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Caregiver, Child, Family, and Service System Contributors to Caregiver Strain in Two Child Mental Health Service Systems

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Abstract

Children's mental health researchers are increasingly recognizing the importance of caregiver strain (i.e., the impact on families of caring for children with emotional and behavioral disorders). This study examined the caregiver, child, family, and service variables associated with caregiver strain with special attention to the role of barriers to care. These relationships were compared across enrollees in a managed care Medicaid and a traditional fee-for-service system. Findings indicated that severity of child problems was the most consistent predictor of caregiver strain. Although there was considerable similarity in the variables associated with caregiver strain across the two systems, important differences were also evident. Caregivers in the managed care setting were significantly more likely to report provider/payer-related barriers to care. Provider/payer barriers predicted strain in the managed care sample. In the fee-for-service system, barriers related to family perceptions and inconvenient location and appointment times were significant predictors.

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Acknowledgments

Preparation of this manuscript was supported by the National Institute of Mental Health (grant no. R21 MH 067905-02) and a pilot grant from the Family Research Program of the Vanderbilt Kennedy Center for Research on Human Development. The authors would like to extend a special thanks to the families who participated in this research.

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Authors and Affiliations

  1. Peabody College, Center of Evaluation and Program Improvement, Vanderbilt University, Peabody #151, 230 Appleton Place, Nashville, TN, 37203, USA

    Ana María Brannan PhD

  2. Center of Evaluation and Program Improvement, Vanderbilt University, 2213 Autumn Drive, Bloomington, IN, 47401, USA

    Ana María Brannan PhD

  3. Human and Organizational Development, Peabody College, Vanderbilt University, 230 Appleton Place, Peabody Box 90, Nashville, TN, 37203, USA

    Craig Anne Heflinger PhD

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  1. Ana María Brannan PhD
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  2. Craig Anne Heflinger PhD
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Correspondence to Ana María Brannan PhD.

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Brannan, A.M., Heflinger, C.A. Caregiver, Child, Family, and Service System Contributors to Caregiver Strain in Two Child Mental Health Service Systems. J Behav Health Serv Res 33, 408–422 (2006). https://doi.org/10.1007/s11414-006-9035-1

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