Table 5 Factors influencing young mothers’ use of mental health care services
Facilitators | Barriers |
|---|---|
Social factors | |
Fear of negative consequences associated with seeking mental health care, including potential report to child protective services Perceived stigma of accessing mental health services and being a young mother | |
Organization or community attributes | |
Appointment management Option to book, cancel, or re-schedule appointment via “text” (SMS) Service coordination Co-location of health, education, social services Access to services or providers Primary care provider model Options for home visits available Services or provider available to respond to acute mental health needs Voluntary participation | Service environment Decreased sense of privacy with presence of cameras Not easily accessible via public transportation or to navigate with infant/stroller Appointment management Punitive response to cancelled or missed appointments Limited options for contacting organization Access to services or providers Mandatory participation Limited access to affordable mental health care Service coordination Lack of care coordination or information sharing between providers, resulting in requirement to repeat social and mental health history to multiple providers |
Provider attributes within the context of a therapeutic relationship | |
Establishment of good client-provider therapeutic relationship Demonstrates care and understanding when appointments need to be cancelled or re-scheduled Demonstrates genuine concern and sincerity Is respectful and non-judgmental Prioritizes client needs or concerns Respects client’s time and decisions Fully present during encounter by limiting distractions (i.e., forms, phone) and does not appear rushed Communication skills Skilled active listener Provides anticipatory guidance Validates client’s experiences Able to clearly communicate information about client’s mental health disorder Allows client to control narrative; does not pressure client to talk or disclose information before they are ready to Planning and delivery of care Identifies and prioritizes client needs or concerns Engages in shared decision-making, providing client with choice and control over final decisions Offers options for care or service, provides detailed description of each option Assesses client’s understanding of each option Co-develops plan of care with client that is perceived as helpful to address priority needs and feasible to implement Creates time and space to assess client’s perceptions and expectations with respect to treatment/services Seeks client’s permission or consent to share information with other professionals or to allow other individuals to be present during an appointment Actively assist client in making, confirming and accessing referrals, including identifying and addressing any barriers | Unsafe client-provider relations Provider perceived to be punitive when client misses or cancels appointment Does not prioritize client privacy or emotional safety Infantilizes client by speaking to other adults (partner/family member) instead of client, speaks in a condescending manner Perceived to be overly intrusive and judgmental Planning and delivery of care Provides advice or directly tells client what to do Dismisses client’s concerns, needs, or experiences |
Individual attributes | |
Help-seeking behaviours Social or family supports met identified needs Expressed preference for informal support over formal supports Past positive experiences with health care providers | Help-seeking behaviours Preference to manage stressors/mental health disorders independently Past negative experiences with health care providers or social services |