Elizabeth Barnert1, Mikaela Kelly2, Sarah Godoy2, Laura S Abrams3, Eraka Bath2. 1. Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children's Hospital, UCLA Pediatrics, 2-467 MDCC, Los Angeles, CA, 90095-1752, United States. Electronic address: ebarnert@mednet.ucla.edu. 2. Department of Psychiatry, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Room A8-228, Los Angeles, CA, 90024, United States. 3. Department of Social Welfare, UCLA Luskin School of Public Affairs, 5323 Public Affairs Building Los Angeles, CA, 90095-1656, United States.
Abstract
BACKGROUND: Adolescent females with histories of commercial sexual exploitation (CSE) have high mental health and substance use treatment needs, yet little is known about their perspectives regarding behavioral health and behavioral health treatment. OBJECTIVE: We sought to understand the attitudes of adolescent females with histories of CSE regarding behavioral health to identify factors influencing "buy-in" to behavioral healthcare. PARTICIPANTS AND SETTING: Participants included 21 adolescent females, affiliated with our partner organizations (two group homes, a service agency, and a juvenile specialty court), who reported having exchanged sex for something of value. METHODS: In-depth qualitative interviews explored participants' perspectives towards behavioral health. We conducted thematic analysis to identify themes concerning behavioral health. RESULTS: Participants provided insightful definitions of "mental health" that included positive and negative aspects of emotional and cognitive states (e.g. "being happy with yourself" and "not thinking suicidal"), indicating intensified mental health challenges and resilience. Substance use was viewed as a coping mechanism for childhood trauma and their exploitation. Trusted relationships with providers and navigable health systems that encourage autonomy were key to promoting "buy-in" and thus engagement in behavioral health treatment. A conceptual model emerged illustrating factors leading to treatment engagement. CONCLUSION: Adolescent females with histories of CSE constitute a vulnerable population with high levels of trauma as well as unmet mental health and addiction treatment needs. The delivery of trauma-focused, behavioral healthcare centered on patient-provider trust and shared-decision making that encourages client autonomy should be prioritized.
BACKGROUND: Adolescent females with histories of commercial sexual exploitation (CSE) have high mental health and substance use treatment needs, yet little is known about their perspectives regarding behavioral health and behavioral health treatment. OBJECTIVE: We sought to understand the attitudes of adolescent females with histories of CSE regarding behavioral health to identify factors influencing "buy-in" to behavioral healthcare. PARTICIPANTS AND SETTING:Participants included 21 adolescent females, affiliated with our partner organizations (two group homes, a service agency, and a juvenile specialty court), who reported having exchanged sex for something of value. METHODS: In-depth qualitative interviews explored participants' perspectives towards behavioral health. We conducted thematic analysis to identify themes concerning behavioral health. RESULTS:Participants provided insightful definitions of "mental health" that included positive and negative aspects of emotional and cognitive states (e.g. "being happy with yourself" and "not thinking suicidal"), indicating intensified mental health challenges and resilience. Substance use was viewed as a coping mechanism for childhood trauma and their exploitation. Trusted relationships with providers and navigable health systems that encourage autonomy were key to promoting "buy-in" and thus engagement in behavioral health treatment. A conceptual model emerged illustrating factors leading to treatment engagement. CONCLUSION: Adolescent females with histories of CSE constitute a vulnerable population with high levels of trauma as well as unmet mental health and addiction treatment needs. The delivery of trauma-focused, behavioral healthcare centered on patient-provider trust and shared-decision making that encourages client autonomy should be prioritized.
Authors: Mikaela A Kelly; Eraka P Bath; Sarah M Godoy; Laura S Abrams; Elizabeth S Barnert Journal: J Pediatr Adolesc Gynecol Date: 2018-12-07 Impact factor: 1.814
Authors: Elizabeth S Barnert; Eraka Bath; Nia Heard-Garris; Joyce Lee; Alma Guerrero; Christopher Biely; Nicholas Jackson; Paul J Chung; Rebecca Dudovitz Journal: Public Health Rep Date: 2022 Jul-Aug Impact factor: 3.117
Authors: Elizabeth S Barnert; Laura S Abrams; Nathalie Lopez; Ava Sun; John Tran; Bonnie Zima; Paul J Chung Journal: Child Youth Serv Rev Date: 2020-01-27
Authors: Elizabeth S Barnert; Sarah M Godoy; Ivy Hammond; Mikaela A Kelly; Lindsey R Thompson; Sangeeta Mondal; Eraka P Bath Journal: Acad Pediatr Date: 2019-12-10 Impact factor: 3.107
Authors: Eraka P Bath; Sarah M Godoy; Georgia E Perris; Taylor C Morris; Madison D Hayes; Kara Bagot; Elizabeth Barnert; Marina Tolou-Shams Journal: J Health Care Poor Underserved Date: 2021-05