Black and White Parents' Willingness to Seek Help for Children's Internalizing and Externalizing Symptoms

ADHD Prevalence Rose, Yet Disparities Remain: Commentary on the 2022 National Survey of Children's Health

This is a commentary on Danielson and colleagues' report entitled "ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment," which provides updated prevalence rates related to ADHD diagnosis and treatment utilization using data from the 2022 National Survey of Children's Health (NSCH). This timely article is among the first to report on ADHD prevalence rates since the COVID-19 pandemic, and highlights important patterns related to ADHD diagnosis and treatment utilization. In this commentary, we contextualize these findings with consideration to the COVID-19 pandemic and within the existing literature on health disparities among youth with ADHD and their families. We end with recommendations for future work involving researchers, clinicians, and policymakers with the intention of reducing disparities in ADHD diagnosis and treatment in the U.S.

Parent attributions and attention deficit/hyperactivity disorder knowledge as predictors of specific help-seeking interests

Many children diagnosed with attention deficit/hyperactivity disorder (ADHD) do not receive appropriate services following diagnosis. Although information about ADHD is widely available and abundant, sometimes conflicting information may impede parent help-seeking. The present study examined parent knowledge of ADHD and attributions of child behavior as predictors of interest in formal and informal help seeking at the point of child evaluation for possible ADHD. Participants (89 caregivers of children ages 5-12) completed a measure of ADHD knowledge, rated attributions of child behavior in response to vignettes depicting ADHD symptoms, and indicated their interest in a range of formal and informal services that could be recommended following the child's evaluation. Parents reported strongest interest in academic services followed by medication, child focused therapy, and informal services (e.g., seeking information about ADHD). Family income, ADHD knowledge and attributions that child behavior will persist over time were associated with all types of help-seeking interest except academic services. Perceptions of child control over behavior predicted greater interest in medication. Findings suggest that increasing parent knowledge of ADHD and exploring parent goals and preferences for treatment may increase service utilization for children following assessment/diagnosis of ADHD.

"It was Just Good to Have an Outlet for Other Parents to Talk to": Feasibility and Acceptability of Integrating Mental Health and Wellness Services into Predominantly Black Early Childhood Education Centers During the COVID-19 Pandemic

Racial disparities in mental health care access and quality are associated with higher levels of unmet need for Black parents and families, a population disproportionately affected by the COVID-19 pandemic. Integrating services within early childhood education centers may increase mental health care access for Black families with young children. The current study examined the feasibility, acceptability, and perceived impact of an integrated program offering mental health care for parents, children, and dyads during the pandemic. Black parents (N = 61) completed measures of program satisfaction and perceived benefits of participation, and 47 parents also participated in focus groups further assessing perceptions of the program. Results demonstrated high levels of satisfaction and perceived benefit of the program for parents and children. Themes generated through analysis included: social support, creating a safe space, prioritizing self-care, and sharing parenting strategies. Parents' feedback provides preliminary feasibility and acceptability for the integrated mental health program.

Asylum seeking and refugee adolescents' mental health service use and help-seeking patterns: a mixed-methods study

Almost a third of all people who entered Germany to seek protection since 2010 were under the age of 18. Asylum-seeking and refugee (ASR) adolescents in Germany face reduced entitlements to healthcare and experience barriers in accessing mental healthcare, despite documented mental health needs. This mixed-methods study aims to describe the mental health needs and service use of ASR adolescents in Germany and identify the predictors of their help-seeking patterns. Here we report findings of cross-sectional data collected between February 2019 and November 2020 in schools and refugee accommodations in three German federal states. Our subsample consists of ASR between the ages of 11 and 18, coming from Syria, Afghanistan, and Iraq (N = 216). Cross-sectional data are supplemented by semi-structured interviews with nine mental health professionals in one region of the study. Our findings reveal an underutilization of mental health services relative to the emotional difficulties reported. Perceived and experienced access barriers, age, and externalizing and internalizing symptoms predict different help-seeking patterns. Psychotherapy-related social resources, as well as reporting of emotional difficulties, are predictors of actual or intended psychotherapeutic service utilization. Based on our quantitative and qualitative findings, we highlight the need for widespread, accessible, and low-threshold mental health initiatives designed to work with ASR adolescents, for additional assistance in navigating the mental healthcare system, as well as for support to important people in ASR adolescents' lives who fill the gap between mental health needs and accessible mental healthcare services.

Commentary: Timely recognition of mental health needs in young children - parental perception as a way for professionals to understand child, parent, and family needs? - a commentary on McGinnis et al. (2021)

There is a growing awareness that identification and intervention of mental health problems in early childhood are effective and have a preventive effect. Nevertheless, the use of mental health services in early childhood is still limited. Investigating parental perception of mental health needs in young children is highly relevant, as parents are the primary informants for young children. In this commentary, we discuss the findings reported by McGinnis et al. on child and parent factors associated with parent perception of mental health needs in young children. We agree with their plea for a shift from the individual child to the family in assessment and intervention, and elaborate on the relevance of endorsing a transdiagnostic, relationship-based approach to early detection, assessment, and intervention. We propose beginning with the acknowledgment and deeper understanding by professionals of parental perception of young children's mental health problems and needs, and the realization that the young child's symptoms and needs are connected with the family and broader (relational) context.

Correlates of help-seeking by parents for the socioemotional development of their 3-year-old children: a longitudinal study

OBJECTIVES

Timely parental help-seeking regarding their child's socioemotional development is associated with a lower rate and lower severity of psychosocial problems in later life. This study aimed to examine the correlates of parental help-seeking for the socio-emotional development of 3-year-old children.

