Monday, June 13, 2022

Study Identifies Barriers, Facilitators to African American Parents Seeking MH Care for Children

Many factors influence parents’ abilities to seek help for their children experiencing mental health problems. A report in Psychiatric Services found that African American parents were more likely to postpone seeking professional help for a child experiencing emotional or behavioral problems if they feared the child might be involuntary hospitalized and/or if their health insurance would not cover treatment.

“Barriers to mental health care are greater for African American parents, who are more likely than White parents to experience structural obstacles that hinder timely diagnosis,” wrote Jennifer Richmond, Ph.D., M.S.P.H., of Vanderbilt University Medical Center and colleagues. “African American children are also exposed to systemic racism and other harmful structures in the health care system … As a result, African American children with emotional and behavioral challenges are more often misdiagnosed and less likely to receive early intervention than are White children.”

Richmond and colleagues used data from the Teaching Advocacy Skills for Kids study, which included 289 African American parents living in North Carolina who were raising children with several mental health or developmental challenges. Parents completed a computer-assisted telephone interview upon recruitment to the study. During the interviews, the authors determined whether the parents rapidly sought care (defined as seeking care within 30 days of identifying their child’s need) or deferred care (defined as waiting one year or longer to seek care) for their children after recognizing the children had mental health or developmental challenges.

Parent activation (meaning the parent had the knowledge, skills, and confidence to access and engage in the appropriate services) was assessed using the 13-item parent-focused Patient Activation Measure. The authors also assessed if there were other adults with mental health challenges living in the home; if parents mistrusted doctors; and if they were deterred from getting help for their children for other reasons, including a fear of involuntary hospitalization, lack of health insurance coverage, or not initially finding the children’s behaviors to be bothersome.

About 22% of parents rapidly sought care, while 49% deferred care. Parents were more likely to rapidly seek care if they had higher parent activation scores or if they lived with other adults with mental health challenges. They were less likely to rapidly seek care if their children’s challenges did not initially bother them or if their health insurance would not cover the service. Similarly, they were more likely to defer care if they feared involuntary hospitalization for their children.

Contrary to the authors’ hypothesis, parents were more likely to rapidly seek care for their children if they reported mistrusting doctors. “It is possible that parents who mistrust doctors make different choices for their children than for themselves,” the authors theorized. “For example, parents who mistrust doctors, perhaps because of previous negative health care experiences, may be more motivated to advocate for their child to receive rapid, high-quality care so that their family can avoid further negative experiences.”

For related information, see the Psychiatric Services article “Barriers to Increasing Access to Brief Pediatric Mental Health Treatment From Primary Care.”

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