Barriers to Help Seeking for Mental Disorders in a Rural Impoverished Population

This study examined barriers to seeking mental health care reported by individuals in a rural impoverished population, by screening 646 randomly selected adults for depression, anxiety, and alcohol abuse. Respondents who screened positive were randomly assigned to one of three groups: (1) no intervention, (2) an educational intervention alone, or (3) the educational intervention in the presence of a significant other. Those who screened positive for disorders cited barriers to care at significantly higher rates than respondents who screened negative. Respondents who received the educational intervention endorsed several barriers at significantly lower rates in the follow-up telephone call (subsequent to the intervention) than in the original interview (prior to the intervention). Virtually all respondents in a subsample of 142 subjects (99.3%) said they would seek mental health care if they thought mental health services would help them.     

An Overview of Help Seeking by Problem Gamblers and their Families Including Barriers to and Relevance of Services

Research demonstrates that gambling support services often do not meet the needs of people seeking help for their gambling problems. In particular, the needs of cultural groups, and gender-specific needs of men and women are neglected. Understanding differences in help seeking behaviour can assist in developing early interventions to address gambling related problems and in developing effective strategies. This paper reviews the literature on help seeking by problem gamblers and their families, including barriers to and relevance of services through a gender and cultural lens. Research findings from international and New Zealand studies are examined, highlighting ways in which gender and culturally appropriate strategies can be implemented. Ways of changing barriers and social policies are proposed which may improve the responsiveness of services. Ultimately it may encourage health care access and utilisation for people and their families seeking help for problem gambling.     

Barriers to Mental Health Help Seeking at School for Asian– and Latinx–American Adolescents

Adolescents are most likely to receive mental health services in schools compared to other settings; however, few studies have examined barriers to mental health help seeking at school for ethnic minority adolescents. The current mixed-methods study utilized surveys and semi-structured interviews to explore the mental health literacy (MHL), stigma toward mental illness, and perceived barriers toward help seeking at middle or high schools among 55 adolescents (81.8% female; 50.0% Asian–American, 44.6% Latinx–American, 5.4% Asian/Latinx bi-racial; M age = 17.13 years, SD = 2.33). Participants’ MHL was assessed using case vignettes that depicted adolescents with symptoms of depression or bulimia. Overall, 83.9% of participants correctly recognized depression and 57.1% correctly recognized bulimia from the vignettes. Stigma correlated with perceived helpfulness of the formal service providers (r = − .37, p < .01). Qualitative analysis of participant interviews revealed important knowledge, attitudinal, and practical barriers that inhibit Asian– and Latinx–American adolescents from seeking help for mental health problems at school. The current work has implications to assist school personnel and mental health providers in understanding and reducing barriers to help seeking for Asian– and Latinx–American adolescents.     

Facilitators and Barriers to Family Involvement in Problem Gambling Treatment

Research has shown that family involvement in problem gambling (PG) treatment is important because families are significantly impacted and their involvement can improve treatment outcomes for the family and PG individual. This qualitative study examined facilitators and barriers to family involvement in PG treatment with a sample of PG individuals and family members (n = 11 dyads) receiving treatment at an addiction/mental health treatment centre. The study found that communication, coping skills and support facilitated family involvement; while conflict, isolation, mental health concerns and substance use were barriers to family involvement. There were three types of family involvement among participants in this study including high, moderate and low involvement. Families with high involvement described several facilitators and no barriers to family involvement. They had better treatment outcomes, as well as more positive individual and family functioning. The study demonstrates the importance and complexity of family involvement. Practice and research implications are discussed.     

Barriers and Facilitators in Implementing Illness Management and Recovery for Consumers with Severe Mental Illness: Trainee Perspectives

We conducted an on-line survey of clinicians who attended training on illness management and recovery (IMR) to identify the extent of implementation and barriers and facilitators of IMR practice. Of 89 direct service providers, 50.6% reported using the formal IMR curriculum, 25.8% reported using parts of IMR, and 23.6% never used IMR following training. Factor analysis of facilitator items revealed three internally consistent factors: agency leadership support, program level structure, and job-related structural support. Participants who used formal IMR endorsed a greater percentage of overall facilitators, and scored higher on each of the three factors of agency leadership support, program-level structures (e.g., fidelity reports) and job-related structures (e.g., presence of weekly supervision). In addition to training and toolkit materials, attention needs to be given to other elements to support IMR implementation.     

