The mental health of children and adolescents at Matosinhos: characteristics and obstacles to care

BACKGROUND: Mental health disorders are a public health issue. Most mental disorders begin during childhood and adolescence. Epidemiological studies regarding the diagnosis, prevalence, and access to treatment by children and adolescents are scarce, especially in Portugal. This research protocol aims to characterize the referral process and waiting times for these consultations at a Portuguese Local Health Unit between 2017 and 2022 (covering about 180,000 people); and to identify barriers to adequate health care for children and adolescents from the perspective of healthcare professionals from the hospital and primary care units. METHODS: We used a mixed methods study. Qualitative data allowed interpretation and reflection of quantitative data, with validation and integration of results. We conducted a descriptive analysis of the variables obtained through the local Health Information System and semi-structured interviews with a sample of healthcare professionals involved in mental health care for children and adolescents at the hospital and primary care unit levels. RESULTS: Preliminary results show a break in the number of consultations in 2018, due to the lack of professionals, and a yearly increase after COVID-19. Follow-up appointments and evaluation processes have long waiting times since there is a focus on ensuring shorter waiting times for the first consultation, and there is a shortage of professionals in mental health teams. The staff identified the need to integrate schools into care - referral and evaluation - and to promote community-based programs that train skills in children, adolescents, and caregivers. CONCLUSIONS: Health indicators allow the assessment of epidemiological data and access to care, yet it is fundamental to listen to the professionals in the field to identify barriers, needs, and possible actions that more effectively promote mental health in this population. KEY MESSAGES: • Mental health disorders in children and adolescents are a significant public health issue in Portugal, yet there are scarce epidemiological studies on diagnosis, prevalence, and access to treatment. • There is a need to address the shortage of mental health professionals and integrate schools and community-based programs into mental health care to improve access and promote mental health.