Discrepancies between parent- and adolescent-perceived problem severity and influences on help seeking from mental health services

Objectives: Attitudinal and practical barriers prevent many young people who are experiencing mental health problems from seeking professional help. The influence of others can help young people to overcome barriers to help seeking. Understanding the relative influence of parents and others on the help-seeking decision and the extent of parent–child agreement on the severity of the young person’s problems, may be helpful in facilitating intake processes in child and adolescent mental health services (CAMHS). Methods: One hundred and nineteen parent–child (14–18-years-old) dyads attending an initial appointment at a Sydney and regional CAMHS completed the parent and youth Strength and Difficulties Questionnaires (SDQs) prior to their assessment interview. Parents and children also answered three equivalent questions on sources of influence in their decision to access services. Results: Ninety-four per cent of young people reported that others had influenced their decision to access help, with parents being the strongest influence. Higher levels of parental influence in the help-seeking process were related to greater disagreement between parent and child on the severity of the problems. Parent and child ratings of influence were related to the severity of externalizing problems. Conclusion: The findings are consistent with models that highlight help seeking as a social process involving high degrees of influence particularly from parents. Referral sources and clinicians need to be aware of the effects of discrepant views between parent and child regarding the presenting problem. To facilitate joint therapy it may be helpful for clinicians to address the level of influence involved in having the young person attend their first appointment with parents and children.