The Barriers Perceived by Teenagers in Accessing Mental Health Care - Term Paper Example

Running Header: The barriers perceived by teenagers in accessing mental health care Client inserts his/her name Client inserts tutor’s name Subject of Study Date Part A: Framing a research question Introduction Many teenagers choose not to seek mental health care despite the self-perceived need for mental health services (Elliot & Larson, 2004, p.303). When adolescent feel that they need mental health assistance or counseling and fail to access the mental health services, it results into untreated and deteriorative mental health status. This presents a significant health problem in the society. According to the U.S. Department of Health and Human Services[DHHS], (1999, p.2), a report on children’s mental health services by the former U.S. Surgeon David Satcher point out that 1 to about 10 teenagers in the United States suffer from mental illnesses and yet few of them receive the required mental health services. As a result of this, many youths all over the world may be at a risk of not reaching their potential either socially or academically due to untreated mental health statuses. This research therefore focuses on finding out the barriers perceived by teenagers in accessing mental health care. Rationale of the study From the description of the research problem, it is evident that this study is of much significance in the field of mental health management especially for adolescents and children. The study is necessary so as to reveal the barriers perceived by teenagers in accessing mental health care and hence help in formulating strategies through which the worsening teenage mental health problem facing many nations can be solved. The research findings will be of much use for future researches on the same topic as they form the foundation for developing potential solutions to encourage youth to seek mental health services. PICO Worksheet and Search Strategy 1. Define your question using PICO by identifying: Problem, Intervention, Comparison Group and Outcomes Your question should be used to help establish your search strategy. Patient/Problem_____Teenagers with metal health problem Intervention________Creation of awareness to minimize stigmatization Comparison_________Improving mental health services Outcome____________Improved access to mental health care by teenagers Write out your Question: Does minimization of stigma associated with mental illness lead to improved access to mental health care by teenagers? 2. Type of question/problem: Circle (or Highlight) one: Therapy/ Prevention/ Diagnosis/ Etiology/ Prognosis/ Human Interest 3. Type of study (Publication Type) to include in the search: Check all that apply: (HINT: if you type this out in a Word document you can use symbols to insert checked boxes) Meta-Analysis ❏ Systematic Review ❏ Randomized Controlled Trial ❏ Cohort Study ❏ Case Control Study ❏ Case series or Case Report ❏ Editorials, Letters, Opinions ❏ Animal Research ❏ In Vitro/Lab Research ❏ Qualitative ❏ 4. List main topics and alternate terms from your PICO question that can be used for Your search Mental health care Barriers perceived by teenagers in accessing mental health care Stigmatization in relation to mental sicknesses List your inclusion criteria – gender, age, year of publication, language. List irrelevant terms that you may want to exclude in your search. Causes and diagnosis of mental health sickness Treatment of mental health sicknesses 5. List where you plan to search, i.e. EBM Reviews, Medline, AIDSLINE, CINAHL, PubMed Part B: Literature review According to Elliot & Larson (2004, p.304), teenagers are known to experience difficulties in accessing mental health care services. Elliot and Larson carried out a study back in the year 2004 to investigate the barriers perceived by some adolescents living in rural communities and the associated risk factors of foregone mental medical care. The researchers used a sample of 15-17-year-old tenth grade students and some non-attending teenagers in Midwestern County in North America. The results of this study indicated that 44% of the teenagers reported having forgone mental health services due to various reasons. Some of the barriers highlighted by the participants included: cost of mental health care, lack of coverage for injuries and sickness, lack of knowledge on the importance of seeking mental health services, stigma associated with mental sickness, embarrassment among others. The two researchers concluded that some of the barriers perceived by teenagers in accessing mental health care included lack of access to the providers, lack of insurance coverage/funds, issues with parenting, stigmatization and confidentiality issues. According to the researchers, most of the participants who reported to have forgone mental health care are the ones who were once involved in dangerous activities under peer pressure. This is due to the fear that their mental health condition would have been associated to their involvement in risky behaviors. This implies that most of the youth choose not to seek mental medical care due to the stigma associated with the illness. The researchers therefore recommended mental health practitioners should focus on creating more awareness in order to minimize stigmatization associated with mental illness to encourage teenagers to seek mental health care. 89 Hmong high school students in China were used in a study conducted by Meng (2013), to investigate teenagers’ attitudes towards seeking mental health services and the perceived barriers. Meng’s main hypothesis stated that the perceived family stigmatization would be related to self perceived stigmatization. The results of the study confirmed this hypothesis by indicating that family and self perceived stigmatization were directly correlated. In his discussion, the author points out those teenagers from poor and minority families are at the highest risk of not accessing mental health care. According to the author, most of these teenagers from poor families are also at a high risk of developing mental illnesses as a result of depression due to the low economic status. From the research, it is quite clear that family and self stigmatization is the most significant barrier hindering teenagers from accessing mental health care. Meng points mental illness is associated with various factors in various communities which results into ether family or self stigmatization. Some parents feel ashamed when their teen children develop mental illness and due to this may fail to accompany them or finance their medical needs. Mend advices that there is need for awareness creation through campaigns and community-based education programs in order to overcome the stigma associated with mental illnesses and hence encourage youth to seek mental health care. A study carried out by Francis, Boyd and Aisbett and others in 2006 to explore the barriers perceived by adolescents living in rural areas in seeking mental healthy services for various mental health problems. The researchers recruited 52 students from year 9 and 10 rural-based Victorian high schools. The results of this study indicated that there were recurring themes of common obstacles to mental health care as observed by the participants. These common obstacles included: fear of social stigma, lack of mental heath care providers, and inaccessibility of the few providers due to transport needs, health cost, and lack of awareness among others. The