Our previous work has demonstrated that a significant percentage of mothers who bring their children to mental health clinics have high rates of untreated DSM IV disorders themselves. Most do not accept a referral for care, a phenomena that has negative effects on the child's well being and his/her treatment. This research enhancement proposal, linked to our funded Social Work Research Center is an expansion of a funded research enhancement project (MK Shear, PI). This proposal will seek to determine why mothers with diagnosable disorders do not seek or accept mental health care. We will use ethnographic methods, supplemented by standardized scales, to achieve a greater understanding of the ways mothers see their lives, their symptoms, and available treatment systems. We will also compare the perceptions of mothers presenting their children to a mental health center to those presenting to a social agency to determine whether differences in agency orientation or level of congruity between clinician and maternal perceptions play a role in engagement. We propose to use the increased understanding of maternal needs, preferences, and characteristics discovered in this way to develop and test a brief psychoeducational intervention to increase maternal acceptance and engagement with the services they need. This study addresses a widespread serious unmet need and a public health problem impacting significant numbers of women and children living in disadvantaged communities. It should contribute to our knowledge base about help-seeking behaviors and the barriers experienced by low-income mothers of disturbed children, and facilitate the application of efficacious treatments to disadvantaged populations in the community.
