Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study

Sayal, Kapil; Tischler, Victoria; Coope, Caroline; Robotham, Sarah; Ashworth, Mark; Day, Crispin; Tylee, André; Simonoff, Emily

doi:10.1192/bjp.bp.110.081448

Cited by 108 publications

(101 citation statements)

References 26 publications

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“…In the low-cost children's insurance environment, the primary care physician has a very important role in access to mental health services-for most subscribers the doctor may be the first health professional with whom mental health issues are addressed. This study confirms other studies and provides examples of the importance of the primary care interface-and how primary care staff can create barriers-with mental health treatment (Sayal et al, 2010). Improvements in screening for potential emotional or psychiatric disorders are required, as is the smooth referral and exchange of information with mental health specialists.…”

Section: Discussionsupporting

confidence: 85%

Parents' Perspectives on Access to Child and Adolescent Mental Health Services

Cohen

Calderon²,

Salinas

et al. 2012

Social Work in Mental Health

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This article reports parents' perspectives on access to mental health services for their children enrolled in a state children's health insurance program (CHIP). Little has been published about mental health services utilization in states' CHIP programs. Focus groups with parents yielded many contextual factors, confirming previous reports about the importance of the primary care interface and cultural competence. In addition, the findings pointed to the importance of taking seriously parents' perception of severity of the child's problem, reducing administrative barriers to accessing treatment, promoting education about mental health to the community, and eliciting regular input from parents about system performance.

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Section: Discussionsupporting

confidence: 85%

Parents' Perspectives on Access to Child and Adolescent Mental Health Services

Cohen

Calderon²,

Salinas

et al. 2012

Social Work in Mental Health

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“…A possible explanation for this finding may be that PCPs at this site had a style that made parents more comfortable with discussing their difficulties with parenting, whereas at other sites parents may not have been as comfortable talking with their child's PCP. This would fit with previous research indicating that parents disclose concerns regarding behavior when they are comfortable with their child's PCP (Sayal et al, 2010). The relationship between PID and parenting factors may also differ based on physician communication style, practice environment, or availability of mental health services (Horwitz et al, 2007;Brown & Wissow, 2008).…”

Section: Research Directionssupporting

confidence: 63%

“…Additionally, parents who use a harsh discipline style may fear that they will be reported or have their children taken away from them. Indeed, parents report that a common reason for not seeking help from their child's PCP is that they are afraid their child will be removed from their home (Sayal et al, 2010). Another possibility is that parents with this parenting style in our sample may have been more likely to have children with mood disorders (e.g.…”

Section: Discussionmentioning

confidence: 96%

Pediatrician Identification of Child Behavior Problems: The Roles of Parenting Factors and Cross-Practice Differences

Dempster

Wildman

Langkamp

et al. 2011

J Clin Psychol Med Settings

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While most primary care pediatricians acknowledge the importance of identifying child behavior problems, fewer than 2% of children with a diagnosable psychological disorder are referred for mental health care in any given year. The present study examined the potential role of parental characteristics (parental affect, parenting style, and parenting self-efficacy) in pediatrician identification of child behavior problems, and determined whether these relationships differed across practices. Parents of 831 children between 2 and 16 years completed questionnaires regarding demographic information, their child's behavior, their affect, their parenting style, and their parenting self-efficacy. Pediatricians completed a brief questionnaire following visits in four community-based primary care practices in the Midwest. Logistic regressions controlling for child behavior and demographic predictors of pediatrician identification found that an authoritarian parenting style, in which parents yell or strongly negatively react to problem behavior, was negatively associated with likelihood of identification in the overall sample. However, the variables that were predictive of pediatrician identification differed depending on the specific practice. Parental characteristics can aid in understanding which children are likely to be identified by their pediatrician as having behavioral problems. The finding that practices differed on which variables were associated with pediatrician identification suggests the need to potentially individualize interventions to certain physicians and practices to improve identification of child behavior problems in primary care.

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“…21 These include embarrassment, stigma of mental health problems, concerns about the child being labelled or given a diagnosis, concerns about being judged as a poor parent, and concerns their child would be removed from the family should they seek help. Similar factors were given as reasons for reluctance to access services in this study, but they did not significantly impact on rates of service use.…”

Section: Strengths and Limitationsmentioning

confidence: 99%