Barriers to Pediatric Mental Healthcare Access: Qualitative Insights from Caregivers

Abstract

The Centers for Disease Control and Prevention approximates that 1 in 5 children experience a mental or behavioral health disorder. Pediatric mental healthcare service access cannot be improved without strong coordination between educational settings, social service providers for children, and adequate policy support. Addressing this critical child development issue is dependent on us understanding the barriers to mental healthcare access faced by pediatric populations. This qualitative study explored barriers to pediatric mental healthcare access based on in-depth interviews with 53 key informants representing childcare settings, K-12 schools, foster care settings, and evidence-based home visitation programs. Semi-structured interviews with participants identified barrier-related themes and subthemes. The themes reflect a series of hurdles related to pediatric mental healthcare access including, lack of preparedness/training for pediatric mental health screening and management, limited resources, lack of policy support, transportation, and family issues that have hindered mental health support for children. The findings highlight the compounding barriers to pediatric mental healthcare services and point to opportunities for improving pediatric mental health using a holistic approach. Future research should focus on designing and implementing community and organization-based strategies to break down these barriers for families to optimize their children’s mental health and wellness.

Keywords:

• Barriers
• educators
• caregivers
• pediatric
• mental healthcare
• social services

Acknowledgments

We thank all the participating organizations and individuals who helped us with the data collection. In addition, we thank Jessica Ern, MPH, and Jessica Pahwa, MPH, both Research Assistants at the Center for Reducing Health Disparities, for their help and contribution to this qualitative assessment. Also, we want to thank Jennifer Auman, Program Manager, and Kathy Karsting, RN, MPH Program Manager II, both at Nebraska-Maternal, Infant & Early Childhood Home Visiting Program, Division of Public Health, Nebraska Department of Health and Human Services, for their support and facilitating participant recruitment.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Informed Consent

Key informants were recruited and interviewed (via Zoom) on a pre-arranged day and time according to participants’ convenience. Before each interview, informed consent was emailed to potential participants to explain the study purpose, what participation in the study incurs, and foreseeable risk and benefit. At the beginning of the interview, informed consent was confirmed from those willing to participate.

Additional information

Funding

The original project was supported by the Health Resources and Services Administration’s (HRSA) Pediatric Mental Health Care Access Program, Grant No. U4CMC32322, with Nebraska Department of Health and Human Services (DHHS) as the lead state agency. This study’s views and opinions do not necessarily represent official views or endorsements by HRSA or Nebraska DHHS. Health Resources and Services Administration’s (HRSA) with Nebraska Department of Health and Human Services (DHHS).