Mental healthcare for children and adolescents

2022 ◽  
pp. 193-218
Author(s):  
Jennifer Fraser ◽  
Lindsay Smith ◽  
Julia Taylor
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare

scholarly journals Proactive detection of people in need of mental healthcare: accuracy of the community case detection tool among children, adolescents and families in Sri Lanka

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Myrthe van den Broek ◽  
Puvaneswary Ponniah ◽  
P. Judy Ramesh Jeyakumar ◽  
Gabriela V. Koppenol-Gonzalez ◽  
John Vijay Sagar Kommu ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Children And Adolescents ◽  
Help Seeking ◽  
Mental Healthcare ◽  
Clinical Interview ◽  
Daily Routine ◽  
Case Detection ◽  
Children And Families ◽  
Community Members ◽  
Detection Tool

Abstract Background Most children and adolescents in need of mental healthcare remain untreated even when services are available. This study evaluates the accuracy of a new tool, the Community Case Detection Tool (CCDT). The CCDT uses illustrated vignettes, two questions and a simple decision algorithm to support proactive community-level detection of children, adolescents and families in need of mental healthcare to improve help-seeking. Methods Trusted and respected community members in the Eastern Province of Sri Lanka used the CCDT in their daily routine. Children and families detected as potentially in need of mental healthcare based on utilizing the CCDT (N = 157, aged 6–18 years) were invited for a clinical interview by a mental health counsellor using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). The CCDT results were compared against the results of the clinical interview. The concurrent validity and performance of the CCDT were also evaluated by comparing the CCDT outcomes against the Strengths and Difficulties Questionnaire (SDQ). Results 7 out of 10 children and families detected by community members using the CCDT were confirmed to be in need for treatment (positive predictive value [PPV] = 0.69; 0.75 when compared to the SDQ). Detections based on the family problem vignette were most accurate (PPV = 0.76), followed by the internalising problem vignette (PPV = 0.71) and the externalising problem vignette (PPV = 0.62). Conclusions The CCDT is a promising low-cost solution to overcome under-detection of children and families in need of mental healthcare. Future research should focus on evaluating the effectiveness, as well as additional strategies to improve help-seeking.

scholarly journals The Persistence of Child and Adolescence Mental Healthcare: Results from Registry Data

2020 ◽  
Author(s):  
Hermien Dijk ◽  
Roel Freriks ◽  
Rob Alessie ◽  
Jochen Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Essential Information ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background: Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods: We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results: All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 (p < 0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 (p < 0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) results are robust to different definitions of care and (2) persistence of care does not differ significantly across subgroups. Conclusions: The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with an average of less than 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals The Persistence of Child and Adolescence Mental Healthcare: Results from Registry Data

2020 ◽  
Author(s):  
Hermien Dijk ◽  
Roel Freriks ◽  
Rob Alessie ◽  
Jochen Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Policy Reforms ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background: Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods: We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results: All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 ( p < 0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 ( p < 0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) policy reforms only slightly affected persistence of care, (2) results are robust to different definitions of care and (3) persistence of care does not differ significantly across subgroups. Conclusions: The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with approximately 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals Internet- and Mobile-Based Interventions for Mental and Somatic Conditions in Children and Adolescents

2020 ◽  
Vol 48 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Matthias Domhardt ◽  
Lena Steubl ◽  
Harald Baumeister
Keyword(s):  
Mental Disorders ◽  
Children And Adolescents ◽  
Effect Size ◽  
Treatment Effects ◽  
Meta Analysis ◽  
Mental Healthcare ◽  
Quality Ratings ◽  
Meta Review ◽  
Mean Differences ◽  
Meta Analyses

Abstract. This meta-review integrates the current meta-analysis literature on the efficacy of internet- and mobile-based interventions (IMIs) for mental disorders and somatic diseases in children and adolescents. Further, it summarizes the moderators of treatment effects in this age group. Using a systematic literature search of PsycINFO and MEDLINE/PubMed, we identified eight meta-analyses (N = 8,417) that met all inclusion criteria. Current meta-analytical evidence of IMIs exists for depression (range of standardized mean differences, SMDs = .16 to .76; 95 % CI: –.12 to 1.12; k = 3 meta-analyses), anxiety (SMDs = .30 to 1.4; 95 % CI: –.53 to 2.44; k = 5) and chronic pain (SMD = .41; 95 % CI: .07 to .74; k = 1) with predominantly nonactive control conditions (waiting-list; placebo). The effect size for IMIs across mental disorders reported in one meta-analysis is SMD = 1.27 (95 % CI: .96 to 1.59; k = 1), the effect size of IMIs for different somatic conditions is SMD = .49 (95 % CI: .33 to .64; k = 1). Moderators of treatment effects are age (k = 3), symptom severity (k = 1), and source of outcome assessment (k = 1). Quality ratings with the AMSTAR-2-checklist indicate acceptable methodological rigor of meta-analyses included. Taken together, this meta-review suggests that IMIs are efficacious in some health conditions in youths, with evidence existing primarily for depression and anxiety so far. The findings point to the potential of IMIs to augment evidence based mental healthcare for children and adolescents.

scholarly journals The Persistence of Child and Adolescence Mental Healthcare: Results from Registry Data

2020 ◽  
Author(s):  
Hermien Dijk ◽  
Roel Freriks ◽  
Rob Alessie ◽  
Jochen Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Policy Reforms ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background: Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods: We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results: All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 (p < 0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 (p < 0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) policy reforms only slightly affected persistence of care, (2) results are robust to different definitions of care and (3) persistence of care does not differ significantly across subgroups. Conclusions: The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with approximately 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals The persistence of child and adolescence mental healthcare: results from registry data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hermien H. Dijk ◽  
Roel D. Freriks ◽  
Rob J.M. Alessie ◽  
Jochen O. Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Essential Information ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 (p<0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 (p<0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) results are robust to different definitions of care and (2) persistence of care does not differ significantly across subgroups. Conclusions The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with an average of less than 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

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