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. 2017 Jun;26(6):623-647.
doi: 10.1007/s00787-016-0930-6. Epub 2017 Jan 4.

What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies

Tessa Reardon  1 , Kate Harvey  2 , Magdalena Baranowska  1 , Doireann O'Brien  1 , Lydia Smith  1 , Cathy Creswell  1
Affiliations

What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies

Tessa Reardon et al. Eur Child Adolesc Psychiatry. 2017 Jun.

Abstract

A minority of children and adolescents with mental health problems access treatment. The reasons for poor rates of treatment access are not well understood. As parents are a key gatekeeper to treatment access, it is important to establish parents' views of barriers/facilitators to accessing treatment. The aims of this study are to synthesise findings from qualitative and quantitative studies that report parents' perceptions of barriers/facilitators to accessing treatment for mental health problems in children/adolescents. A systematic review and narrative synthesis were conducted. Forty-four studies were included in the review and were assessed in detail. Parental perceived barriers/facilitators relating to (1) systemic/structural issues; (2) views and attitudes towards services and treatment; (3) knowledge and understanding of mental health problems and the help-seeking process; and (4) family circumstances were identified. Findings highlight avenues for improving access to child mental health services, including increased provision that is free to service users and flexible to their needs, with opportunities to develop trusting, supportive relationships with professionals. Furthermore, interventions are required to improve parents' identification of mental health problems, reduce stigma for parents, and increase awareness of how to access services.

Keywords: Adolescents; Barriers; Children; Mental health; Treatment access.

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Figures

Fig. 1
Fig. 1
PRISMA flowchart
Fig. 2
Fig. 2
Perceived barrier/facilitator themes
Fig. 3
Fig. 3
Perceived systemic-structural barriers and facilitators: Percentage of quantitative* and qualitative** studies to report each barrier/facilitator. *Percentage of quantitative studies = Percentage of 24 included samples where a ‘medium’ (10-30) or ‘large’ (>30) percentage of participants endorsed the barrier/facilitator. **Percentage of qualitative studies = Percentage of 24 included studies that reported the barrier/facilitator
Fig. 4
Fig. 4
Perceived barriers and facilitators related to attitudes towards service providers and psychological treatment: Percentage of quantitative* and qualitative** studies to report each barrier/facilitator. *Percentage of quantitative studies = Percentage of 24 included samples where a ‘medium’ (10-30) or ‘large’ (>30) percentage of participants endorsed the barrier/facilitator. **Percentage of qualitative studies = Percentage of 24 included studies that reported the barrier/facilitator
Fig. 5
Fig. 5
Perceived barriers and facilitators related to knowledge and understanding of a child’s mental health problem and the help-seeking process: Percentage of quantitative* and qualitative** studies to report each barrier/facilitator. *Percentage of quantitative studies = Percentage of 24 included samples where a ‘medium’ (10–30) or ‘large’ (>30) percentage of participants endorsed the barrier/facilitator. **Percentage of qualitative studies = Percentage of 24 included studies that reported the barrier/facilitator
Fig. 6
Fig. 6
Perceived barriers and facilitators related to a family’s circumstances: Percentage of quantitative* and qualitative** studies to report each barrier/facilitator. *Percentage of quantitative studies = Percentage of 24 included samples where a ‘medium’ (10–30) or ‘large’ (>30) percentage of participants endorsed the barrier/facilitator. **Percentage of qualitative studies = Percentage of 24 included studies that reported the barrier/facilitator
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