Skip to main content
SpringerLink
Log in

Self-reported Barriers to Treatment Engagement: Adolescent Perspectives from the National Comorbidity Survey-Adolescent Supplement (NCS-A)

  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

The objective of this study was to assess youth self-reported treatment barriers in the past 12 months to obtain youth’s perspective on reasons they seek treatment, do not engage in treatment, or terminate treatment. The present study uses data from the National Comorbidity Survey-Adolescent Supplement (NCS-A), a nationally representative survey administered to youth ages 13–18 that was conducted between February 1, 2001 and January 30, 2004. A total of 10,123 youth participated in the NCS-A study and provided the information on which the current paper draws its data. Within the past 12 months over 63 % of youth reported seeking treatment to manage and cope with emotions. The greatest percentage of youth reported that they did not seek treatment because they wanted to handle the problem on their own (59.3 %). The greatest percentage of youth reported that treatment was terminated because they wanted to handle the problem on their own (57.5 %). Findings suggest professionals need to educate youth about the importance of professional treatment to increase engagement. If providers can motivate youth to see the value of treatment and help them understand that there can be positive outcomes, they may be less likely to terminate prematurely.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aebi, M., Giger, J., Plattner, B., Metzke, C. W., & Steinhausen, H. C. (2013). Problem coping skills, psychosocial adversities and mental health problems in children and adolescents as predictors of criminal outcomes in young adulthood. European Child and Adolescent Psychiatry,. doi:10.1007/s00787-013-0458-y.

    PubMed  Google Scholar 

  • Alexander, C. S., Somerfield, M. R., Ensminger, M. E., Johnson, K. E., & Kim, Y. J. (1993). Consistency of adolescents’ self-report of sexual behavior in a longitudinal study. Journal of Youth and Adolescence, 22(5), 455–471. doi:10.1007/BF01537710.

    Article  Google Scholar 

  • Benjamin, C. L., Harrison, J. P., Settipani, C. A., Brodman, D. M., & Kendall, P. C. (2013). Anxiety and related outcomes in young adults 7 to 19 years after receiving treatment for child anxiety. Journal of Consulting and Clinical Psychology, 81(5), 865–876. doi:10.1037/a0033048.

    Article  PubMed  Google Scholar 

  • Blake, C. S., & Hamrin, V. (2007). Current approaches to the assessment and management of anger and aggression in youth: A review. Journal of Child and Adolescent Psychiatric Nursing, 20(4), 209–221. doi:10.1111/j.1744-6171.2007.00102.x.

    Article  PubMed  Google Scholar 

  • Brener, N. D., Billy, J. O., & Grady, W. R. (2003). Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: Evidence from the scientific literature. Journal of Adolescent Health, 33(6), 436–457.

    Article  PubMed  Google Scholar 

  • Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614–625.

    Article  PubMed  Google Scholar 

  • Davoli, M., Perucci, C. A., Sangalli, M., Brancato, G., & Dell’uomo, G. (1992). Reliability of sexual behavior data among high school students in Rome. Epidemiology, 3(6), 531–535.

    Article  CAS  PubMed  Google Scholar 

  • De Man, A. F., & Leduc, C. P. (1994). Validity and reliability of a self-report suicide ideation scale for use with adolescents. Social Behavior and Personality, 22(3), 261–266.

    Article  Google Scholar 

  • Durlak, J. A., & Wells, A. M. (1997). Primary prevention mental health programs for children and adolescents: A meta-analytic review. American Journal of Community Psychology, 25(2), 115–152.

    Article  CAS  PubMed  Google Scholar 

  • Edlund, M. J., Wang, P. S., Berglund, P. A., Katz, S. J., Lin, E., & Kessler, R. C. (2002). Dropping out of mental health treatment: Patterns and predictors among epidemiological survey respondents in the United States and Ontario. American Journal of Psychiatry, 159, 845–851. doi:10.1176/appi.ajp.159.5.845.

    Article  PubMed  Google Scholar 

  • Farrand, P., Perry, J., Lee, C., & Parker, M. (2006). Adolescents’ preference towards self-help: Implications for service development. Primary Care and Community Psychiatry., 11(2), 73–79.

