Do Parent Perceptions Predict Continuity of Publicly Funded Care for Attention-Deficit/Hyperactivity Disorder?

Parent perceptions of care did not predict whether or not their child stayed in treatment for ADHD.

Children enrolled in Medicaid may be at risk of having poor continuity of care, particularly for mental health services and long-term treatment for attention deficit hyperactivity disorder (ADHD). Various factors—at the child, parent, and system levels—influence access to, and use of, mental health services.

In this study, investigators examined whether parents’ perceived barriers to care, knowledge about ADHD, and willingness to have their child treated, were predictive of a child staying in care. Their study population was 529 children ages 5 to 11 receiving outpatient mental health care in the Los Angeles Medicaid managed care program (2003–2006). Most of the children were male (80%), from racial ethnic minority (83%) backgrounds, and met criteria for an ADHD diagnosis (77%).

Some 58 percent of parents reported barriers to care such as logistical problems (42%); problems with the clinic wait time or services (31%); concerns about talking with the doctor (20%); or fear of losing child custody (17%). Parents had poor knowledge about ADHD, medications, and counseling.

Reporting fewer barriers and knowledge of ADHD did not improve the likelihood of a child staying in care. Willingness to have a child receive medication treatment, however, was predictive of staying in care.