By Jay Morse & Heidi RadunovichWe reviewed the barriers to mental health care reported by military wives in the previous blogs: Military Wives Matter and Mental Health Care Needs of Military Wives. What are the barriers expressed by teens in military families?
Military children are 2.5 times more likely to develop psychological problems than American children in general, but their utilization of mental health services is low. Adolescents from military families experience stressors unique to the military environment, such as parental deployment and frequent moves. As a result of these stressors they may be more likely to display depressive disorders and/or behavioral disorders. In a recent study by Becker and colleagues, the researchers used structured focus groups and interviews to develop feedback on the barriers to seeking mental health treatment among military families with adolescents .
Focus groups and interviews were conducted with 12 parents of adolescent children who had experienced deployment, 13 adolescents with an average age of 13, and 20 mental health providers who had worked with adolescents from military families. Over one-half of the parents participating reported that their adolescent was experiencing emotional or behavioral problems. A total of 7 focus groups or interview discussions were conducted with the 25 family members. Service providers participated in individual interviews in person, or by telephone. Themes that emerged in the analysis were divided into two groups: (1) Internal barriers related to attitudes; and (2) External barriers related to time and effort or financial concerns. The most often cited internal barriers related to attitudes for not seeking mental health care among teens were: lack of interest or perceived relevance, stigma, an ethic of self-reliance, and confidentiality concerns.
Teens most often reported a lack of perceived relevance in seeking help. Teens reported that they would not participate in services that “required them to talk about their feelings” or that they didn’t need help or did not have problems. Adolescents also reported that they were self-reliant and wanted to “figure things out” on their own and cited their military family’s attitude of self-reliance. This attitude of self-reliance in military families was consistent with therapists’ observations – acknowledging military families’ strong sense of independence. They also expressed concerns about what others would think of them if they attended therapy, particularly other family members who had a negative view of therapy. Confidentiality was the most often cited reason for not seeking help when all three groups were considered, and was often related to concerns about the effect of seeking mental health care on the military member’s career.
Additionally, external barriers were cited as a reason for not pursuing mental health services. Time, effort, logistical concerns, and financial barriers were all found to be external barriers impacting the decision to pursue mental health services. Families and therapists reported a high number of activities and appointments during the teen years, and the ability to handle the busy schedules becomes even more challenging for families during a parental deployment, when the burden of family responsibilities fall to the remaining parent.
When addressing the needs of a teen it is important to consider that a teen’s attitude toward seeking help for the stressors of military life may vary from those of their parents. While the ethic of self-reliance may be a family norm, considering barriers due to a perceived lack of relevance and stigma may be particularly important when working with adolescents. It is also important to consider the external realities faced by many military families that can make participation in therapy challenging.
 Becker, S. J., Swenson, R. R., Esposito-Smythers, C., Cataldo, A. M., & Spirito, A. (2014). Barriers to seeking mental health services among adolescents in military families. Professional Psychology: Research And Practice, 45(6), 504-513. doi:10.1037/a003612.
This post was written by Jay Morse & Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on Twitter, YouTube, and on LinkedIn.