    Article  Google Scholar 

  • Garcia, J. A., & Weisz, J. R. (2002). When youth mental health care stops: Therapeutic relationship problems and other reasons for ending youth outpatient treatment. Journal of Consulting and Clinical Psychology, 70(2), 439–443.

    Article  PubMed  Google Scholar 

  • Gearing, R. E., Schwalbe, C. S., & Short, K. D. (2012). Adolescent adherence to psychosocial treatment: Mental health clinicians’ perspectives on barriers and promoters. Psychotherapy Research, 22(3), 317–326. doi:10.1080/10503307.2011.653996.

    Article  PubMed  Google Scholar 

  • Goodman, R., Meltzer, H., & Bailey, V. (1998). The Strengths and Difficulties Questionnaire: A pilot study on the validity of the self-report version. European Child and Adolescent Psychiatry, 7(3), 125–130.

    Article  CAS  PubMed  Google Scholar 

  • Gould, M. S., Velting, D., Kleinman, M., Lucas, C., Thomas, J. G., & Chung, M. (2004). Teenagers’ attitudes about coping strategies and help-seeking behavior for suicidality. Journal of the American Academy of Child and Adolescent Psychiatry, 43(9), 1124–1133.

    Article  PubMed  Google Scholar 

  • Grisso, T. (2005). Why we need mental health screening and assessment in juvenile justice programs. In T. Grisso, G. Vincent, & D. Seagrave (Eds.), Mental Health Screening and Assessment in Juvenile Justice (pp. 3–21). New York, NY: The Guilford Press.

    Google Scholar 

  • Gumber, S., & Stein, C. H. (2013). Consumer perspectives and mental health reform movements in the United States: 30 years of first-person accounts. Psychiatric Rehabilitation Journal, 36(3), 187–194. doi:10.1037/prj0000003.

    Article  PubMed  Google Scholar 

  • Hollin, C. R. (1999). Treatment programs for offenders. Meta-analysis, “what works,” and beyond. International Journal of Law and Psychiatry, 22(3–4), 361–372.

    Article  CAS  PubMed  Google Scholar 

  • Kazdin, A. E., & Wassell, G. (1998). Treatment completion and therapeutic change among children referred for outpatient therapy. Professional Psychology: Research and Practice, 29(4), 332–340. doi:10.1037/0735-7028.29.4.332.

    Article  Google Scholar 

  • Kendall, P. C., & Kessler, R. C. (2002). The impact of childhood psychopathology interventions on subsequent substance abuse: Policy implications, comments, and recommendations. Journal of Consulting and Clinical Psychology, 70(6), 1303–1306.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Aguilar-Gaxiola, S., Andrade, L., et al. (2001). Mental-substance comorbidities in the ICPE surveys. Psychiatria Fennica, 32, 62–79.

    Google Scholar 

  • Kessler, R. C., Avenevoli, S., Costello, E. J., et al. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372–380.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kuhl, J., Jarkon-Horlick, L., & Morrissey, R. F. (1997). Measuring barriers to help seeking behavior in adolescents. Journal of Youth and Adolescence, 26(6), 637–650.

    Article  Google Scholar 

  • Lorenzo, M. K., Pakiz, B., Reinherz, H. Z., & Frost, A. (1995). Emotional and behavioral problems of Asian American adolescents: A comparative study. Child and Adolescent Social Work Journal, 12(3), 197–212. doi:10.1007/BF01876772.

    Article  Google Scholar 

  • Manfred-Gilham, J. J., Sales, E., & Koeske, G. (2002). Therapist and case manager perceptions of client barriers to treatment participation and use of engagement strategies. Community Mental Health Journal, 38(3), 213–221.

    Article  PubMed  Google Scholar 

  • Merikangas, K. R., He, J. P., Burstein, M., et al. (2011). Service utilization for lifetime mental disorders in U.S. adolescents: Results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 50(1), 32–45.

    Article  PubMed Central  PubMed  Google Scholar 

  • Miller, L. M., Southam-Gerow, M. A., & Allin, R. B. (2008). Who stays in treatment? Child and family predictors of youth client retention in a public mental health agency. Child & Youth Care Forum, 37(4), 153–170.

    Article  Google Scholar 

  • Mirabito, D. M. (2006). Revisiting unplanned termination: Clinicians’ perceptions of termination from adolescent mental health treatment. Families in Society: The Journal of Contemporary Social Services., 87(2), 171–180.

