Barriers to Mental Health Access for Students Affected By Bullying

Saturday, October 24, 2015: 3:09 PM
102B (Walter E. Washington Convention Center)
Amira El Sherif, MD1, Erin Nicole Trent, PA-C1, Jean Snider, BS2, Arthi Khazanchi, MD1, Shawn Sherry, BS2, Borris Abbey, PHD, JD, MBA3 and Ashok Jain, MD, MBA1, (1)KidzCare Pediatrics, Fayetteville, NC, (2)Methodist University, Fayetteville, NC, (3)Fayetteville State University, Fayetteville, NC

Objectives: Nearly 30% of US adolescents are involved in bullying. Studies indicate a correlation between bullying and several mental health concerns including attention deficit hyperactivity disorder, anxiety, self-harm, suicidal ideation, and suicide attempts. Only 21% of US children who require a mental health evaluation receive services implying roughly 7.5 million children have an unmet need. The aim of our study is to assess specific barriers to mental health services for adolescents affected by bullying.

Methods: Focus groups were conducted with bullying victims and their parents. Semi-structured interviews were also completed with teachers and community mental health providers. Data collected was used to develop a quantitative survey using a 5-point Likert scale that was completed by 440 middle and high school students in Cumberland County, NC. For data analysis, the mean results were extrapolated to allow for a ranking of barriers, with a score of 5 being the highest potential barrier.  The mean scores for positively worded survey statements were reverse scored. Logistical regression models, univariate and multivariate analyses were used to evaluate reported barriers. 

Results: 29% of 440 respondents endorsed prior bullying. Twenty-eight barriers were reported, 11 of which were specific to respondents who experienced prior bullying. Health care barriers ranked highest among barriers reported. Students indicated a lack of adequate screening and counseling by medical providers. School system and education barriers were also strongly endorsed including inaction by school personnel and poor enforcement of investigation procedures. Inadequate school follow-up and communication with parents were other major obstacles.

     

Demographic Factors and Bullying  

Variables

All Respondents (N = 440)

Bullied Respondents

(N = 126)

11 to 14 yrs old

54%

58%

15 to 18 yrs old

46%

42%

Male

55%

44%

Female

45%

56%

White

18%

25%

Black

65%

51%

Asian

1%

0%

Hispanic

5%

9%

Other race

11%

15%

Ranking of Barriers to Mental Health CareΔ

ΔMean scores for positively worded survey statements were reverse scored.

* Denotes barriers with a statistically significant difference between bullied and non-bullied respondents with 95%CI.

Conclusions: Efforts are needed to encourage medical providers to screen for bullying and to refer to mental health services when necessary. There is also a continuous need for school training programs which incorporate quality assurance reviews and interval evaluations.  Overall, streamlining a process of communication between medical providers, school officials and parents would allow for a multidisciplinary approach which in turn would improve mental health screening and access to services. 

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