Barriers to mental health service receipt among Appalachian and

rural survivors of brain tumors

Allison P. Fisher, M.A.,  Jamie Patronick, Sandra Glazer, Emily L. Moscato, MA, Chloe Elleman, Kaelynn Knestrick, Shari L. Wade, PhD

Understand most common Appalachian: Caregiver-Reported Barriers

barriers that prevent adolescents
young adult brain tumor survivors from
receiving mental health
and
Perceived need
Appalachian parents = Perceived need non-
Appalachian parents
46% endorsed long-wait times
46% stated the problem was not a mental health
Perceived need
Appalachian survivors < Perceived need non-
Appalachian survivors

METHODS
problem

46% believed their child’s problems are not so serious

Perceived need Rural
Parents > Perceived need non-
Rural Parents

• 45 survivors of pediatric brain tumors (ages

13-25) and 47 parents completed a survey Appalachian: Adolescent/Young Adult Barriers
Perceived need Rural
survivors = Perceived need non-
Rural survivors

that assessed perceived barriers to care Numbers of Barriers Endorsed

• Also described whether the survivor could 53% felt out of place in services 12

benefit from mental health services

10

(“perceived need”)
46% felt uncomfortable talking to strangers/ burdening 8

others
6

• Percentages were used to capture barriers 4

47% felt they could handle their problems on their own

2

• Independent samples t-tests to determine 0

differences in barriers reported among Number of Barriers Endorsed

Appalachian/non-Appalachian and
Rural: Caregiver-Reported Barriers
14

Rural/non-Rural participants. 12

10

56% endorsed long-wait times

8

56% reported services were too expensive 0

P < .05

14 Appalachian 7 Rural 56% noted insurance benefits were exhausted/services DISCUSSION

parents parents were not covered
16 survivors
• Rural and Appalachian families endorsed
8 survivors
56% stated the problem was not a mental health barriers in numerous areas including practical
problem barriers (e.g., wait times), cost-related barriers,
N = 5 parents,
5 survivors
and concerns about discomfort and the
Rural Parents: Would your child benefit from Rural Survivors: Would you benefit from mental
Rural: Adolescent/Young Adult Barriers helpfulness of services
mental health services? health services? • Rural parents endorsed greater perceived
89% felt they could handle their problems on their own mental health service need and more barriers
than non-Rural parents
78% felt uncomfortable talking to strangers/ burdening • Appalachian parents did not report greater
Yes No
others need or barriers to care than non-Appalachian
Yes No
Appalachian Parents: Would your child benefit Appalachian Survivors: Would you benefit from families
from mental health services? mental health services?
67% noted concerns that services would not be helpful • Appalachian survivors reported less
perceived need
• Findings suggest the need to adapt services to
We would like to thank the families who participated. Correspondence to:
Allison.fisher@cchmc.org meet the needs of Appalachian and Rural
Yes No Yes No
families