Project IMPACT: A Report on Barriers and Facilitators to Sustainability

Project IMPACT is a collaborative care intervention to assist older adults suffering from major depressive disorder or dysthymia. Qualitative research methods were used to determine the barriers and facilitators to sustaining IMPACT in a primary care setting. Strong evidence supports the program’s sustainability, but considerable variation exists in continuation strategies and operationalization across sites. Sustainability depended on the organizations’ support of collaborative care models, the availability of staff trained in the intervention, and funding. The intervention’s success was the most important sustainability factor, as documented by outcome data and through the “real world” experience of treating patients with this intervention.     

Age-Related Concerns of Male Veteran Callers to a Suicide Crisis Line

In July 2007, the United States Department of Veterans Affairs (VA) partnered with the Department of Health and Human Services’ Substance Abuse and Mental Health Service Administration (SAMHSA) to create the Veterans Crisis Line (VCL) in order to meet the unique needs of Veterans in distress. The current study utilized a mixed methods design to examine characteristics of male callers to the VCL. Results from qualitative analyses demonstrated that the majority of callers between April 1 and August 31, 2008 contacted the VCL with concerns related to mental health issues, suicide ideation, and substance abuse issues. Quantitative analyses demonstrated age differences associated with concerns presented by callers such that middle-aged and older callers were more likely to present with loneliness and younger callers were more likely to present with mental health concerns. The results of this study will help to inform future research designed to optimize the effectiveness of the VCL for suicide prevention in Veterans.     

Veteran Perspectives on Adaptations to a VA Residential Rehabilitation Program for Substance Use Disorders During the Novel Coronavirus Pandemic

Community Mental Health Journal - Individuals attending residential rehabilitation programs for substance misuse are particularly vulnerable to treatment disruptions spurred by the novel...     

Barriers and Facilitators of Addiction Treatment: a Qualitative Study

International Journal of Mental Health and Addiction - Addictive disorders affect a considerable proportion of the population worldwide and in India. Treatment-related barriers and facilitators...     

Barriers and Facilitators to Children's and Young People's Views Affecting CAMHS Planning and Delivery

The views of children and young people about the mental health services they receive are central to the tenets of recent government health services policymaking. But do changes to service delivery result from research or projects eliciting children's and young people's views? This article presents evidence that changes may well not result and then discusses what prevents or facilitates CAMHS acting on recommendations gained from user views.     

Barriers and Facilitators of a Healthy Lifestyle Among Persons with Serious and Persistent Mental Illness: Perspectives of Community Mental Health Providers

The investigators used qualitative methods to examine perspectives of community mental health professionals on obesity management in adults with serious mental illness (SMI). Data from 5 focus groups were subjected to constant comparison analysis and grounded theory. Results showed that influences at individual, social, community, and societal levels impact development and maintenance of obesity. Mental health providers desired a collaborative relationship with health promotion program staff. They also believed that frequent, group-based health promotion should include participation incentives for adults with SMI and should occur over durations of at least 6-months to achieve improved health outcomes for this population.     

Facilitators and Barriers to Support Group Participation for Family Caregivers of Adults with Mental Illness

OBJECTIVE: Few low-income and minority caregivers of persons with serious mental illness participate in support groups. This study examined the facilitators and barriers to participation in support groups for families of persons with serious mental illness among lower socioeconomic African-American and Caucasian family caregivers. Three hypotheses were tested in a multivariate model which included need, enabling and predisposing variables utilizing a revised version of the Andersen model. Support group membership was hypothesized to be predicted by a higher perceived cost-benefit ratio (benefits minus costs) of group participation, fewer numbers of access barriers and higher levels of service use. METHODS: A non-experimental cross-sectional design was used. Subjects were 145 lower socioeconomic status African-American and Caucasian family caregivers, 65 of whom were current support group members and 80 of whom had never participated in support groups. RESULTS: Findings confirmed that support group members reported a more favorable cost-benefit ratio and fewer access barriers than did non-support group members, controlling for other variables. Level of non-support group service use was not significantly different for support and non-support group members. CONCLUSIONS: Non-members' assessments of support group participation may be based on inaccurate perceptions and/or incomplete knowledge. Educational campaigns, sponsored by support groups and mental health authorities focusing on both perceptions about support groups as well as structural impediments to participation, such as access barriers, should be undertaken.     

