Confidential Mental Healthcare for Minors: Knowledge and Attitude Among Urban Minority Families

• In Event: Poster Session 02
  In Poster Session: PS 02 Topic - Prevention and Interventions

Abstract

Mental health among adolescents is a significant concern in the United States with suicide being the second leading cause of death among 15- to 24-year-olds (Centers for Disease Control, 2020). Based on a national survey, Merikangas et al. (2010) found that 42% to 48% of adolescents reported experiencing mental health concerns and estimates are that only half of adolescents with mental health problems access treatment (Costello et al., 2014). Existing research has identified logistic barriers (e.g., lack of transportation), recognition of mental health problems, and stigma as significant obstacles to adolescent treatment utilization. Adolescents’ trust in treatment providers also predicts services utilization (Gulliver et al., 2010; Martin et al., 2012; Wang et al., 2018). Adolescents who forgo mental health services because of concerns over confidentiality also have been found to be those who had greater need for help (e.g., sexual minority youths, youth at suicide risk, and youth engaged in risky behaviors) (Lehrer et al., 2007, Williams & Chapman, 2011).

Laws in some states allow minors to obtain certain aspects of healthcare without parental consent. Research on confidential care has focused largely on physical health, especially sexual and reproductive healthcare. Less research has examined confidentiality as a factor in mental healthcare, although the right for minors to receive confidential mental healthcare is explicitly supported by laws in many states (Kerwin et al., 2015). The current study aimed to examine caregivers’ and adolescents’ knowledge and attitude about the availability of confidential mental healthcare for minors living in Michigan, where confidential mental health services can be obtained starting at age 14 years without parental permission.

Sixty-nine predominately African American, low-income, urban youth (81.2% African American, 60.9% girls, Age 13–17 years, M = 15.13, SD = 1.45) and their caregivers were recruited at the waiting room of a large pediatric integrated primary care clinic in Detroit, Michigan. The participating adolescents and caregivers were interviewed separately either at the clinic or at a university office. Results showed that caregiver and adolescent awareness of confidential mental healthcare was strikingly low, with only 21.4% of caregivers and 14.5% of adolescents reporting that they knew that minors have a right to receive limited confidential outpatient mental healthcare. It is encouraging that when caregivers were informed by the researchers of the laws regarding confidential mental healthcare, most caregivers reported clear positive attitudes (69.6%) and only 10.7% of the caregivers reported clear negative opinions. These estimates of acceptability were comparable or higher than expected based on a study focusing on physical healthcare (Song et al., 2019). This research highlights the need to inform Michigan adolescents and those caring for them about the availability of confidential care starting at age 14 years.

Authors

• Yi Tak Tsang, University of Michigan - Ann Arbor
  Presenting Author

• Kelsey Sala-Hamrick, Wayne State University
  Non-Presenting Author

• Bridget Murphy, UTHealth San Antonio
  Non-Presenting Author

• Mareena Atalla, Wayne State University
  Non-Presenting Author

• Douglas Barnett, Wayne State University
  Non-Presenting Author