researchers argue that there are few if any mental health care providers in rural areas and the few are always serving long queues of patients, making it difficult for all the people with such health condition to access the mental health care services provided by them. Recurring themes across all groups were .The researchers conclude by pointing out that it is highly important that the health policy makers recognize the fact that rural settings create additional barriers that hinder teenagers from seeking mental health care. Therefore, the researchers advise that it is important that special programs are designed to fit into the rural context in order to assist teenagers in overcoming barriers to mental health care. From the authors’’ perspective, it is also important that policy makers develop school-based mental health services since it is clear from the research that many rural teenagers prefer seeking medical help from them. Part C: Construction of an appropriate research methodology and method Criteria 1 – Research design The research will take a qualitative approach as it aims to explain the social phenomena by answering the question as to why teenagers may fail to access mental health care. The research design chosen is ethnography. Ethnography involves the qualitative study of human behavior as exhibited by social or cultural groups. Ethnography is the best design to explain teenagers’ behavior and attitudes associated with teenagers and their attitudes towards seeking mental health services and the perceived barriers. The research design will offer detailed first-hand information on barriers perceived by teenagers in accessing mental health care since the data will be conducted over an extended period of time. Criteria 2 – Participants 52 teenagers aged between the years 15-19 will be recruited from Headspace Local Youth Mental Health Centre. All the participants included should have experienced or currently suffering from some form of mental illness. First, the Centre’s management team will be approached for official permission. After being granted the official permission, all the willing teenagers eligible for the study in terms of age and mental health condition will be asked to register themselves for the study. After getting the 52 participants, they will be asked to sign a consent form to show that they will participate in the study under no coercion or force. Criteria 3 – Research setting The research will be conducted in a local mental health Centre by the name Headspace Local Youth Mental Health centre. This setting is suitable for this research it is in a local location and as literature review indicate rural settings offer additional barriers encountered by teenagers in accessing mental health care. Criteria 4 – Data collection Data will mainly be collected through the use of an open-structured questionnaire. Once the participants have been enrolled for the study, each will be issued with a questionnaire. The questionnaire will be developed in such away that it will include all relevant questions aimed at revealing the participants’ perceptions in relation to barriers to seeking mental health care. From the 52 participants, 5 of them will be chosen for detailed interviews in order to gather an in-depth data on barriers as perceived by teenagers in accessing mental health care. The five interviews will be audio-recorded and structured with the same questions in order to bring out recurring themes from the response given by the five respondents. Criteria 5 – Data analysis The collected qualitative data will be analyzed using thematic analysis. All potential themes arising from the response gathered will be listed down. Since structure interviews will be used, there is a probability that there will be recurring themes arising from the study. The identified themes will then be analyzed and discussed into details so as to explain the barriers perceived by teenagers in accessing mental health care. The thematic analysis will provide a highly meaningful structure to explain the responses gathered from the questionnaires and the interviews. The emerging themes from the data gathered will also be insightful in developing the solutions to the established barriers to mental health care as perceived by teenagers. Criteria 6 – Ethical considerations Psychological and other risks to the participants The method used I recruiting the participants may pose some minor psychological risk to the already psychological unstable participants. It is important to point out that the participants will have to undergo a psychological test before being enrolled or the study. The test may negatively affect some of the participant psychological wellbeing. steps that will be taken to ensure protection of the participants’ physical, social and psychological welfare The data gathered from the participants will be handled with confidentiality. The participants will be handled with respect through out the study. No coercion will be used. The study is designed in such away that it will be beneficial to the participants by enhancing their psychological wellbeing. Communication of the research’s aims to the participants The aims of the research which is to find out the perceived barriers to mental health care by students will be communicated effectively. The participants will under a session of briefing whereby they will be informed of all the aims of the study. Steps to be taken to ensure informed consent of the participants/guardians As explained earlier, the participants will be recruited for this study on voluntary basis. The participants/guardians will sign a consent form before participating in the study to indicate that they are willing to take part in study. The participants will be informed of all the procedures and the period of time that the study will take before signing the consent form. The participants will also be assured f their freedom to withdrawal from the study at any time without any fear of the shortcomings. Measures which will be taken to ensure the confidentiality of the participants The participants will fill in their questionnaires at their own preferred locations where thy feel more secure. The interviews will also be carried out in a secluded serene location, in order to ensure the confidentiality of the participants. How to store and protect the confidentiality of the data. The filled questionnaires and recorded interviews will be stored in a secure place which cannot be accessed by any person without permission. The data will only be used for enhancing mental health research and no other purposes. Bibliography Elliott, B. A., & Larson, J. T. (2004). Adolescents in midsized and rural communities: Foregone care, perceived barriers, and risk factors. Journal of Adolescent Health, 35, 303-309. Francis, K., Boyd, C., Aisbett, D., Karyn N. & Krystal, N. (2006). Rural adolescents’ attitudes to seeking help for mental health problems. Youth Studies Australia, Vol 25(4): 42-49. Meng, K.V. (2013). Mental health: Identifying barriers to Hmong students' use of mental health services. Dissertation. Available at: http://udini.proquest.com/view/mental-health-identifying-barriers-goid:755757022/ [Accessed on 11th April 2013] U.S. Department of Health and Human Services. (1999). Report of the Surgeon General's Conference on Children's Mental Health: A national action agenda. Retrieved August 4, 2003, Available at: from http://www. surgeongeneral.gov/cmh/childreport.htm [Accessed on 12th April 2013]. Read More