parents have incongruous skills or beliefs, service providers can find it difficult to develop treatment plans and goals (Hawley & Weisz, 2003). For example, parent-child discordance in beliefs about mental health has been found to be associated with poorer outcomes and lower utilization of mental health services (Lewis et al, 2012; Williams, Lindsey, & Joe, 2011). Approaches to addressing health literacy challenges in teens with special health care needs are complex because of the needs of providing understandable information to both the youth and the parent.…”

Understanding the Behavioral Determinants of Mental Health Service Use by Urban, Under-Resourced Black Youth: Adolescent and Caregiver Perspectives

“…Adolescents, however, face unique contingencies that facilitate or deter their positive connections to mental health services: (1) increased autonomy from parents regarding whether to participate in particular behaviors they might be view as problematic (e.g. whether to smoke cigarettes, drink alcohol or do drugs) (Smetana et al 2004); and (2) adolescent and caregiver agreement/disagreement regarding mental health needs and whether formal mental health services are necessary to resolve observed problems (Williams et al 2011). …”

Adolescent and Caregiver Reports of ADHD Symptoms Among Inner-City Youth

“…These results underscore the clinical salience of the I/D subtype in adolescent populations: Not only are I/D symptoms more prevalent than H/I symptoms, they appear to be strongly related to family perceptions about counseling needs. This finding takes on added significance in light of emerging data suggesting that both parent and adolescent perceptions about the need for behavioral treatment are important predictors of treatment participation (e.g., Williams et al, 2011), including treatment for ADHD specifically (Bussing et al, 2011). …”