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The Mental Health Care Gap among Children and Adolescents: Data from an Epidemiological Survey from Four Brazilian Regions

INTRODUCTION: Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHS...

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Autores principales: Paula, Cristiane S., Bordin, Isabel A. S., Mari, Jair Jesus, Velasque, Luciane, Rohde, Luis A., Coutinho, Evandro S. F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928169/
https://www.ncbi.nlm.nih.gov/pubmed/24558382
http://dx.doi.org/10.1371/journal.pone.0088241
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author Paula, Cristiane S.
Bordin, Isabel A. S.
Mari, Jair Jesus
Velasque, Luciane
Rohde, Luis A.
Coutinho, Evandro S. F.
author_facet Paula, Cristiane S.
Bordin, Isabel A. S.
Mari, Jair Jesus
Velasque, Luciane
Rohde, Luis A.
Coutinho, Evandro S. F.
author_sort Paula, Cristiane S.
collection PubMed
description INTRODUCTION: Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHSU) among Brazilian children/adolescents are extremely scarce and are needed to guide public policy. OBJECTIVES: To establish the frequency of MHSU among 6-to-16-year-old with psychiatric disorders from four Brazilian regions; and to identify structural/psychosocial/demographic barriers associated with child/adolescent MHSU. METHODS: Multicenter cross-sectional-study involving four towns from four out of five Brazilian regions. In each town, a representative sample of elementary public school students was randomly selected (sample: 1,721). Child/adolescent MHSU was defined as being seen by a psychologist/psychiatrist/neurologist in the previous 12 months. Standardized instruments measured: (1) children/adolescent characteristics [(1.1) Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL)-psychiatric disorders; (1.2) Ten Questions Screen-neurodevelopment problems; (1.3) two subtests of WISC-III-estimated IQ; (1.4) Academic Performance Test-school performance)], (2) factors related to mothers/main caregivers (Self-Reporting Questionnaire-anxiety/depression), (3) family (Brazilian Research-Companies-Association's Questionnaire-SES). RESULTS: Only 19.8% of children/adolescents with psychiatric disorder have used mental health services in the previous 12 months. Multiple logistic regression modeling identified five factors associated with lower rates of MHSU (female gender, adequate school performance, mother/main caregiver living with a partner, lower SES, residing in deprived Brazilian regions) regardless of the presence of any psychiatric disorders/neurodevelopmental problems. CONCLUSIONS: Only a small proportion of children/adolescents with psychiatric disorders had been seen by a mental health specialist in the previous 12 months. Structural/psychosocial/demographic factors were associated with uneven access to service for certain groups of children/adolescents. These results call attention to the urgent need to implement programs to help reduce this large unmet mental health need; inequalities must be considered by policy makers when planning strategies to address barriers for care.
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spelling pubmed-39281692014-02-20 The Mental Health Care Gap among Children and Adolescents: Data from an Epidemiological Survey from Four Brazilian Regions Paula, Cristiane S. Bordin, Isabel A. S. Mari, Jair Jesus Velasque, Luciane Rohde, Luis A. Coutinho, Evandro S. F. PLoS One Research Article INTRODUCTION: Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHSU) among Brazilian children/adolescents are extremely scarce and are needed to guide public policy. OBJECTIVES: To establish the frequency of MHSU among 6-to-16-year-old with psychiatric disorders from four Brazilian regions; and to identify structural/psychosocial/demographic barriers associated with child/adolescent MHSU. METHODS: Multicenter cross-sectional-study involving four towns from four out of five Brazilian regions. In each town, a representative sample of elementary public school students was randomly selected (sample: 1,721). Child/adolescent MHSU was defined as being seen by a psychologist/psychiatrist/neurologist in the previous 12 months. Standardized instruments measured: (1) children/adolescent characteristics [(1.1) Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL)-psychiatric disorders; (1.2) Ten Questions Screen-neurodevelopment problems; (1.3) two subtests of WISC-III-estimated IQ; (1.4) Academic Performance Test-school performance)], (2) factors related to mothers/main caregivers (Self-Reporting Questionnaire-anxiety/depression), (3) family (Brazilian Research-Companies-Association's Questionnaire-SES). RESULTS: Only 19.8% of children/adolescents with psychiatric disorder have used mental health services in the previous 12 months. Multiple logistic regression modeling identified five factors associated with lower rates of MHSU (female gender, adequate school performance, mother/main caregiver living with a partner, lower SES, residing in deprived Brazilian regions) regardless of the presence of any psychiatric disorders/neurodevelopmental problems. CONCLUSIONS: Only a small proportion of children/adolescents with psychiatric disorders had been seen by a mental health specialist in the previous 12 months. Structural/psychosocial/demographic factors were associated with uneven access to service for certain groups of children/adolescents. These results call attention to the urgent need to implement programs to help reduce this large unmet mental health need; inequalities must be considered by policy makers when planning strategies to address barriers for care. Public Library of Science 2014-02-18 /pmc/articles/PMC3928169/ /pubmed/24558382 http://dx.doi.org/10.1371/journal.pone.0088241 Text en © 2014 Paula et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Paula, Cristiane S.
Bordin, Isabel A. S.
Mari, Jair Jesus
Velasque, Luciane
Rohde, Luis A.
Coutinho, Evandro S. F.
The Mental Health Care Gap among Children and Adolescents: Data from an Epidemiological Survey from Four Brazilian Regions
title The Mental Health Care Gap among Children and Adolescents: Data from an Epidemiological Survey from Four Brazilian Regions
title_full The Mental Health Care Gap among Children and Adolescents: Data from an Epidemiological Survey from Four Brazilian Regions
title_fullStr The Mental Health Care Gap among Children and Adolescents: Data from an Epidemiological Survey from Four Brazilian Regions
title_full_unstemmed The Mental Health Care Gap among Children and Adolescents: Data from an Epidemiological Survey from Four Brazilian Regions
title_short The Mental Health Care Gap among Children and Adolescents: Data from an Epidemiological Survey from Four Brazilian Regions
title_sort mental health care gap among children and adolescents: data from an epidemiological survey from four brazilian regions
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928169/
https://www.ncbi.nlm.nih.gov/pubmed/24558382
http://dx.doi.org/10.1371/journal.pone.0088241
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