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Barriers to Mental Health Care: Perceived Delivery System Differences

Lingley-Pottie, Patricia PhD, BNRN, CCRC; McGrath, Patrick J. PhD, OC, FRSC; Andreou, Pantelis PhD

doi: 10.1097/ANS.0b013e31828077eb
Original Articles

Treatment barriers have prompted the development of new models of care. Distance delivery systems bridge the access gap, increasing service availability. Understanding differences between systems can inform system improvements. Sixty participants from the Strongest Families telephone intervention for child behavior difficulties participated. Participants completed a questionnaire to explore differences in perceived treatment barriers (Treatment Barriers Index—TBI) and therapeutic processes (eg, therapeutic alliance, self-disclosure, health outcome) between face-to-face versus distance treatment. The TBI scale has strong internal reliability (Cronbach α: 0.95 [face-to-face]; 0.90 [distance]). Statistically significant differences were found between delivery system TBI mean scores, indicating fewer barriers with distance treatment. Therapeutic process differences between delivery modes suggest enhanced therapeutic alliance and self-disclosure scores with distance treatment. Increased access, convenience, and sense of privacy (visual anonymity) offered by a distance delivery system may provide an enhanced experience for some individuals.

Strongest Families Institute (Dr Lingley-Pottie), Department of Psychology, Pediatrics, and Psychiatry, Research and Innovation Capital District Health Authority, IWK Health Centre, Dalhousie University (Dr McGrath), and Faculty of Medicine, Community Health & Epidemiology, Dalhousie University (Dr Andreou), Halifax, Nova Scotia, Canada.

Correspondence: Patricia Lingley-Pottie, PhD, BNRN, CCRC, Strongest Families Institute, 7105 Chebucto Rd, Ste 355, Halifax, Nova Scotia, Canada, B3L 4W8 (

This research study was conducted in association with the Strongest Families Institute, the Centre of Research in Family Health at the IWK Health Centre, and Dalhousie University, Halifax, Nova Scotia, Canada, as part of Dr Lingley-Pottie's PhD dissertation.

This study was supported by research funds from The Canadian Institutes of Health Research—Team Grant and a Canada Research Chair to P.J.M. The authors thank the families who shared their experiences.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2013 Lippincott Williams & Wilkins, Inc.