title: Barriers to and supports of family participation in a rural system of care for children with serious emotional problems.
abstract: Researchers have not adequately addressed the unique characteristics of rural areas that influence the accessibility of services for families with children who have serious emotional problems. Understanding rurality is particularly important to "systems of care" grant sites because these grants are intended to restructure mental health service delivery by building upon the strengths of a community and addressing the community's needs. This qualitative study examines the barriers to and supports for participation in services within a rural system of care site through the reported experiences of eight caregivers and nine staff. Findings indicate families face many challenges related to rurality, including stigma, transportation, isolation, poverty, and service availability. In addition to these challenges, however, participants reported many meaningful supports such as the religious community and the close-knit community of families and service providers. We present implications for planning, implementing, and evaluating systems of care in rural areas.
authors: Department of Human and Organizational Development, Peabody College of Vanderbilt University, 230 Appleton Place, Peabody Box 90, Nashville, TN 37203, USA. Michael.D.Pullmann@Vanderbilt.edu
authors: Michael D
authors: MD
authors: Pullmann
authors: Sarah
authors: S
authors: VanHooser
authors: Cheri
authors: C
authors: Hoffman
authors: Craig Anne
authors: CA
authors: Heflinger
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012720:Severity of Illness Index