Barriers and facilitators for mental healthcare in pediatric lupus and XXXX : a qualitative study of youth and parent perspectives.

@entity1 @entity308 @entity1252 @entity148 @entity2406
BACKGROUND: Untreated mental health problems may result in poor outcomes for youth with @entity1252 ( @entity1252 ) and @entity2406 ( @entity2406 ). We investigated perceptions, barriers and facilitators for mental healthcare of these youth. METHODS: We conducted 32 semi-structured interviews with 16 outpatient youth with @entity1252 / @entity2406 , ages 11-22 years, and their parents. We used purposive sampling to deliberately obtain the experiences of youth screened during a previous study for @entity308 and @entity148 with the @entity1 Health Questionnaire 9 and the Screen for Childhood @entity148 , respectively. We recruited 6 youth with previous positive screens and 10 with negative screens. We assessed interim mental health history, and qualitatively examined perceptions, barriers and facilitators for mental healthcare. RESULTS: Youth with a mental health history increased from 6 (38  %) at initial screening to 9 (56  %) at interview (mean follow-up   =   2.1  years). Youth receiving mental health treatment increased from 33 to 67  %. Youth and parents identified rheumatologists as primary physicians and found mental health screening in rheumatology acceptable. Barriers to mental healthcare included: stigma; fear; uncertainty about getting help; parental emotional burden; minimization by doctors; and limited mental healthcare access. Facilitators included: strong clinician relationships; clinician initiative, sincerity and normalization in discussing mental health; and increased @entity1 /family awareness of mental health issues in @entity1252 / @entity2406 . CONCLUSION: Youth with @entity1252 / @entity2406 and their parents perceive pediatric rheumatologists as a preferred source for mental health screening, guidance and referral. Interventions addressing barriers and enhancing facilitators may improve mental healthcare for youth with @entity1252 / @entity2406 .
