(PS5-C74) Engaging Caregivers in Youth Mental Healthcare: Provider- and Organizational-level Supports

Between 20-25% of children globally are experiencing depressive or anxiety symptoms (Racine et al., 2021). This number is two times that of pre-COVID-19 pandemic levels. However, data suggest that youth mental healthcare utilization has declined during the pandemic (Stewart et al., 2021). Of youth who seek mental health care services, between 30 and 75% do not complete treatment (De Haan et al., 2013; Kapke & Gerdes, 2016). Caregiver involvement can facilitate youth mental healthcare utilization and can improve clinical outcomes (Richards et al., 2008; Wright et al., 2019). However, engaging caregivers can be met with various barriers at the client level (e.g., client age, externalizing symptoms), the caregiver level (e.g., lack of transportation, socioeconomic status, single parenthood), and the agency level (e.g., lack of services in preferred language, clinic setting; Barnett et al., 2020; Dickson et al., 2020; Fawley-King et al., 2013; Meza et al., 2020; Ofonedu et al., 2017). These barriers may be exacerbated during an emergency, like the COVID-19 pandemic, and are thus important to address in both routine and emergency situations. Nonetheless, few studies have examined how providers and agencies can support caregiver engagement in community mental health settings (CMHC). Thus, the current study examines whether addressing the barriers identified in the literature impacts in-person caregiver engagement. Data come from CMHC providers (N = 134) who participated in the Washington state Cognitive Behavioral Therapy training initiative in 2020-2021 (CBT+; Dorsey et al., 2016). Providers completed a self-report survey that indicated the use and frequency of provider-level strategies (i.e., prioritization of family involvement, collaboration with bilingual staff, frequency of addressing social risk factors) and agency-level strategies (i.e., expectations to address social risk factors, services in multiple languages, proximity to public transportation, flexible operating hours, family support services). Results from a 2-level linear regression indicate that providers who frequently address social risk factors in therapy had more frequent in-person contact with caregivers, holding all else constant (b = -0.28, SE = .13, p = .041). No other provider-level or agency-level strategies were associated with caregiver engagement. The results suggest that solutions for engaging caregivers may need to be personalized based on the barriers (i.e., social risk factors) experienced by the family, rather than agency-wide strategies. To better prepare providers and agencies for engaging caregivers in routine and emergency mental health care, future research should explore how an agency can support the design and implementation of personalized strategies.