Black and White Parents’ Willingness to Seek Help for Children's Internalizing and Externalizing Symptoms

Abstract

Objective: Understanding social and environmental factors that contribute to parental help-seeking intentions is an important step in addressing service underutilization for children in need of treatment. This study examined factors that contribute to parents' intentions to seek formal and informal help for child psychopathology (anxiety and attention-deficit/hyperactivity disorder [ADHD]). Method: A total of 251 parents (N = 128 mothers, N = 123 fathers; 49% Black, 51% White) read 3 vignettes describing children with anxiety, ADHD, and no diagnosis. Measures of problem recognition, perceived barriers, and formal (pediatricians, psychologists, teachers) and informal (religious leaders, family/friends, self-help) help seeking were completed. Four separate hierarchical logistic regression models were used to examine parental help-seeking likelihood from formal and informal sources for internalizing and externalizing symptoms. Predictors were socioeconomic status, parent race, age, and sex, parent problem recognition (via study vignettes), and perceived barriers to mental health service utilization.Result: Mothers were more likely than fathers to seek help from pediatricians, psychologists, teachers, and religious leaders for child anxiety and pediatricians, religious leaders, and self-help resources for child ADHD. Black parents were more likely to seek help from religious leaders and White parents were more likely to use self-help resources. Problem recognition was associated with greater intentions to seek help from almost all formal and informal sources (except from friends/family). Conclusion: Understanding factors that contribute to parental help seeking for child psychopathology is critical for increasing service utilization and reducing the negative effects of mental health problems. This study highlights the importance of decreasing help-seeking barriers and increasing problem recognition to improve health equity.

Exploring Racial Disparities in Mental Health Diagnoses and Neighborhood Disorganization Among an Urban Cohort of Children and Adolescents with Chronic Medical Conditions

“…38 In addition, studies have documented that Black cultural values of personal strength and addressing problems within the family or through religious practices may view seeking professional help for mental health problems as a sign of weakness. [39][40][41][42][43] Several structural health system factors are known barriers to Blacks receiving behavioral health care. First, historical racism that is embedded in medical research and clinical treatment has contributed to mistrust of providers and the mental health system.…”

Correlates of help-seeking by parents for the socioemotional development of their 3-year-old children: a longitudinal study

“…Previous research has suggested, especially among non-native parents, limited and difficult access to healthcare facilities. 20 66 Longitudinal and experimental studies are recommended to examine the differential pathways between parent–perceived versus diagnosed child psychosocial problems and the use of healthcare. Environment factors, including health care system and external environment, should be studied as contemplated by the Andersen model; taking into account access parents have to healthcare, but also barriers they perceive to make use of healthcare.…”

“…Previous studies have found that predisposing factors, such as child’s ethnic background and gender, are associated with parental help-seeking. 20 21 Enabling factors, such as higher parental educational levels and higher incomes, have been shown to positively encourage parents to seek help for their child’s problem behaviour (4–14 years old). 22 23 An important need factor that has been reported to increase help-seeking by parents is recognition of the child’s problem (6–11 years old).…”

Increasing mental health service utilization in Black populations during COVID-19: Clarifying clinician responsibility.

“…Particularly for Black parents, the church may play an important role in encouraging parents to seek mental health services for their child for both internalizing and externalizing problems. Previous research has demonstrated that Black adults more often turn to religious institutions for personal support than White adults (Thurston et al, 2018). Since Black populations are more likely to look to church leaders for support, it is crucial for clinicians to encourage clergy and other trusted agents at faith communities and religious jurisdictional bodies to make mental health care more accessible to Black families.…”