Examining Perceptions About Mental Health Care and Help-Seeking Among Rural African American Families of Adolescents

Abstract

Rural African American children living in poverty have a higher prevalence rate of mental health disorders than their urban counterparts. While access to mental health services is lacking in resource scarce rural communities, African American rural residents may also be the most likely to confront significant barriers to care and help-seeking. Studies of mental health help-seeking behavior among rural families are rare, even rarer are studies of African Americans living in these areas. To address this gap, the current study examined perceptions about help-seeking for adolescents with mental health problems among rural African American families. Data were obtained from African American mothers in rural Georgia to assess their perceptions of the mental health service system, help-seeking processes, and service experiences. A mixed-method approach was implemented, integrating a quantitative survey (n = 163) with qualitative interviews (subsample n = 21). Most of the mothers expressed confidence in mental health care providers' to help. Preferred sources of support, however, were family, church, and schools. Community stigma towards children with mental health problems and their families was a frequently endorsed perceived barrier to help-seeking. Although cultural mistrust was one of the two most frequently endorsed barriers in the survey, it did not emerge as a universal barrier to help-seeking for the mothers in this sample. Implications for research, policy, and practice include addressing family concerns about stigma, preferences for informal support and non-specialty services in addressing adolescents' mental health problems, and building community resources to enable all youth to participate in community life.

Addressing the Mental Health Needs of Pregnant and Parenting Adolescents

“…49 Rates are often much lower for youth who are poor, of ethnic minority status, or from disadvantaged backgrounds. 50,51 Youth and families from impoverished communities face many barriers to treatment, which may explain the disparities in access to mental health care. First, mental health services in urban and rural communities are often inadequate or insufficient to meet the mental health needs of low-income youth, particularly those from families that rely on public or communitybased health care services.…”

“…As a result, many youth receive mental health services in the primary care setting; however, primary care providers vary in their expertise and ability to treat mental health disorders in adolescents. 50,51 Lack of insurance, time availability, and transportation, which are especially salient issues for teenage parents, may also impede access to mental health services. Although some states allow adolescents to consent for mental health care, teens may still refuse or avoid services out of fear that their parent or guardian will discover their help seeking.…”

“…Furthermore, when pediatricians directly facilitate and encourage access to mental health services, mothers are more likely to use them. 50 Perhaps the best method for engaging teen mothers in behavioral health services is to integrate them directly into a primary care setting with a multidisciplinary treatment team. Mothers who are reluctant to seek services for themselves might be more amenable to dyadic work with a focus on their child.…”

A Randomized Controlled Trial of a Depression Prevention Curriculum for Rural Middle School Girls: Initial Findings and 6-Month Follow-up

“…Potential peer group facilitators (ages [16][17][18] were recruited from the local high school's Family, Career, & Community Leaders of America (FCCLA) program. The research staff presented the opportunity to the female students enrolled (n = 88) in all sections (n = 5) of this course offered on the campus and gave interested students applications (n = 30) to apply to become a peer group facilitator.…”

“…While the above findings are important to consider when thinking about depression prevention for rural youth, rural communities present additional challenges that must be addressed. For example, rural areas tend to be more impoverished and have greater proportions of ethnic minorities [17][18][19][20][21]. Along with greater proportions of lowincome families, rural communities lack access to the healthcare facilities and services that are typical within urban communities [8,[10][11][12][13].…”