Christina Sakai1, Thomas I Mackie2, Rashmi Shetgiri3, Sara Franzen4, Anu Partap3, Glenn Flores3, Laurel K Leslie5. 1. Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, Mass. Electronic address: csakai@tuftsmedicalcenter.org. 2. Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Mass. 3. Division of General Pediatrics, Department of Pediatrics, The University of Texas Southwestern Medical Center at Dallas, Dallas, Tex; Children's Medical Center, Dallas, Tex. 4. Children's Medical Center, Dallas, Tex. 5. Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, Mass; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Mass.
Abstract
OBJECTIVE: To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. METHODS: Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. RESULTS: Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. CONCLUSIONS: Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care.
OBJECTIVE: To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. METHODS: Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. RESULTS: Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. CONCLUSIONS: Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care.