Understanding Barriers to Initial Treatment Engagement among Underserved Families Seeking Mental Health Services.
Understanding Barriers to Initial Treatment Engagement among Underserved Families Seeking Mental Health Services.
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DOI：
10.1007/s10826-016-0603-6
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发表时间：
2017-03
影响因子：
2.1
通讯作者：
Gross DA
中科院分区：
文献类型：
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作者：
Ofonedu ME;Belcher HME;Budhathoki C;Gross DA
这项混合方法研究考察了父母在最初为2-5岁的孩子寻求帮助后没有参加孩子的心理健康治疗的相关因素。这是一项更大规模研究的一部分，该研究对寻求儿童心理健康服务的低收入种族/少数民族家庭进行了两种循证治疗的比较。在123名发起心理健康治疗的父母中(71%是非洲裔美国人或多种族；97.6%是低收入者)，36人(29.3%)从未参加过他们孩子的第一次治疗。对参加和没有参加第一次治疗的家庭的社会人口学特征、育儿压力、抑郁、儿童行为问题的严重程度以及从接受治疗到第一次预定治疗的延迟时间进行了比较。从未参加过孩子第一次治疗的父母更有可能与4个以上的成年人和儿童一起生活(p=.007)，并有更多的抑郁症状(p=.003)。参加治疗的患者延迟治疗的中位时间为80天(IQR=55)，没有参加孩子第一次治疗的患者为85天(IQR=67.5)(p=0.142)。护理者访谈中出现了三个主题：(A)对治疗的期望，(B)获得帮助的延迟，以及(C)对研究参与的矛盾心态。调查结果表明，需要制定更好的战略，在治疗过程早期处理风险因素，并减少有不利心理社会状况的家庭必须等待儿童心理健康治疗的时间长度。
This mixed method study examined factors associated with parents not attending their child’s mental health treatment after initially seeking help for their 2–5 year old child. It was part of a larger study comparing two evidence-based treatments among low-income racial/ethnic minority families seeking child mental health services. Of 123 parents who initiated mental health treatment (71% African American or multi-racial; 97.6% low-income), 36 (29.3%) never attended their child’s first treatment session. Socio-demographic characteristics, parenting stress, depression, severity of child behavior problems, and length of treatment delay from intake to first scheduled treatment session were compared for families who did and did not attend their first treatment session. Parents who never attended their child’s first treatment session were more likely to live with more than 4 adults and children (p=.007) and have more depressive symptoms (p=.003). Median length of treatment delay was 80 days (IQR =55) for those who attended and 85 days (IQR =67.5) for those who did not attend their child’s first treatment session (p=.142). Three themes emerged from caregiver interviews: (a) expectations about the treatment, (b) delays in getting help, and (c) ambivalence about research participation. Findings suggest the need to develop better strategies for addressing risk factors early in the treatment process and reducing the length of time families with adverse psychosocial circumstances must wait for child mental health treatment.