The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions.

<h4>Introduction</h4>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 heal...

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Autores principales:	Cristiane S Paula, Isabel A S Bordin, Jair Jesus Mari, Luciane Velasque, Luis A Rohde, Evandro S F Coutinho
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d095db6890b34bbc83d850257a1c1290
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spelling	oai:doaj.org-article:d095db6890b34bbc83d850257a1c12902021-11-18T08:32:20ZThe mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions.1932-620310.1371/journal.pone.0088241https://doaj.org/article/d095db6890b34bbc83d850257a1c12902014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24558382/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>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.<h4>Objectives</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusions</h4>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.Cristiane S PaulaIsabel A S BordinJair Jesus MariLuciane VelasqueLuis A RohdeEvandro S F CoutinhoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 2, p e88241 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Cristiane S Paula Isabel A S Bordin Jair Jesus Mari Luciane Velasque Luis A Rohde Evandro S F Coutinho The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions.
description	<h4>Introduction</h4>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.<h4>Objectives</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusions</h4>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.
format	article
author	Cristiane S Paula Isabel A S Bordin Jair Jesus Mari Luciane Velasque Luis A Rohde Evandro S F Coutinho
author_facet	Cristiane S Paula Isabel A S Bordin Jair Jesus Mari Luciane Velasque Luis A Rohde Evandro S F Coutinho
author_sort	Cristiane S Paula
title	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_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_sort	mental health care gap among children and adolescents: data from an epidemiological survey from four brazilian regions.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/d095db6890b34bbc83d850257a1c1290
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The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions.

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