“Disconnected from everyone and everything around them”: A mixed method study to explore the perspectives of children with language difficulties and their caregivers on mental health concerns and mental health support.

Background: Globally, as many as 1 in 8 children experience severe and persistent language difficulties. These children are at heightened risk for mental health difficulties, however, both the ways in which mental health concerns manifest in the context of language difficulties, and the experiences of children with language difficulties and their caregivers in accessing and engaging with formal mental health supports remain under researched. Aim: The aim of the current study was to explore lived experience perspectives (child and caregiver) on mental health concerns and, mental health support, for children (≤ 18 years) with language difficulties. Method: A 2-phased sequential explanatory design was employed, which combined findings from an online international survey of caregivers (n = 120) of children with language difficulties with data from semi-structured interviews with both children (n = 4) and caregivers (n = 12). Results: Combined data from the survey and interviews highlighted a high level of caregiver concern about the mental health of children with language difficulties but low levels of access to formal mental health support. Interviews highlighted several reasons for not accessing formal mental health supports including limited availability of mental health care providers; funding and time constraints (i.e., not wanting to over-schedule their child); mental health providers lacking knowledge about DLD, and perceived or actual barriers of traditional methods of therapy (e.g., one-on-one talk therapy) for children with language difficulties. Conclusions and Implications: The findings of our study support the view that children with language difficulties are at risk of mental health concerns and yet are also under-served by mental health services. These findings highlight the need for targeted interprofessional training and integrated models of collaborative care between mental health and language specialists to more adequately meet these children’s needs. Future research to engage a wider range of child perspectives and the perspectives of clinicians on the facilitators and barriers to engaging children with language difficulties in formal mental health support is needed.