Barriers to Seeking Mental Health Services Among Adolescents in Military Families

Authors
Becker, S. J. Swenson, R. R. Esposito-Smythers, C. Cataldo, A. M. Spirito, A.
Publication year
2014
Citation Title
Barriers to seeking mental health services among adolescents in military families
Journal Name
Professional Psychology: Research and Practice
Journal Volume
45
Issue Number
6
Page Numbers
504-513
DOI
10.1037/a0036120
Summary
Adolescent children of Service members can experience significant stress and emotional difficulties during parent deployment; however, mental health care utilization rates are low. This qualitative study interviewed military adolescents, their mothers, and health care providers about barriers to utilization and suggestions for services for military adolescents. Seven common barriers and suggestions to decrease barriers for mental health care services for military adolescents were identified.


Key Findings
The most commonly noted barriers to military adolescents seeking mental health services were concerns about time and effort (69%), logistics (58%), confidentiality (51%), and stigma (49%).
Mothers and providers in particular noted that barriers such as no transportation, time, or childcare may make it difficult for adolescents to receive services, especially during deployment.
Mothers reported barriers of concerns about the impact on their Service member’s career or that the Service member would be less focused on the mission due to worry about the family.
Most participants suggested mental health services for military adolescents should be group sessions, on an as-needed basis, and built into enjoyable social or recreational activities.
Implications for Program Leaders
Provide childcare and transportation services to military families during mental health care service utilization to decrease logistical barriers to services
Disseminate information about mental health care services, confidentiality concerns, and mental health care stigma to military families
Educate military parents regarding when to seek mental health care services for their children
Implications for Policy Makers
Recommend education for professionals working with Service members and their families regarding the unique barriers to seeking mental health services among military families
Promote the development of social media tools for military adolescents to connect and support one another
Encourage collaboration between military insurance programs and community mental health programs to ensure mental health care services are affordable for military families
Methods
Military spouses and adolescents were recruited at multiple events for three military family outreach and support programs across the course of nine months.
Mental health providers were recruited through referrals from other providers or agencies.
All participants completed either a focus group or individual interview to discuss their views regarding barriers to and suggestions for mental health treatment aimed at military adolescents.
Participant statements were analyzed and coded using thematic analysis, and the number of participants expressing each theme or idea was totaled to report a final frequency count.
Participants
The sample included 13 adolescents, who were 62% male, had an average age of 13 years (SD = 1.4), and were children of an Active Duty Service member.
The sample also included 12 of the adolescent’s mothers, with an average age of 42 years (SD = 5.8), and 20 mental health care providers who worked with military adolescents.
All providers and the majority (80%) of military mothers and adolescents identified as White.
Limitations
Participants were interviewed in both group and individual settings due to difficulties with scheduling, which may have resulted in differences in participants’ answers and input.
Military-connected participants were recruited at events for military families and may have been more connected to programs and services than families not attending the events.
Recruitment took place in a location not near any military base, and military families far from bases may face different barriers to seeking services than families living on base.
Avenues for Future Research
Examine whether military families’ reported barriers to mental health services predict actual service utilization
Explore whether the title (e.g., therapy, treatment, resilience training) or presentation of mental health care services to military families impacts the rates of utilization
Compare rates of military adolescents’ attendance at mental health service appointments in either group or individual settings
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (nonenlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: 4 internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and 3 external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population.
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