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Help-seeking for early childhood mental health problems
thesisposted on 16.02.2017, 04:47 authored by Oh, Elizabeth
Children's mental health has significant implications for functioning across home, school, and community settings. The infant to preschool years has been found to be a crucial stage in a child’s development. As such, problems that arise during these years are likely to impact a child’s social and emotional development if no treatment is sought. Childhood mental health problems affect up to almost one quarter of children globally (Belfer, 2008; Canino, Bird, Rubio-Stipec, & Bravo, 1995; Egger & Angold, 2006). The negative sequelae of child mental health problems can include peer and learning difficulties, school dropout, substance abuse, poor vocational prospects, family conflict and suicide. Access to professional services in childhood may help reduce future mental health problems and address risk factors including parenting practices and social competence (Webster, Stratton, & Reid, 2004). Findings indicate that many children with mental health problems do not receive appropriate mental health treatment (Sawyer et al., 2001). In order to receive treatment, young children are primarily reliant on their parents to seek help on their behalf. This thesis is aimed at exploring early childhood mental health problems and factors that predict parents seeking professional help for their child. Understanding the patterns of need and service use, as well as parents’ underlying attitudes and beliefs regarding help-seeking is integral when developing early intervention programs and guiding public health policies. In light of the existing literature, the overarching aims of this thesis were i) examine the prevalence of mental health problems as well as the patterns and predictors of service use in young children ii) explore parents’ underlying help-seeking intentions and beliefs about young children’s mental health problems using the well validated Theory of Planned Behaviour iii) examine parents’ help-seeking pathways to accessing professional treatment when their young child has a mental health problem. Three studies are reported. The first study examined the prevalence rates of early childhood mental health problems and service use patterns during early toddlerhood, preschool and school entry age. The factors that influenced professional service in relation to child emotional and behavioural problems were also explored. It was found that few children with mental health problems accessed professional health services and even fewer accessed specialist mental health services. Facilitators to parents seeking help were recognition that their young child is difficult to manage and seeking help for their personal stress within the same year. The second study examined the construct of parental help-seeking for early childhood mental health problems. Intention to perform a behaviour has been proposed as a key factor in determining whether an individual will behave in a certain way. Using the ‘Theory of Planned Behaviour’, the study aimed to explore the most important factors that predict parents’ intentions to seek help if their child were to have a mental health problem. Findings indicated that the strongest predictor of help-seeking intentions were parents’ personal attitudes, and to a lesser extent the perceived opinions of other people. The key beliefs that distinguished parents with positive intentions were that mental health professionals would provide empathy/understanding, the right expert strategies to manage their young child’s difficulty, and that attending appointments is value for time and money. The final study of this thesis explored a model of parent help-seeking for early childhood mental health problems and whether parents’ intentions to seek help resulted in help-seeking behaviour when their own child was actually in need. It was found that parents are not following through and actually acting on their positive intentions and beliefs when their child has a mental health problem. Parents’ ability to recognise their child’s behaviour as problematic was a key barrier in the pathway to accessing professional services. Together, the findings from these three studies have implications for the detection and treatment of young children with mental health problems. The significant discrepancy between prevalence rates and professional service use highlights the issue of unmet need within young children. As the high rates of unmet need suggests that existing services are not reaching young children in need and thus their opportunity to receive appropriate treatment, it is critical to identify the factors that facilitate access and tailor new early intervention programs targeted at these families. Findings from this thesis suggest that addressing parents’ specific attitudes and beliefs about help-seeking for early childhood mental health problems may improve engagement and a desire to seek professional help. However, results also suggest that recognition of a young child’s difficulties plays a significant role in the help-seeking process within this sample. This has implications for parents of young children exhibiting behavioural or emotional problems as well as for services such as general practices or maternal child health centres who may be consulted about a child’s functioning.