    Article  Google Scholar 

  • Moskos, M. A., Olson, L., Halbern, S. R., & Gray, D. (2007). Utah youth suicide study: Barriers to mental health treatment for adolescents. Suicide and Lifethreatening Behavior, 37(2), 179–186.

    Article  Google Scholar 

  • Peterson, A. C., Leffert, N., Graham, B., Alwin, J., & Ding, S. (1999). Promoting mental health during the transition into adolescence. In Health Risks, J. Schulenberg, J. L. Maggs, & K. Hurrelmann (Eds.), Developmental transitions during adolescence. Cambridge: Cambridge University Press.

    Google Scholar 

  • Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Psychology Review, 3(4), 223–241.

    Article  CAS  PubMed  Google Scholar 

  • Ross-Durow, P. L., Mccabe, S. E., & Boyd, C. J. (2013). Adolescents’ access to their own prescription medications in the home. Journal of Adolescent Health, 53(2), 260–264.

    Article  PubMed Central  PubMed  Google Scholar 

  • Shillington, A. M., & Clapp, J. D. (2000). Self-report stability of adolescent substance use: Are there differences for gender, ethnicity and age? Drug and Alcohol Dependence, 60(1), 19–27.

    Article  CAS  PubMed  Google Scholar 

  • Stevens, J., Kelleher, K. J., Ward-Estes, J., & Hayes, J. (2006). Perceived barriers to treatment and psychotherapy attendance in child community mental health centers. Community Mental Health Journal, 42(5), 449–458.

    Article  PubMed  Google Scholar 

  • Walker, J. S., & Gowen, L. K. (2011). Community-based approaches for supporting positive development in youth and young adults with serious mental health conditions. Portland, OR: Research and Training Center for Pathways to Positive Futures, Portland State University.

  • Walsh, J., Scaife, V., Notley, C., Dodsworth, J., & Schofield, G. (2011). Perception of need and barriers to access: The mental health needs of young people attending a Youth Offending Team in the UK. Health and Social Care in the Community, 19(4), 420–428.

    Article  PubMed  Google Scholar 

  • Warnick, E. M., Gonzalez, A., Weersing, V. R., Scahill, L., & Woolston, J. (2012). Defining dropout from youth psychotherapy: How definitions shape the prevalence and predictors of attrition. Child and Adolescent Mental Health, 17(2), 76–85.

    Article  Google Scholar 

  • Williams, R. J., & Chang, S. Y. (2000). A comprehensive and comparative review of adolescent substance abuse treatment outcome. Clinical Psychology: Science and Practice., 7(2), 138–166.

    Google Scholar 

  • Winters, K. C., Stinchfield, R. D., Henly, G. A., & Schwartz, R. H. (1990). Validity of adolescent self-report of alcohol and other drug involvement. International Journal of Mental Health and Addiction, 25(11A), 1379–1395.

    Google Scholar 

  • Wisdom, J. P., Cavaleri, M., Gogel, L., & Nacht, M. (2011). Barriers and facilitators to adolescent drug treatment: Youth, family, and staff reports. Addiction Research & Theory, 19(2), 179–188.

    Article  Google Scholar 

  • World Health Organization. (2004). Prevention of mental disorders: Effective interventions and policy implications. Geneva: World Health Organization.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Forensic Psychology, The Chicago School of Professional Psychology, 325 N. Wells, Chicago, IL, 60654, USA

    Amy Sylwestrzak, Chelsea E. Overholt, Kelly I. Ristau & Kendell L. Coker

  2. Department of Psychology, University of New Haven, West Haven, CT, 06516, USA

    Kendell L. Coker

  3. Department Criminal Justice, University of New Haven, West Haven, CT, 06516, USA

    Kendell L. Coker

Authors
  1. Amy Sylwestrzak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chelsea E. Overholt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kelly I. Ristau
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kendell L. Coker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chelsea E. Overholt.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sylwestrzak, A., Overholt, C.E., Ristau, K.I. et al. Self-reported Barriers to Treatment Engagement: Adolescent Perspectives from the National Comorbidity Survey-Adolescent Supplement (NCS-A). Community Ment Health J 51, 775–781 (2015). https://doi.org/10.1007/s10597-014-9776-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-014-9776-x

Keywords

Search

Navigation