Experiences of Colorado Parents as They Recognized Their Child''s Mental Illness

Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2016 Experiences of Colorado Parents as They Recognized Their Child's Mental Illness Lori Salgado Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Psychiatric and Mental Health Commons, Public Health Education and Promotion Commons, and the Public Policy Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks For more information, please contact ScholarWorks@waldenu.edu Walden University College of Social and Behavioral Sciences This is to certify that the doctoral dissertation by Lori Salgado has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made Review Committee Dr Steven Matarelli, Committee Chairperson, Public Policy and Administration Faculty Dr Tracy Mallett, Committee Member, Public Policy and Administration Faculty Dr Kristie Roberts, University Reviewer, Public Policy and Administration Faculty Chief Academic Officer Eric Riedel, Ph.D Walden University 2016 Abstract Experiences of Colorado Parents as They Recognized Their Child’s Mental Illness by Lori Salgado MPA, City University, 1997 BA, San Jose State University, 1984 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration Walden University May 2016 Abstract Mental illness is not only the leading cause of disability among adults, but there is also an emerging public health crisis in childhood mental illness A majority of parents not recognize symptoms of psychological disorder in their children, and current policies and programs for mental health service delivery are not sufficiently responsive to the early help-seeking dynamics of families Using a concurrent mixed methods design, this study explored how parents in the Pikes Peak region of Colorado learned to recognize their child’s mental illness Phenomenological interviews, augmented by poetic inquiry and quantitative measurements, were used to discover factors that inhibited or enhanced five mothers’ recognitions These factors were then evaluated using a frequency distribution analysis and a rank-order correlation The phenomenon of recognition was, for these mothers, a process of waiting to hear that “normal” had stopped, wherein they miscategorized symptoms as normal behaviors in a passing developmental phase Prior experience with mental illness appeared to significantly decrease both the length of time and the level of distress necessary for recognition Ultimately, recognition did not occur until someone in their social network validated their concerns and provided explicit confirmation, which galvanized them to seek treatment Governance network collaborations can facilitate positive social change by standardizing guidance on how to differentiate symptoms of a disorder from normal childhood development Public policies and programs such as universal mental health screening, mental health literacy, and more supportive and responsive school policies can foster dialogue for parental recognition in Colorado and throughout the country Experiences of Colorado Parents as They Recognized Their Child’s Mental Illness by Lori Salgado MPA, City University, 1997 BA, San Jose State University, 1984 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration Walden University May 2016 Dedication To my parents – Daniel and Joan Aceto – who modelled the value of education, family, and a sense of humor To my children – Bram, Ramona, Jeremy, and Elena Salgado – who endured so many frozen dinners, hugged me almost every night, and graciously permitted me to graduate before they did To my husband – Paul Salgado – who for 30 years (and counting) enriches my life every day, and rarely complained about washing the dishes This is the second time you’ve helped me earn my wings Acknowledgments Each of us has cause to think with deep gratitude of those who have lighted the flame within us ~ Albert Schweitzer With the utmost respect, I thank the following people, without whom this study would not have been possible: The Colorado mothers who shared their stories so that others might benefit The members of my validation panel and my translator, whose advice and perspective helped me understand and empathize: Lynn Bakken, Patricia Kule, Dr Maureen White, and Maria Zubia My committee member, Dr Tracey Mallett, and University Research Reviewer, Dr Kristie Roberts—your scholarly insights and questions motivated me to dig deeper, reach farther, and search more broadly Most importantly, my brilliant and inspiring chairperson, Dr Steven A Matarelli For more than 100 weeks, your mentoring and example truly sparked the flame within me No matter what obstacles arose, you never failed to rekindle my enthusiasm, and ignite my aspirations for social change—Onward! I hope to prove worthy of your trust, and keep the flame alive Table of Contents List of Tables vi List of Figures vii Chapter 1: Introduction to the Study Recognition of Childhood Mental Illness Background Problem Statement Purpose Nature of the Study Research Questions and Hypotheses Theoretical Foundation and Conceptual Framework Definitions Scope 12 Assumptions 12 Limitations 13 Delimitations 13 Significance and Implications for Social Change 14 Summary .15 Chapter 2: Literature Review .17 Introduction 17 Literature Search Strategy 17 Theoretical and Conceptual Base 19 i Model of Parent-Mediated Pathways to Mental Health Services for Adolescents 19 Mental Health Literacy 20 Governance Network Theory 22 The Intersection of the Three Perspectives 24 Background on Help-seeking Models for Mental Illness 25 Overview of the Progression of Help-Seeking Models 28 Factors Affecting Parental Recognition and Help-seeking .37 Distress and Crisis 38 Delays, Avoidance, and Normalization 40 Social Network 40 Community Systems and Policies 46 Public Policy and Parental Help-Seeking 50 Systems of Care 51 School Based Health Centers 52 Colorado Policies and Programs for School Based Health Centers 55 Parents and SBHCs 57 Research Design and Approach 58 Rationale for a Mixed Methods Methodology 58 Justification for the Methodological Paradigms 59 Summary and Conclusion 64 Chapter 3: Research Method 66 ii Research Design 66 Population and Sampling Strategy 68 Protocol and Data Collection 70 Screening Phase 71 Pre-Interview Phase 72 Interview Phase 75 Benefits and Disadvantages to This Protocol 78 Role of the Researcher 79 Protocol Validation and Pilot Study 80 Data Analysis Strategy 81 Qualitative Strand 81 Quantitative Strand and the Melding of the Two Approaches 82 Threats to Validity and Issues of Trustworthiness 84 Protection of Participants .86 Summary .87 Chapter 4: Results .88 Introduction 88 Research Instrument and Procedure Modifications 90 Validation Exercise 90 Pilot Study 92 Data Collection Process 94 Recruitment Approach 94 iii ... Administration Faculty Chief Academic Officer Eric Riedel, Ph.D Walden University 2016 Abstract Experiences of Colorado Parents as They Recognized Their Child’s Mental Illness by Lori Salgado MPA, City... foster dialogue for parental recognition in Colorado and throughout the country Experiences of Colorado Parents as They Recognized Their Child’s Mental Illness by Lori Salgado MPA, City University,... explored the process of how parents and caregivers in the Pikes Peak Region of Colorado learned to recognize their child’s behaviors as resulting from mental illness, and how school-based health centers