Medical Student University of Pittsburgh School of Medicine University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania, United States
Background: Mental health disorders are prevalent globally and have been associated with poor health outcomes and an increased financial burden. Many, however, arise before adulthood, creating an opportunity for early intervention and treatment. Parental recognition of mental health disorders, as well as parent-child connectedness, are critical in adolescent engagement with mental health treatment. Parents, however, often have difficulty identifying signs of mental illness.
Objective: This study aims to explore how adolescents and their parents/guardians communicate about mental health.
Design/Methods: This study recruited seventeen adolescents with a history of depression and/or anxiety and their parent from an adolescent and young adult medical clinic affiliated with an academic medical center in Pittsburgh, PA. The adolescent and parent each completed a baseline survey including demographic information, PHQ9, and GAD7 questionnaires. Separate, semi-structured interviews were conducted via Zoom for both the adolescent and parent. A data-driven codebook was developed based on themes that emerged from the interviews. Qualitative data was analyzed via template analysis. Double coding was utilized and Cohen’s Kappa scores were calculated for each code; the average score was 0.90, indicating substantial agreement.
Results: We identified themes around adolescents’ reluctance to communicate about mental health, at times due to a preference for communicating with peers and a feeling of being burdensome. Additionally, a theme of using “code words”, or substitutes for diagnoses such as depression and anxiety, was found amongst adolescents, which may at times elude parental recognition. Amongst parents, we identified themes of parents seeking mental health education and disclosing family history, which could potentially facilitate more informed conversations that lead to greater mutual understanding. A positive impact of therapy on communication was described by parents and may be particularly beneficial for parents and adolescents who have poor communication or frequent disagreement. Conclusion(s): This study identifies a number of themes that may improve communication about mental health between parents and adolescents, including parents seeking mental health education, and disclosing family history. Other themes, such as adolescents’ feeling of being burdensome and the use of mental health code words, may be used as educational tools that allow parents to recognize when and how to start a conversation about mental health.
Table 1. Adolescent Demographic Characteristics
Table 2. Adolescent Themes and Corresponding Quotations
Table 3. Parental Themes and Corresponding Quotations
Authors/Institutions: Sophie Wecht, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States; Morgann Hendrixson, Miami University, Oxford, Ohio, United States; Kayla Odenthal, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States; Ana Radovic, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States