Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study.
BACKGROUND
Child and adolescent mental health problems are common in primary care. However, few parents of children with mental health problems express concerns about these problems during consultations.


OBJECTIVE
To explore the factors influencing parental help-seeking for children with emotional or behavioural difficulties.


METHODS
Focus group discussions with 34 parents from non-specialist community settings who had concerns about their child's mental health. All groups were followed by validation groups or semi-structured interviews.


RESULTS
Most children had clinically significant mental health symptoms or associated impairment in function. Appointment systems were a key barrier, as many parents felt that short appointments did not allow sufficient time to address their child's difficulties. Continuity of care and trusting relationships with general practitioners (GPs) who validated their concerns were perceived to facilitate help-seeking. Parents valued GPs who showed an interest in their child and family situation. Barriers to seeking help included embarrassment, stigma of mental health problems, and concerns about being labelled or receiving a diagnosis. Some parents were concerned about being judged a poor parent and their child being removed from the family should they seek help.


CONCLUSIONS
Primary healthcare is a key resource for children and young people with emotional and behavioural difficulties and their families. Primary care services should be able to provide ready access to health professionals with an interest in children and families and appointments of sufficient length so that parents feel able to discuss their mental health concerns.
Section of Developmental Psychiatry, Division of Psychiatry, University of Nottingham, UK. kapil.sayal@nottingham.ac.uk
Kapil
K
Sayal
Victoria
V
Tischler
Caroline
C
Coope
Sarah
S
Robotham
Mark
M
Ashworth
Crispin
C
Day
Andre
A
Tylee
Emily
E
Simonoff
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care / Q000592:standards; D005192:Family Health; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010817:Physician-Patient Relations; D011320:Primary Health Care; D036301:Qualitative Research