Addressing the barriers to mental health services for inner city children and their caretakers

McKay, Mary M.; McCadam, Kathleen; Gonzales, Jude

doi:10.1007/bf02249453

Cited by 191 publications

(142 citation statements)

References 30 publications

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“…Therefore, methods to impute missing values were not used in the study. One family's modality information in the choice group was missing ORIGINAL RESEARCH inexpensive strategies (e.g., a phone call the day before the session, troubleshooting logistical barriers) [37] can significantly increase show rates, most clinics do not use such strategies to improve retention. Our findings resonate with the literature showing average length of treatment in community mental health clinics is just three to four sessions [38].…”

Section: Discussionmentioning

confidence: 99%

A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics

Gewirtz

Lee

et al. 2015

Behav. Med. Pract. Policy Res.

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Incorporating participant preferences into intervention decision-making may optimize health outcomes by improving participant engagement. We describe the rationale for a preference-based approach to the personalization of community-based interventions. Compensating for the limitations of traditional randomized controlled trials (RCTs) and partially randomized preference trials (PRPTs), we employed a doubly randomized preference trial in the present study. Families (N=129) presenting to community mental health clinics for child conduct problems were randomized to choice or no-choice conditions. Within each condition, parents were again randomized, or offered choices between home-and clinic-based, individual and group versions of a parent training program or services-as-usual. Participants were assessed at baseline, and treatment retention data were gathered. Families assigned to the choice condition were significantly less likely to drop out of treatment than those in the no-choice condition. In the choice condition, in-home treatment was the preferred modality, and across conditions, families were less likely to be retained in group and clinic modalities. Research on preferences may boost participant engagement and inform shared decision-making.

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Section: Discussionmentioning

confidence: 99%

A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics

Gewirtz

Lee

et al. 2015

Behav. Med. Pract. Policy Res.

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“…[50][51][52][53][54][55][56] Other skills target symptoms that occur commonly across multiple mental health problemsfeelings of anger, ambivalence, and hopelessness-and the family conflicts frequently associated with these problems. These skills come from family therapy, 6 cognitive therapy, 57 motivational interviewing, 52 family engagement, 58 family-focused pediatrics, 42,43 and solution-focused therapy. 59 The proposed competencies further assume that collaboration-among A final assumption is that PCCs can expand their capacity beyond managing ADHD to care effectively for children with other commonly occurring pediatric mental health problems: anxiety, depression, and substance abuse.…”

Section: Assumptionsmentioning

confidence: 99%

The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care

COLEMAN¹,

Dobbins²,

Garner³

et al. 2009

Pediatrics

302

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Pediatric primary care clinicians have unique opportunities and a growing sense of responsibility to prevent and address mental health and substance abuse problems in the medical home. In this report, the American Academy of Pediatrics proposes competencies requisite for providing mental health and substance abuse services in pediatric primary care settings and recommends steps toward achieving them. Achievement of the competencies proposed in this statement is a goal, not a current expectation. It will require innovations in residency training and continuing medical education, as well as a commitment by the individual clinician to pursue, over time, educational strategies suited to his or her learning style and skill level. System enhancements, such as collaborative relationships with mental health specialists and changes in the financing of mental health care, must precede enhancements in clinical practice. For this reason, the proposed competencies begin with knowledge and skills for systems-based practice. The proposed competencies overlap those of mental health specialists in some areas; for example, they include the knowledge and skills to care for children with attention-deficit/hyperactivity disorder, anxiety, depression, and substance abuse and to recognize psychiatric and social emergencies. In other areas, the competencies reflect the uniqueness of the primary care clinician's role: building resilience in all children; promoting healthy lifestyles; preventing or mitigating mental health and substance abuse problems; identifying risk factors and emerging mental health problems in children and their families; and partnering with families, schools, agencies, and mental health specialists to plan assessment and care. Proposed interpersonal and communication skills reflect the primary care clinician's critical role in overcoming barriers (perceived and/or experienced by children and families) to seeking help for mental health and substance abuse concerns.

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“…"Motivational enhancement" in the treatment of adolescent substance use (Tevyaw and Monti 2004) is a set of skills that combines relationship factors (demonstrating provider acceptance and warmth) and influence skills (developing discrepancy, making statements that affirm self-efficacy, exploring readiness to change). Interventions that address participant factors (parents' beliefs about and barriers to help seeking) increase rates of attendance at initial mental health appointments (McKay et al 1996). In early intervention programs for children at developmental risk, efforts targeting participant factors (promoting parent-program involvement) are more strongly associated with outcomes than the amount or type of services delivered (Dunst et al 1988).…”

Section: Common Factors In Child Psychotherapymentioning

confidence: 99%

A Common Factors Approach to Improving the Mental Health Capacity of Pediatric Primary Care

Wissow

Anthony

Brown

et al. 2008

Adm Policy Ment Health

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To expand the mental health service capacity of pediatric primary care, we ask whether there are evidence-based skills to allow providers to 1) immediately begin treatment for children with emotional and behavioral problems while diagnostic procedures are being pursued, and 2) offer evidence-based care to children who do not meet criteria for a specific diagnosis. We discuss why the epidemiology of child mental health problems poses difficulties for disorder-specific mental health interventions, and review evidence that "common factors" contributing to the outcome of mental health treatments define a core set of skills that primary care providers might use to complement disorder-specific interventions.

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Addressing the barriers to mental health services for inner city children and their caretakers

Cited by 191 publications

References 30 publications

A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics

A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics

The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care

A Common Factors Approach to Improving the Mental Health Capacity of Pediatric Primary Care

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