title: Caregiver perceptions about mental health services after child sexual abuse.
abstract: The objective of this study was to describe caregiver perceptions about mental health services (MHS) after child sexual abuse (CSA) and to explore factors that affected whether their children linked to services. We conducted semi-structured, in-person interviews with 22 non-offending caregivers of suspected CSA victims<13 years old seen at a child advocacy center in Philadelphia. Purposive sampling was used to recruit caregivers who had (n=12) and had not (n=10) linked their children to MHS. Guided by the Health Belief Model framework, interviews assessed perceptions about: CSA severity, the child's susceptibility for adverse outcomes, the benefits of MHS, and the facilitators and barriers to MHS. Interviews were audio-recorded, transcribed, coded, and analyzed using modified grounded theory. Recruitment ended when thematic saturation was reached. Caregivers expressed strong reactions to CSA and multiple concerns about adverse child outcomes. Most caregivers reported that MHS were generally necessary for children after CSA. Caregivers who had not linked to MHS, however, believed MHS were not necessary for their children, most commonly because they were not exhibiting behavioral symptoms. Caregivers described multiple access barriers to MHS, but caregivers who had not linked reported that they could have overcome these barriers if they believed MHS were necessary for their children. Caregivers who had not linked to services also expressed concerns about MHS being re-traumatizing and stigmatizing. Interventions to increase MHS linkage should focus on improving communication with caregivers about the specific benefits of MHS for their children and proactively addressing caregiver concerns about MHS.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, 13th Floor, Philadelphia, PA 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104, USA; Division of General Pediatrics, The Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, 12th Floor Northwest, Philadelphia, PA 19104, USA.
authors.forename: Hiu-fai
authors.initials: HF
authors.lastname: Fong
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA.
authors.forename: Colleen E
authors.initials: CE
authors.lastname: Bennett
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, 12th Floor Northwest, Philadelphia, PA 19104, USA; PolicyLab, The Children's Hospital of Philadelphia, 3535 Market Street, Philadelphia, PA 19104, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Mondestin
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, 12th Floor Northwest, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA.
authors.forename: Philip V
authors.initials: PV
authors.lastname: Scribano
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA; PolicyLab, The Children's Hospital of Philadelphia, 3535 Market Street, Philadelphia, PA 19104, USA; Division of Emergency Medicine, The Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Mollen
authors.affiliation: Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104, USA; Division of General Pediatrics, The Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, 12th Floor Northwest, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA; PolicyLab, The Children's Hospital of Philadelphia, 3535 Market Street, Philadelphia, PA 19104, USA.
authors.forename: Joanne N
authors.initials: JN
authors.lastname: Wood
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D002651:Child Advocacy; D002653:Child Behavior Disorders / Q000523:psychology / Q000628:therapy; D000068216:Child Protective Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010465:Perception; D015143:Philadelphia; D012017:Referral and Consultation / Q000706:statistics & numerical data
keywords: Caregiver; Child; Mental health services; Sexual abuse; Therapy