Mothers seeking mental health care for their children: A qualitative analysis of pathways to care

Approximately 20% of youth meet criteria for a psychiatric disorder. Despite the availability of effective community-based psychosocial treatments, nearly 80% of youth with a psychiatric disorder do not receive treatment. In the United States, parents (typically mothers) are primarily responsible for accessing mental health services for their child. Consequently, researchers have suggested that one of the most promising ways to close the gap between unmet need and service use for youth is to improve our understanding parental help-seeking. However, our understanding of parental help-seeking has been limited by the dominance of atheoretical studies that focus on the characteristics of help-seekers, problem-types, and service locations, that are useful in establishing public health policy but have limited application to front line service delivery. Consequently, almost no research has examined the process that mothers go through - the how and why - to seek mental health services for their children.;This dissertation sought to describe and characterize the perceptions and experiences of mothers who accessed mental health services for their child. This study is a qualitative secondary analysis of a random selection of 60 of 127 interviews gathered from mothers 3 months after accessing mental health services. Grounded theory analysis was used to code the interviews and identify themes and patterns. The analysis suggested that mothers went through four stages of help-seeking: (1) recognizing a problem: mothers became concerned about their child's behaviors and then tried to identify the cause of the behaviors; (2) responding to the problem: mothers identified six coping strategies they used to try and resolve their child's problem(s); (3) using mental health services (MHS): mothers identified the type and modality of treatment they received, their mode of entry into services, and their reasons for seeking services; (4) evaluating services: mothers determined if the pathway had terminated, deviated, or changed.;This study suggests that most mothers use mental health services only after other coping strategies have been exhausted. Social workers can improve services by clarifying the mother's reasons for seeking services, identifying prior coping strategies, and recognizing that most mothers see MHS as a stop along an on-going pathway, rather than an endpoint or solution to their child's problems.