FR 2-1

3/07

Abstract

Barriers to Help-Seeking for Economically Disadvantaged Parents and Children

Prepared by: Glade Topham, Ph.D., Assistant Professor

Human Development and Family Science Department

233 HES; Oklahoma State University

Stillwater, OK 74078

(405) 744-8356

glade.topham@okstate.edu

Topham, G. L., Briggs, K., Hendrix, C. C., & Fournier, D. G. (2006). Barriers to help-seeking for economically disadvantaged parents and children in Tulsa. Report to Anne and Henry Zarrow Foundation.

IMPLICATIONS FOR COOPERATIVE EXTENSION. Extension as well as a host of other agencies, schools, and programs often experience frustration trying to engage parents and families in community education and services. Likewise, parents and children who may benefit from such programs are not accessing available services.

This report contains findings and recommendations from a one-year study of barriers that prevent disadvantaged parents from obtaining mental or behavioral health services for their children. Over 550 disadvantaged parents in Tulsa were interviewed. Unique findings are presented for African American, Caucasian, Native American, and Hispanic parents. FCS/4-H Educators and community partners may find this information helpful in understanding these issues and how we can more effectively facilitate the help-seeking process with parents.

PURPOSE

The purpose of this assessment was to better understand the barriers economically disadvantaged parents experience to obtaining mental or behavioral health services for their children (ages 3 to 10) or services to assist them in parenting their children. Parents were the only respondents in this study. No data was collected from service providers or community stakeholders.

PROBLEM

Estimates are that between 50 and 80% of children who need mental health services fail to receive them (Costello, Costello, Edelbrock, & Burns, 1988; Katoaka, Zhang, & Wells, 2002). Children in economically disadvantaged households are even less likely than other children to receive needed mental or behavioral health services (Katoaka et al., 2002). This is of concern when considering that these children experience an elevated level of mental health care needs (Aber, Jones, & Cohen, 2000). Untreated children are likely to exhibit continued mental health problems, criminal behavior, drug dependence, and relationship difficulties in adolescence and into adulthood (Fergusson, Horwood, & Ridder, 2005). Thus, mental and behavioral health professionals, community leaders, and other stakeholders in children’s mental health must identify ways to reduce or remove barriers to help-seeking for families with young children. Successful treatment, completed early in children’s lives, translates into a number of benefits to children, families, and communities.

METHOD AND PROCEDURES

A combination of telephone and face-to-face interviews were used to collect data. Phone interviews provided a means to reach a larger population more quickly, while face-to-face interviews provided a means to gain a more in-depth understanding of the barriers to help-seeking. In total, 393 phone interviews and 151 face-to-face interviews were completed with disadvantaged parents of young children in Tulsa. The sample was stratified so

Barriers to Help-Seeking for Economically Disadvantaged Parents and Children (continued)

that Hispanic, African American, American Indian, and Caucasian parents each made up approximately 25% of the sample. Telephone interviews were conducted in July, 2005, and face-to-face interviews were conducted from August, 2005 to May of 2006.

FINDINGS

TREATMENT NEED AND PATTERNS OF HELP-SEEKING

Many parents who need behavioral health services for their children or for parenting their children are not receiving them.

o 47% of all parents interviewed reported a problem with their child or raising their child.

o 31% of parents reported wanting but not obtaining behavioral health services for their child sometime during the previous 5 years.

BARRIERS TO HELP-SEEKING

Below is a list of the top six barriers to help-seeking reported by parents in the study. The percent of parents reporting the barrier to be a problem in getting help for their child is listed in parentheses.

o Not having the money (72%)

o Not knowing where to go (60%)

o Worrying that it would take too long to get needed services (54%)

o Not having time to go to an appointment (47%)

o No child care (45%)

o Belief that it would likely not help (43%)

Language was the most significant barrier for Hispanic parents with 77% of parents stating this was a problem for them in their ability to get help.

TREATMENT ACCEPTABILITY

o In general, parents were most open to treatment for their child if both they and their child were involved in the treatment.

• Native American parents were more likely than other parents to report they would go to a counselor who would meet with them alone or meet with their child alone.
• Native American parents reported being less likely to take advantage of treatment programs for their child if it was an in-home program.

Parenting Groups

• Hispanic parents were more likely than other parents to report they would go to a parenting group if they needed help.

o Native American parents were less likely than other parents to report they would go to a parent group.

o Caucasian parents were more likely to report they would attend a parent group if it was held in a church or public place as opposed to a counseling center.

o Parents reported being much more likely to go to a parent group if they already knew the group leader and if they already knew some of the participants. This was particularly important for Hispanic parents.

Referral Source

o Hispanic, Native American, and Caucasian parents reported being most likely to get help if their child’s teacher or school counselor recommended they get help.

o African American parents reported they were most likely to get help if their religious or spiritual leader had recommended it.

INFLUENCES ON THE HELP-SEEKING PROCESS

Parents were more likely to have received needed treatment in the past, to be more open to treatment, and to perceive fewer and less severe barriers to help-seeking if:

o They had a better relationship with the personnel at their child’s school.

• They reported living in a safer and more supportive neighborhood.
• They received more emotional and instrumental support from family and friends.
• They experienced fewer symptoms of depression.
• They expressed feeling more open and trusting of others.
• They or their children were more involved in their communities (e.g. after school programs, religious activities, etc.)

Barriers to Help-Seeking for Economically Disadvantaged Parents and Children (continued)

RECOMMENDATIONS

REDUCING OR REMOVING BARRIERS TO HELP-SEEKING

1. More services need to be provided at low cost with free child care.

2. More services need to be provided in or near the communities in which disadvantaged families live.

3. The intake process should be simplified, requiring less time and effort for families.

4. Helping agencies need to get families in for treatment more quickly.

5. More helping agencies need to expand the times when services are available to enable parents with busy and/or inflexible schedules to get needed help.

6. School personnel should make an extended effort to foster positive relationships with parents.

7. When possible services should be offered to parents and their children within schools.

8. Mental health professionals and school personnel should continue to seek innovative ways to work collaboratively in identifying child needs and in providing needed services.

9. Efforts should continue to be invested in improving the marketing of the 211 hotline phone number.

10. Service professionals should work with religious/spiritual leaders and physicians to make them more aware of the services that are available.

11. Providers need to increase their capacity to provide culturally competent services in the Spanish language.

INCREASING PARENT OPENNESS TO TREATMENT

1. Parents and children should commonly be included in treatment together

2. Efforts should be made to organize groups in which parents will be familiar with each other and with the group leaders.

3. When providing services, counselors or educators should take extra care to communicate respect and understanding to parents.

4. Treatment providers should work continually to keep parents informed about the treatment process.

5. Activities and opportunities should be provided for parents and their children to become more involved in the community and to increase the breadth of their social networks.