Parental perceptions of barriers to mental health services for young people

Aim: This study explores a range of barriers that parents encountered in accessing mental health services. The study also explored whether parents experienced similar barriers to accessing services in 2003 and 2013. Methods: One hundred and thirty-four parents of young people attending an initial assessment at a Child and Adolescent Mental Health Service (CAMHS) or headspace centre completed a questionnaire assessing 10 general barriers to care. These data were compared to those collected from 129 participants at CAMHS in 2003. Results: The ranking of barriers to mental health care for their children was similar for both survey years, with \u27wait time being too long\u27 and \u27help being too expensive\u27 the two highest ranked barriers. Cost factors were related to not knowing that the services did not charge fees and having to take time off work to attend appointments. Multiple referral steps and uncertain wait times were the main concerns regarding wait times. The overall strength with which barriers were endorsed remained relatively low; however, at least 40% of the sample agreed they had experienced four of the barriers in both years. Conclusions: Despite relatively low endorsement of barriers, there are substantial proportions of parents who experienced some barriers to services, and services should continue working to reduce them to facilitate timely access. There is a particular need for more service-related information to clarify that public sector mental health services do not charge fees. Methods such as rapid initial assessment and actively managing wait lists may go some way to reducing perceived wait time barriers

Parents\u27 and adolescents\u27 perceived influences and barriers to mental health services

Many young people with mental health problems do not seek professional help and remain at risk of suicide and adult psychopathology. The present research investigates the barriers that impede the help seeking of parents and their children and the sources of influence that assist young people to access clinical services. Study 1 uses archival data from a recent survey of non-clinical samples of young people between 15-25 years of age who attended Technical and Further Education (TAPE) colleges (n = 137) or accessed neighbourhood centres (n = 49). Respondents completed measures of psychological distress, suicidal ideation, perceived help seeking barriers and intentions to seek professional help for personal-emotional problems and suicidal thoughts. In TAPE students, psychological and practical barriers were related to intentions to seek help for personal-emotional problems and thoughts of suicide. There was also a positive association between help seeking barriers and the level of suicidal ideation. In the youth centre sample, those in greater distress and therefore most in need, reported more obstacles to obtaining help. There was also evidence of help negation. Higher levels of suicidal ideation were associated with lower levels of intent to seek out professional help. Study 2 examined the relative influence of parents and others on the decision of a young person to access professional help and the relative strength of the barriers faced by parents seeking help for their children. The sample comprised 122 parents and 131 adolescents who attended an initial clinical assessment interview with a Child and Adolescent Mental Health Service (CAMHS) in Sydney or the Illawarra region of New South Wales. Parents completed measures of help-seeking barriers and influences and the Strength and Difficulties Questionnaire (SDQ; Goodman, 1997). The adolescents completed a measure of help-seeking influences and the self-report SDQ (Goodman, Melzer, & Bailey, 1998). Ninety-four percent of young people reported that others had influenced their decision to access help. Almost 87% were influenced by multiple sources but parents were the single strongest source of influence. Parents and children indicated that parents were more influential in the decision to seek help when there was greater disagreement between parent and child on the extent of the young person\u27s overall and externalizing difficulties on the SDQ. Positive relationships emerged between parent-rated influence variables and parent scores on the Total Difficulties and Externalising SDQ scales. Youth-rated total and externalising difficulty scores were positively related to greater self-involvement in accessing help. Parents rated the strongest barriers to accessing help as; help was too expensive, the wait was too long, not knowing where to get help, thinking that they could solve their child\u27s problem without help and, their child not wanting help. The findings are consistent with contemporary process models that suggest help seeking is a social process and that young people in particular are highly dependent on parents to access help (Cauce et al., 2002; Logan & King, 2001). In addition, it highlights the need to better promote local services and in particular increase awareness that public services are no-fee. Providing parents and their adolescents with strategies for managing differences, in perceptions of problem severity, during the waiting period may reduce both the wait time barrier and effects of problem perception discrepancies on the social influence process

Discrepancies between parent-and adolescent-perceived problem severity and influences on help seeking from mental health services

Objectives: Attitudinal and practical barriers prevent many young people who are experiencing mental health problems from seeking professional help. The influence of others can help young people to overcome barriers to help seeking. Understanding the relative influence of parents and others on the help-seeking decision and the extent of parent–child agreement on the severity of the young person’s problems, may be helpful in facilitating intake processes in child and adolescent mental health services (CAMHS). Methods: One hundred and nineteen parent–child (14–18-years-old) dyads attending an initial appointment at a Sydney and regional CAMHS completed the parent and youth Strength and Difficulties Questionnaires (SDQs) prior to their assessment interview. Parents and children also answered three equivalent questions on sources of influence in their decision to access services. Results: Ninety-four per cent of young people reported that others had influenced their decision to access help, with parents being the strongest influence. Higher levels of parental influence in the help-seeking process were related to greater disagreement between parent and child on the severity of the problems. Parent and child ratings of influence were related to the severity of externalizing problems. Conclusion: The findings are consistent with models that highlight help seeking as a social process involving high degrees of influence particularly from parents. Referral sources and clinicians need to be aware of the effects of discrepant views between parent and child regarding the presenting problem. To facilitate joint therapy it may be helpful for clinicians to address the level of influence involved in having the young person attend their first appointment with parents and children