Examining ethnic disparities in provider and parent in-session participation engagement
| Pages | 47-58 |
| Date | 20 March 2017 |
| DOI | https://doi.org/10.1108/JCS-12-2016-0022 |
| Published date | 20 March 2017 |
| Author | Kelsey S. Dickson,Sasha M. Zeedyk,Jonathan Martinez,Rachel Haine-Schlagel |
| Subject Matter | Health & social care,Vulnerable groups,Children's services,Sociology,Sociology of the family,Children/youth,Parents,Education,Early childhood education,Home culture,Social/physical development |
Examining ethnic disparities
in provider and parent in-session
participation engagement
Kelsey S. Dickson, Sasha M. Zeedyk, Jonathan Martinez and Rachel Haine-Schlagel
Abstract
Purpose –Well-documented ethnic disparities exist in the identification and provision of quality services
among children receiving community-based mental health services. These disparities extend to parent
treatment engagement, an important component of effective mental health services. Currently, little is known
about differences in how providers support parents’participation in treatment and the degree to which
parents actively participate in it. The purpose of this paper is to examine potential differences in both provider
and parent in-session participation behaviours.
Design/methodology/approach –Participants included17 providers providing standardcommunity-based
mental health treatmentfor 18 parent-child dyads, with 44 per cent of the dyads self-identifying as Hispanic/
Latino.In-session participationwas measured with the parentparticipation engagementin child psychotherapy
and therapist alliance, collaboration, and empowermentstrategies observational codingsystems.
Findings –Overall, results indicate significantly lower levels of parent participation behaviours among
Hispanic/Latino families compared to their Non-Hispanic/Non-Latino counterparts. No significant differences
were seen in providers’in-session behaviours to support parent participation across Hispanic/Latino and
Non-Hispanic/Non-Latino families.
Research limitations/implications –These findings contribute to the literature on ethnic differences in
parent treatment engagement by utilising measures of in-session provider and parent behaviours and
suggest that further investigation is warranted to documenting and understanding ethnic disparities in
parents’participation in community-based child mental health treatment.
Originality/value –This paper contributes to the evaluation of differences in parent treatment engagement
through demonstrating the utility of an in-session observational coding system as a measure of treatment
engagement.
Keywords Parent engagement, Community-based mental health treatment, Ethnic disparities,
Observational coding, Provider in-session engagement behaviours, Youth mental health services
Paper type Research paper
Introduction
Racial and ethnic disparities exist in the identification and provision of quality healthcare services
for youth and their families; this is especially prevalent for the access and receipt of mental health
services for children from racial/ethnic minority backgrounds. For example, there is some
evidence that Hispanic youth experience higher rates of certain mental health conditions, such as
mood disorders, than their non-Hispanic White peers (Merikangas et al., 2010). Yet, Hispanic
youth are less likely to be appropriately diagnosed or to receive mental health services, resulting
in significant unmet mental health needs, defined as lack of mental health services despite the
presence of functional impairment (Kataoka et al., 2002).
Underscoring this unmet need, it is estimated that fewer than 1 in 11 Hispanic individuals with
mental health issues seek mental health services (Kataoka et al., 2002; US Departmemt of Health
and Human Services, 2001). This lower utilisation in Hispanic individuals may be due to the
significantly greater number of barriers encountered in accessing care, including being
Received 2 December 2016
Revised 6 February 2017
Accepted 13 February 2017
This studywas supported by the
NationalInstitute of Mental Health
of the NationalInstitutes of Health
under awardnumber
K23MH080149(PI: Haine-Schlagel).
The contentis solely the
responsibility of the authorsand
does not necessarily representthe
officialviews of the National
Institutesof Health. The authors
would like to acknowledge
Lauren Brookman-Frazee,PhD,
CristinaBustos, PhD, Amy Drahota,
PhD, Ann Garland, PhD, and
Cortney Janicki for their
contributions to this projectas well
as the participating clinics,
therapists,and families. No conflicts
of interestexist.
The authors affiliations can be
found at the end of this article.
DOI 10.1108/JCS-12-2016-0022 VOL. 12 NO. 1 2017, pp. 47-58, © Emerald Publishing Limited, ISSN 1746-6660
j
JOURNAL OF CHILDREN'S SERVICES
j
PAG E 47
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