Positive and Negative Emotions Related to Seeking Help from a School Counselor

This study explored emotions associated with help-seeking, as measured in secondary school students, school teachers and parents of secondary school students. Participants completed two questionnaires: Ishiyama's (2005) Professional Help-seeking Attitude Scale (PHAS) and a questionnaire on attitudes to seeking help from a school counselor, with regard to four types of problem (school, work, interpersonal and intimate). Findings show that all three groups of respondents felt negative emotions about help-seeking to a greater extent than positive emotions. Such negative emotions were more evident among males. However, the shift from a generally negative attitude to help-seeking to readiness to seek help in times of need was associated with the level of positive emotions about help-seeking, rather than the level of negative emotions about help-seeking. This is a call for mental health professionals to invest in changing attitudes to help-seeking among all populations related to school settings, including students, teachers and parents. It is further suggested that interventions that address reluctance to seek professional help should strive not only to relieve negative emotions, but also to foster positive emotions that can be associated with help-seeking.     

What Teens Want: Barriers to Seeking Care for Depression

This study examined the experiences of teenagers seeking and receiving care for depression from primary care providers. We investigated teens’ perceived barriers in obtaining care to determine how primary care can effectively address depressed teens’ stated needs. In-depth individual (n = 15) and focus group (n = 7) interviews with adolescents were conducted and analyzed using grounded theory and prominent themes were identified. Teenagers reported faring best when providers actively considered and reflected upon the teenagers’ developmentally appropriate desires to be normal, to feel connected, and to be autous. These goals are achieved by providers establishing rapport, exchanging information about depression etiology and treatment, and helping teens make decisions about their treatment. To the extent that providers improve efforts to help teens feel normal, autonomous, and connected, the teens report they are more likely to accept treatment for depression and report success in treatment.     

Evidence-Based Mental Health Programs in Schools: Barriers and Facilitators of Successful Implementation

Although schools can improve children’s access to mental health services, not all school-based providers are able to successfully deliver evidence-based practices. Indeed, even when school clinicians are trained in evidence-based practices (EBP), the training does not necessarily result in the implementation of those practices. This study explores factors that influence implementation of a particular EBP, Cognitive Behavioral Intervention for Trauma in Schools (CBITS). Semi-structured telephone interviews with 35 site administrators and clinicians from across the United States were conducted 6–18 months after receiving CBITS training to discuss implementation experiences. The implementation experiences of participants differed, but all reported similar barriers to implementation. Sites that successfully overcame such barriers differed from their unsuccessful counterparts by having greater organizational structure for delivering school services, a social network of other clinicians implementing CBITS, and administrative support for implementation. This study suggests that EBP implementation can be facilitated by having the necessary support from school leadership and peers.     

Facilitators and Barriers to Service User Involvement in Mental Health Guidelines: Lessons from The Netherlands

This study is the first in-depth qualitative study of service user involvement in the development of multidisciplinary mental health guidelines in the Netherlands. The study comprised a desk study of guidelines (n = 12) and case studies of service user involvement in five guidelines using document analysis, interviews (n = 24) and observations. The desk study shows that all multidisciplinary mental health guidelines have taken service user perspectives into account to some extent. The five guideline case studies led to the identification of ten main themes. Findings will assist guideline developers in making early, informed decisions on involving service users effectively.     

Barriers and Facilitators to Engagement and Retention in Care among Transgender Women Living with Human Immunodeficiency Virus

Background

Transgender women have 49 times the odds of human immunodeficiency virus (HIV) infection compared to other groups, yet they are disproportionately underserved by current treatment efforts.

Purpose

This study aimed to examine culturally unique barriers and facilitators to engagement and retention in HIV care and strengthen efforts to mitigate health disparities, guided by the Models of Gender Affirmation and Health Care Empowerment.

Methods

Through 20 interviews and five focus groups (n?=?38), transgender women living with HIV discussed their experiences and life contexts of engagement in and adherence to HIV care and treatment.

Results

Our participants faced substantial challenges to adhering to HIV care and treatment, including avoidance of healthcare due to stigma and past negative experiences, prioritization of hormone therapy, and concerns about adverse interactions between antiretroviral treatment for HIV and hormone therapy. Receiving culturally competent, transgender-sensitive healthcare was a powerful facilitator of healthcare empowerment.

Conclusions

Recommendations are offered to inform intervention research and guide providers, emphasizing gender affirming HIV care that integrates transition-related healthcare needs.