DESIGN

Retrospective cohort study.

SETTING

Community-based survey in Rotterdam.

PARTICIPANTS

Of 2305 parents and their 2-year-old children at baseline, 1507 who completed follow-up questionnaires were included in the analyses when children were 3 years old.

OUTCOME MEASURES

Parental help-seeking regarding their child's socioemotional development and types of formal and informal help sources (eg, general practitioner, internet) used in the past 12 months were measured. Hierarchical logistic regression models were applied to identify factors correlates of parental help-seeking among 13 predisposing, enabling and need factors according to Andersen's behavioural model.

RESULTS

In total, 22.6% of parents reported help-seeking in the past 12 months for socioemotional development of their 3-year-old child; 6.8% addressed formal help sources and 17.5% addressed informal help sources. General practitioner (2.7%) and family (12.5%) were the most frequently used formal and informal sources, respectively. In the full model, predisposing factors associated with higher odds of parental help-seeking were child's other western ethnic background (OR=1.66, 95% CI 1.02 to 2.68) and parental age ≤29 years old (OR=1.71, 95% CI 1.01 to 2.92). No associated factors were found among enabling factors. The need factors associated with higher odds of parental help-seeking were having previous help-seeking (OR=2.52, 95% CI 1.83 to 3.48) and discussing child's socioemotional development in the well-child visit (OR=2.47, 95% CI 1.73 to 3.53).

CONCLUSIONS

Predisposing and need factors were associated with parental help-seeking for socioemotional development of 3-year-old children. The findings can be used to further develop support for parents accessing adequate information, prevention and anticipatory care with regards to the child's socio-emotional development.

Discrepancies in adolescent-mother dyads' reports of core depression symptoms: Association with adolescents' help-seeking in school and their somatic complaints

OBJECTIVE

Parents of adolescents with mental problems do not always recognize the symptoms in their children, particularly regarding depression, and therefore do not seek professional help. Adolescents themselves tend to seek help from school personnel for their emotional or social difficulties. In contrast, adolescents do report somatic complaints and parents are likely to seek help for these problems. The current study explored whether the divergence between maternal and child reports of depression symptoms is associated with child's help-seeking in school and patterns of somatic complaints.

METHOD

A sample of 9th grade students (N = 693; 56% girls; mean age = 15.1) and their mothers representing the Muslim and Druze populations in northern Israel were interviewed simultaneously and independently. Maternal reports were classified either as underestimating, matching, or overestimating their own child self-report of three core symptoms of depression (depressed mood, anhedonia, and irritability). Adolescents reported whether they had consulted school staff and were classified into clusters based on self-reported somatic complaints.

RESULTS

Maternal misidentification of their child's depression symptoms was associated with increased help-seeking in school, particularly by boys if depressed mood or irritability were misidentified and particularly by girls if anhedonia was misidentified. Hierarchical cluster analysis indicated that the number and severity of somatic complaints was higher among adolescents whose depression symptoms were not identified, regardless of gender.

CONCLUSION

Mental health professionals, educators and parents should be aware that adolescents may attempt to communicate their emotional difficulties through somatic complaints and by seeking help in school.

Using Memoirs and Autobiographies To Enhance the Teaching of Abnormal Child Psychology

Memoirs and autobiographies can be rich sources of real-world information for students in psychology classes. These resources have been used in adult-oriented abnormal psychology classes, but have yet to be explored for use in courses on abnormal child psychology. This manuscript reviews the use of memoirs and autobiographies in adult-oriented abnormal psychology classes and then explores the use of memoirs and autobiographies in abnormal child psychology classes. In the Appendix, lists of memoirs and autobiographies are provided that instructors can use as a resource in the selection of books for abnormal child psychology classes. Data are analyzed regarding undergraduate students’ opinions about the use of memoirs in an abnormal child psychology class and an investigation of learning outcomes for classes with and without assigned memoirs is provided. Overall, the use of memoirs and autobiographies appears to be a promising way of enhancing the teaching of abnormal child psychology.

Exploring Racial Disparities in Mental Health Diagnoses and Neighborhood Disorganization Among an Urban Cohort of Children and Adolescents with Chronic Medical Conditions

Objective: This article describes the demographic distribution of, and association between, neighborhood disorganization and mental health diagnosis by race in a large cohort of urban children with chronic medical conditions. Methods: Data for this study were from Coordinated Healthcare for Complex Kids (CHECK), a health care demonstration project funded by the Center for Medicare and Medicaid Innovation. We conducted regression analyses to examine the relationship between neighborhood disorganization and mental health diagnosis among 6,458 children enrolled in CHECK. Results: The most common mental health diagnoses were mood disorders (8.6%), Attention-Deficit/Hyperactivity Disorder (7.4%), conduct disorders (6.1%), and anxiety disorders (4.8%). Black children had the highest neighborhood disorganization scores compared with other racial/ethnic categories. However, Black children had the lowest proportion of mental health diagnoses. Lower neighborhood disorganization was associated with having a mental health diagnosis; however, when adding race/ethnicity to the model, neighborhood disorganization no longer was significant. Conclusions: Level of neighborhood disorganization was highly correlated with racial/ethnic composition of the neighborhoods, and Black children disproportionately resided in highly disorganized neighborhoods compared with other groups. Neighborhood disorganization may not have sufficient variability within the racial/ethnic categories, which may explain the absence of an interaction between race/ethnicity and mental health diagnosis.