Cited by 38Child Welfare and AdoptionSocial Work Education and PracticeChild Abuse and Trauma

Barriers and facilitators for access to mental health services by traumatized youth

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Damian, April Joy, Gallo, Joseph J., Mendelson, Tamar·2018·Children and Youth Services Review

Abstract

Polytrauma is a highly prevalent public health problem in the U.S. with even higher rates in urban areas. Children with polytrauma often end up in multiple child-serving systems (e.g., mental health, child welfare, education, juvenile justice) with needs that are both complex and severe. Providers within these child-serving systems have potential to serve as gatekeepers to trauma services by linking youth with trauma-informed treatments and supports that promote recovery. The purpose of our study was to assess the perspective of providers who participated in a nine-month, trauma-informed care (TIC) training intervention on 1) their capacity to make referrals to trauma-specific services following the training, and 2) factors external to the training intervention that supported or hindered their ability to link traumatized youth with services. A subset of sixteen participants from the TIC training completed individual interviews. These participants were predominantly female, African American, and based in the social services sector. The constant comparative method was used to derive three thematic domains related to participant perceptions regarding youth referrals: 1) Organizational and provider capacity to provide trauma treatment or to make referrals to trauma-specific services, 2) Barriers to youth accessing trauma services, and 3) Suggestions for improving coordination of care and referrals. Our study highlights the influence of contextual factors on whether a TIC training can improve the capacity of agencies and individual providers to support traumatized youth in accessing appropriate services. The development of a structure that formally connects youth-serving agencies and providers with specialists trained in addressing traumatized youth is recommended.

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Crossref · 10.1016/j.childyouth.2018.01.003

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  • For care-experienced young people, negative and unempathetic responses from adults in services reinforced childhood experiences of abuse, neglect, rejection and abandonment from caregivers, which were connected to feelings of defectiveness and helplessness.

    “For care-experienced young people, negative and unempathetic responses from adults in services were found to reinforce childhood experiences of abuse, neglect, rejection and abandonment from caregivers, which were connected to feelings of defectiveness and helplessness (Damian et al. 2018).”

    From "You Have the Choice of Whether You're Going to Get Help or Attempt Suicide": Exploring the Process and Impact of Mental Health Help-Seeking with Young People (16–25 Years) (2025) · cites this paper as Damian et al. 2018

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  • Inappropriate service provision can contribute to hopelessness, loneliness and suicidal pathways.

    “these findings highlight how inappropriate service provision can contribute to hopelessness, loneliness and suicidal pathways”

    From "You Have the Choice of Whether You're Going to Get Help or Attempt Suicide": Exploring the Process and Impact of Mental Health Help-Seeking with Young People (16–25 Years) (2025) · cites this paper as Damian et al. 2018

    The Results (§3.2; page not supplied) describe poor coordination, staff shortages and delays in traumatized youths’ access to care. Neither those passages nor searches for hopelessness, loneliness and suicide address whether inappropriate service provision contributes to the three claimed outcomes. (LLM, conf=0.77)

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References 19 · Cited by 38

Authors
Damian, A. J., Gallo, J. J., & Mendelson, T.
Affiliations
Johns Hopkins University (US)
Corresponding author
Damian, April Joy
Venue
Children and Youth Services Review
Publisher
Elsevier BV
Published
2018-01
Volume
85
Pages
273-278
ISSN
0190-7409 (ISSN-L)
OpenAlex
W2783613231
Cited by
38
References
19
Citations by year
2026: 3 · 2025: 9 · 2024: 9 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 3 · 2019: 1 · 2012: 1
FWCI
4.47
Type
journal article
Language
en
Open access
Locations
  • Children and Youth Services Review (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development
  • National Institutes of Health (F31HD090851)
Topics
  • Social Sciences › Safety Research › Child Welfare and Adoption
  • Social Sciences › Public Administration › Social Work Education and Practice
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
polytrauma, traumatized youth, trauma-informed care, provider training, referral services, barriers to mental health care, inter-agency coordination, organizational capacity

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