A Qualitative Investigation of Mental Health Service Delivery to Australian Children and their Families with Low Socioeconomic Status

 Background and aims: Child and adolescent mental disorders are twice as prevalent among families from low socioeconomic backgrounds, highlighting that these are the families at greatest need. These young people are less likely to receive mental health care, and even when they do, their outcomes are often poorer compared to their peers with higher socioeconomic status. The aims of this qualitative study were to identify barriers and facilitators to mental health service access and engagement as perceived by children and families with low socioeconomic status in Australia, specifically those falling below the 20th percentile of household incomes nationally. Methods: Employing a multi-informant focus group methodology, thematic analysis was conducted on four focus groups (n = 30) consisting of youth, parents, and mental health professionals with experience working with youth from low socioeconomic backgrounds. Results: Themes related to quality perceptions, service norms, scepticism and trust, mental health knowledge and communication, the role of informal networks, and the valued but overwhelmed nature of school-based services. Participants emphasised barriers more than facilitators. Conclusions: Findings suggest that commonly recognised barriers to mental health care intensify in the context of socioeconomic disadvantage, highlighting the urgency to (re)establish models of mental health care that can support the diverse needs of children and families with low socioeconomic status.