Help-Seeking for Children's Behavioral Health Concerns

Author

Monica Kruse, Southern Illinois University CarbondaleFollow

Date of Award

8-1-2024

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Fehr, Karla

Second Advisor

Habib, Reza

Abstract

Approximately 30% to 60% of children experience a behavioral health problem such as picky eating, toileting, or sleep difficulties; however, less than half of those individuals receive the necessary services to improve their symptoms and functioning. Examining the pathway through which children access behavioral health care is crucial to understanding the gap between the need for services and actual service use. Help-seeking process models suggest that for a child to receive care, caregivers must go through a series of linear stages: problem recognition, decision to seek help, and service selection. This help-seeking process has not been previously examined for sleep, picky eating, and toileting challenges, which leaves a gap in our knowledge about how children receive access to important behavioral health care. The current study aimed to fill gaps in the literature regarding help-seeking for behavioral health concerns. Survey data was collected through Amazon’s Mechanical Turk. Participants were 151 caregivers of children ages 5 to 10 years who provided information about help-seeking and child behavioral health symptoms. Rates of caregiver problem recognition for children who exhibited clinically significant concerns were 39% for sleep, 70% for picky eating, and 52% for toileting. When caregivers identified a problem, rates of help-seeking ranged from 53% (sleep) to 69% (toileting). The severity of the child’s problem predicted caregiver problem identification and help-seeking across all concerns. Caregiver past experience with mental health predicted problem identification and help-seeking for sleep and for picky eating. Family disorganization also predicted identification of picky eating problems. Caregivers demonstrated low knowledge of treatment options for behavioral health, and specialty behavioral health services were underutilized across problem areas with 69% to 75% of caregivers in the sample indicating that they had or would seek help from a pediatrician and only 11% to 19% indicating that they had or would seek help from a therapist or psychologist. Caregivers also reported low rates of pediatrician screening for these behavioral health concerns, and results suggest that caregivers are not fully satisfied with how pediatricians address their concerns. Overall, results support and add to the findings in the literature that suggest child behavioral health problems are under- recognized and under-treated. Future research is needed to close the gap between the need for services and service use.