Providers’ Perceived Barriers to Engaging Underserved Populations in Mental Health Services

Mental health service use among traditionally underserved populations is alarmingly low, with studies estimating that as few as 10% of youth from underserved groups receive treatment for their mental health needs. To date, numerous barriers to seeking and accessing high-quality mental health care for traditionally underserved populations have been identified. However, little is known about the barriers that are most salient to the providers who are routinely working to engage underserved youth and families. This study explored providers’ perceptions about barriers to engaging traditionally underserved youth and families in community mental health services. Providers (N=55) employed by a large community mental health and welfare agency completed semi-structured interviews that asked about barriers to treatment engagement for underserved populations. Responses were coded into themes of: client characteristics and engagement; provider characteristics and service delivery; client-provider match, implementation supports (e.g., supervision); agency climate and culture; and service system and sociopolitical context. Results revealed that many providers endorsed difficulties with building rapport and encouraging consistent treatment attendance with ethnic minority youth as well as with families receiving social services. Many providers believed that client-provider racial and linguistic matching, engagement practices (e.g., accessibility promotion), and implementation supports facilitated engagement, but these views were not unanimous. Some providers reported feeling uncertain about what they could do to engage underserved youth and families. Providers perceived an agency and service system culture focused on productivity to be detrimental to client engagement and endorsed feeling largely powerless to help families navigate stressors stemming from the sociopolitical environment (e.g., immigration concerns). Findings shed light onto providers’ perceived barriers to delivering high quality care to underserved communities. By better understanding these engagement concerns, we hope to inform efforts that can be taken by providers, agencies, and service systems to mitigate disparities in access to and quality of mental health services.