How Do Mothers in Domestic Violence Shelters Perceive Their Children's Mental Health?

BACKGROUND/PURPOSE:

Childhood domestic violence (DV) exposure affects an estimated 15.5 million children. Children exposed to DV face increased risks of externalizing and internalizing disorders and post-traumatic stress symptoms. This poster presents results from an study that examined access to mental health (MH) services for children exposed to DV, focusing on findings related to maternal perceptions of child MH, and their beliefs about causes of child MH challenges. Perceptions of MH needs influence the help attainment process for adult DV victims, but little is known about how they perceive their children’s needs. No studies were identified that examined mothers’ beliefs regarding causes of MH challenges among children exposed to DV.

METHODS:

An ethnically/racially diverse sample of mothers (N=30) was recruited from five DV shelters using maximum variation and purposive sampling. Mothers provided information on the MH of a “focus child” (the child she identified as having the greatest behavioral/emotional challenges). Focus children were ages 5-17 (mean=9.6); half were female. Four indicators of child MH were obtained from mothers through completion of: the Parent Report of Post-traumatic Symptoms (PROPS;Greenwald & Rubin,1999), the Strengths and Difficulties Questionnaire (SDQ;Goodman,2001), and an in-depth ethnographic interview (in English or Spanish), that included questions on whether the child had received a formal MH diagnosis, and any behavioral or emotional challenges that interfered with the child’s daily activities. Qualitative analyses involved developing case summaries, mapping family help-seeking trajectories, and two independent coders reading verbatim interview transcripts, coding for thematic and categorical content, and meeting for consensus discussion of coding decisions. Quantitative analyses involved calculating descriptive information and Cronbach’s alpha for standardized measures, which were all in an acceptable range.

RESULTS:

Findings indicate high levels of need for MH care for focus children, but results varied depending on the indicator. Nearly three-quarters (n=22,73.3%) scored above the PROPS clinical cut-off, while just over half (n=14,53.4%) scored in the “abnormal” or “borderline” range on the overall SDQ score. Only four had ever been diagnosed with a mental condition. In qualitative narratives, 25 mothers described emotional or behavioral issues that interfered with daily activities, but only 12(40%) thought these could or should be addressed. Seventeen shared beliefs about reasons for the child’s emotional/behavioral challenges, which fell into four categories: Moving/Separation from the Father/Abuser; Physiological; DV Exposure; and Social/Interpersonal Motivations (e.g. child is seeking attention, putting on a façade), with this last category implying child control. Mothers shared varied beliefs on the potential benefits of MH intervention.

IMPLICATIONS:

This poster will share implications for research and practice. For example, findings support shelters’ efforts to provide therapeutic services to children and inform mothers of the connection between DV exposure and child emotional/behavioral challenges.  However, further efforts would be beneficial, including screening to identify children needing targeted MH follow-up beyond shelter-based services, and communicating with mothers about the potential for appropriate MH care to address specific child emotional/behavioral challenges they see, since some mothers might be minimizing the need, underestimating potential benefits of MH intervention, or believing that addressing the perceived cause will be sufficient.