A Study of the Lived Experiences of Pediatricians: Helping Parents with Children with Mental Health Needs

Background and Purpose: In the United States, one of five children and adolescents has a psychiatric disorder, but only 5% receive mental health treatment, and 75 % prematurely drop out of treatment. Given that children and adolescents, as minors, are unable to independently receive mental health treatment, adults such as parents and pediatricians play a significant role in mental health service use. While mental health service provision in pediatric settings has to been proposed as a remedy for underutilization of mental health services, information regarding prevalence, the assessment process, and the level of impact pediatricians have in a child’s mental health help-seeking process has not been explored in depth—especially among ethnic minority pediatricians. Guided by Cognitive Dissonance Theory, this exploratory qualitative pilot study proposes to learn more about parents’ mental health help-seeking for their children through the lived experiences of three pediatricians.

Methods: Three ethnic minority pediatricians were interviewed for this study. The transcendental phenomenological paradigm provided the framework for the analysis. Review of insights subsequently lifted appropriate clusters and themes to “grasp the essence of the experiences”.

Results: Preliminary findings from this exploratory study are composed of 2 broad themes and 4 subthemes; Theme 1) I’m comfortable when I’m in control, 1-a) The need to feel comfortable, 1-b) It’s not my role—I feel uncomfortable, 1-c) Not having control is anxiety provoking, and 1-d) The exception—regiments create comfort; Theme 2) Parents are in charge. Themes constructed to reveal the essence of the live experiences of pediatricians are not independent of one another; rather, are interconnected. 

Conclusion and Implications: One of the most intriguing discoveries of this study was the cognitive dissonance that was created for the pediatricians by the ambiguous nature of mental health diagnoses and their discomfort with dealing with the unknown. Participants explicitly stated that pediatrics was purposefully chosen over psychiatry—the need for concreteness deterred them away from mental health/psychiatry, and promoted the decision to pick a field of medicine that was less murky. However, due the heightened mental health needs of and the push to utilize pediatric settings as an integral part of a child’s mental health treatment, in their current pediatric practices, participants are once again confronted with similar mental health related cognitive dissonances they had once resolved by avoiding psychiatry.

Additional to confirming the significant role parents and pediatricians play in a child’s mental health help-seeking process, results also reveal that pediatricians dissonance towards mental health treatment, are in turn allowing more room for parental views towards mental health to dictate treatment. Furthermore, though literature suggest pediatric settings as a optimal settings for early detection of mental health issues, pediatricians appear to have conflicting views about their role in the mental health treatment process. Results from this study cautiously question the applicability and mental health treatment in pediatric settings and calls for more in-depth exploration of pediatricians’ preferences and comfort level with such responsibilities.