Why Lower Income Mothers Do Not Engage With the Formal Mental Health Care System: Perceived Barriers to Care

Abstract

Lower income mothers who bring their children for mental health services also have high rates of depression and anxiety, yet few seek help. Maternal and child mental health are intimately intertwined; thus, the distress of both is likely to continue if the mother's needs are unaddressed. Because mothers overcome numerous instrumental challenges to help their children, the authors identify potential perceptual barriers to mothers' help seeking. An ethnographic analysis of in-depth qualitative interviews with 127 distressed mothers suggests several critical perceptual factors. For example, mothers attributed their distress to external causes (e.g., poverty, negative life stressors), which they believed individually focused mental health services could not affect. Interviewees also anticipated negative ramifications for seeking care, including being labeled unfit mothers, and thus potentially losing custody of their children. The authors discuss the implications of these and other key themes for engaging lower income mothers and their children.

Barriers to Mental Health Treatment Services for Low-Income African American Women Whose Children Receive Behavioral Health Services: An Ethnographic Investigation

“…Qualitative methods provide insight and understanding into the processes, motivations, events, and actions that have contributed to the observed phenomena (Anderson et al, 2006;Copeland & Scholle, 2000;Copeland et al, 2003;Rundall, Devers, & Sofaer, 1999). The ethnographic instrument used in the current study was developed to allow the mothers to tell their own story.…”

“…Although several studies have investigated the relationship between poverty and mental health status in African Americans in general (Miranda et al, 2003;Todd & Worell, 2000), little is known about the impact of multiple life stressors of African American women who meet the criteria for depression and/or anxiety and take their children in to receive mental health services but still face barriers when seeking care for themselves. This article presents the results from the ethnographic interviews, of the African American sample from a parent study, which sought to explore why mothers who seek mental health services for their children do not receive mental health services for themselves (Anderson et al, 2006). The following research questions were addressed: (1) what stressors do African American women who meet baseline criteria for anxiety and/or depression and whose children are receiving mental health services face in their day-to-day lives?…”

“…Four of the themes are consistent with other studies that found that low-income African American women have high levels of stress and depressive symptoms as a result of a chaotic lifestyle (Alder et al, 1994;Chadiha & Brown, 2002;Fischer, & Shaw, 1999;Garrison, Jackson, Marstellar, McKeown, & Addy, 1990;Keith & Riley, 2001;Klonoff et al, 1999;Kwate, Valdimarsdottir, Guevarra, & Bovbjerg, 2003;Lincoln-Smith, 1998). However, the fear of losing one's children as a result of seeking mental health treatment has been given very little attention in the literature (Anderson et al, 2006).…”

PROYECTO MAMÁFELIZ: Estudio sobre la Salud Mental prenatal a través de Internet

“…Mencionaremos a este respecto, el estigma social asociado a los trastornos mentales puesto que dificulta la búsqueda de tratamiento, lo cual junto a otras limitaciones como, el temor a que el profesional sanitario paute tratamiento farmacológico, la falta de conocimientos sobre si la sintomatología que la mujer experimenta es normal o no y el temor a que sus preocupaciones no sean tomadas en consideraciónse definen como factores determinantes a la hora de buscar ayuda (Dennis y Chung-Lee 2006;Flynn et al, 2010;Reay et al, 2011). Asimismo, sentirse avergonzada por estar deprimida y creer en la necesidad de mostrar sentirse bien en todo momento (Bennett et al, 2007;McIntosh, 1993;Small, Brown, Lumley y Astbury, 1994), esforzándose por reducir al mínimo las dificultades que realmente experimentan (Holopainen, 2002;Whitton, Warner y Appleby, 1996), además de no considerar que los trastornos emocionales son un problema de salud (Anderson et al, 2006;Dennis y Chung-Lee, 2006;McIntosh, 1993;Small et al, 1994) son también algunos de los pensamientos y conductas erróneas que siguen presentes en nuestro entorno social.…”

“…Anderson et al, 2006;Benett et al, 2002;Byatt et al, 2012;Holopainen, 2002;Kingston et al, 2015c;McIntosh, 1993;Small et al, 1994;Sword et al, 2008;Whitton et al, 1996;Woolhouse et al, 2009.…”