Barriers and facilitators for access to mental health services by traumatized youth

Abstract

Polytrauma is a highly prevalent public health problem in the U.S. with even higher rates in urban areas. Children with polytrauma often end up in multiple child-serving systems (e.g., mental health, child welfare, education, juvenile justice) with needs that are both complex and severe. Providers within these child-serving systems have potential to serve as gatekeepers to trauma services by linking youth with trauma-informed treatments and supports that promote recovery. The purpose of our study was to assess the perspective of providers who participated in a nine-month, trauma-informed care (TIC) training intervention on 1) their capacity to make referrals to trauma-specific services following the training, and 2) factors external to the training intervention that supported or hindered their ability to link traumatized youth with services. A subset of sixteen participants from the TIC training completed individual interviews. These participants were predominantly female, African American, and based in the social services sector. The constant comparative method was used to derive three thematic domains related to participant perceptions regarding youth referrals: 1) Organizational and provider capacity to provide trauma treatment or to make referrals to trauma-specific services, 2) Barriers to youth accessing trauma services, and 3) Suggestions for improving coordination of care and referrals. Our study highlights the influence of contextual factors on whether a TIC training can improve the capacity of agencies and individual providers to support traumatized youth in accessing appropriate services. The development of a structure that formally connects youth-serving agencies and providers with specialists trained in addressing traumatized youth is recommended.

A population-based sex-stratified study to understand how health status preceding traumatic brain injury affects direct medical cost

“…present five-years prior to the TBI event increased direct medical cost by up to 110%. Unfortunately, to date, care for individuals with TBI and mental health and/or addictions remains fragmented with lack of appropriate services and support for these individuals across the continuum of care [30][31][32]. This need for integrated healthcare has been recognized globally and across many health conditions and settings [33][34][35][36][37][38][39] and is particularly important for survivors of TBI because sequalae from TBI, including but not limited to increased impulsivity, slowed thinking, and impaired reasoning, problem solving and social communication [40,41], may lead to loss of stable housing, employment, and relationships [41,42].…”

“I'm tired of being pulled from pillar to post”: A qualitative analysis of barriers to mental health care for trauma‐exposed young people

“…It is likely that present findings differ from previous research due to the method of data collection. Research in this area thus far has had a narrow scope and has mainly focused on the perspectives of providers (Chung et al, 2012; Damian et al, 2018; Paul, Gray, Elhai, Massad, & Stamm, 2006; Stewart et al, 2017).…”

“…This poster was graduating from university, and therefore would no longer have access to the university counselling service and the therapist they were seeing: The structural barriers identified in this study have previously been reported in the industry, where the impact of funding limitations, a complex and fragmented system, the high cost of care and lengthy wait times limit service accessibility for young people (Bendall et al, 2018;Bush, 2018). These barriers have also been highlighted by mental health service providers, adult service-users in primary healthcare and young people for trauma-related issues (Chung et al, 2012;Damian et al, 2018;Stewart et al, 2017). These included a lack of coordination and integration among services, workforce shortages, socioeconomic constraints and difficulties navigating the healthcare system.…”

“…To the best of our knowledge, there have only been two studies investigating barriers to mental health care for trauma‐exposed young people. One of these surveyed professionals and the other was a case study of four Hispanic young people (Damian, Gallo, & Mendelson, 2018; Stewart, Orengo‐Aguayo, Gilmore, & De Arellano, 2017). These studies found that barriers included distance to clinic, the caregiver's work schedule, confidentiality concerns, socioeconomic constraints, and a lack of cohesion among services.…”

Supporting the mental health needs of underserved communities: A qualitative study of barriers to accessing community resources

“…Practical barriers may also limit youth and families' access to community resources. For instance, it can be difficult for many families, particularly those living in rural or under-resourced areas, to access community resources that are located far from their homes, given challenges with reliable transportation and childcare (Damian, Gallo, & Mendelson, 2018).…”