scholarly journals Child and adolescent psychiatric disorders in general practice

1995 ◽  
Vol 1 (7) ◽  
pp. 184-191
Author(s):  
R. G. Jezzard
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practice ◽  
Child Mental Health ◽  
Mental Health Problems ◽  
Health Service Provision ◽  
Adult Mental Health ◽  
Specialist Services ◽  
Mental Health Literature ◽  
Mental Health Service Provision

It has been known for some time that the majority of adult mental health problems within any community are seen within general practice, making up a fifth to a quarter of the general practitioner's workload (Shepherd & Clare, 1981). Most patients are not referred to specialist services. It is therefore the primary care team and not the psychiatric specialist who assumes the major burden of responsibility for the care of mental disorder. Hence, more attempts are now being made to improve the quality of psychiatric care within general practice. Most of the research on mental health morbidity within primary care has been in the field of adult mental health and it is only relatively recently that equivalent information on child mental health morbidity has become available. In parallel, an increasing number of studies examining the effectiveness of interventions in primary care have been undertaken and different models of mental health service provision within this context have been described (Strathdee & Williams, 1984). There are few evaluated studies of interventions in primary care focused on child mental health. Most guidance for the development of such services has to be obtained from the adult mental health literature, or from work with other types of childhood disorder, often in non-general practice settings.

scholarly journals Suicide and self-harm: vulnerable children and young people

2019 ◽  
Vol 30 (5) ◽  
pp. 218-223 ◽  
Author(s):  
Maddie Burton
Keyword(s):  
Mental Health ◽  
Young People ◽  
Suicidal Behaviour ◽  
Mental Health Problems ◽  
Vulnerable Children ◽  
Health Service Provision ◽  
Children And Young People ◽  
Practice Nurses ◽  
Self Harm ◽  
Mental Health Service Provision

Children and young people are increasingly experiencing mental health problems, including self-harm and suicidal behaviour. Maddie Burton explores the triggers of these two conditions and explains what practice nurses can do for their patients Children and young people’s mental health continues to be a cause for concern at a time of reduced mental health service provision. Worryingly, suicide and self-harm rates continue to rise. An estimated two hundred children and young people lose their lives annually through completed suicide. Half of that number will have a previous self-harm history. Practice nurses are often favoured by young people as being less stigmatising; therefore they can potentially provide opportunities for early help through being vigilant, informed, hearing the young person’s story and then knowing how to support and appropriately respond and signpost. This article explores both the differences between self-harm and suicidal behaviour, and how they are connected.

Child and Adolescent Psychiatry in General Practice

2001 ◽  
Vol 35 (3) ◽  
pp. 308-314 ◽  
Author(s):  
Elena Garralda
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practice ◽  
Psychiatric Disorders ◽  
General Practitioners ◽  
Mental Health Problems ◽  
Child And Adolescent ◽  
Health Problems ◽  
Undergraduate Teaching ◽  
Further Development

Objective: This review discusses the role of general practitioners and primary care health staff in the assessment, treatment and prevention of child and adolescent psychiatric disorders and to consider implications for service delivery. Method: Literature review. Papers were selected as having an empirical evidence base or as describing and documenting new initiatives in general practice. Results: A small proportion of about 3% of children present to general practice with behavioural or emotional problems, but psychiatric disorders in the context of somatic presentations are considerably more common. They are probably higher than in the general population reflecting an increased tendency by children with disorders to consult. Recognition by general practitioners is limited and few children with disorders are referred to specialist clinics. However, referrals are mostly appropriate: the more severely affected children in difficult psychosocial circumstances. A number of pilot studies have shown the feasibility and potential usefulness of setting up shifted specialist clinics in primary care and of training primary care doctors and other staff in the recognition or management of child mental heath problems. Conclusion: Primary care is an appropriate resource to help increase attention to child and adolescent mental health problems. Its potential requires further development and rigorous evaluation. Areas lending themselves to development include: improved medical undergraduate teaching and postgraduate training; suitable information and advice-giving on child mental health problems by the primary care team; the development of specific child and adolescent psychiatric interventions for use in the primary care setting; careful and discriminating development of shifted outpatient clinics for selected child psychiatric disorders; the development of focused protocols for referral to specialist services; further development of mental health promotion clinics in primary care.

Using Administrative Data to Measure Ambulatory Mental Health Service Provision in Primary Care

Medical Care ◽  
2004 ◽  
Vol 42 (10) ◽  
pp. 960-965 ◽  
Author(s):  
Leah S. Steele ◽  
Richard H. Glazier ◽  
Elizabeth Lin ◽  
Michael Evans
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Service ◽  
Health Service ◽  
Administrative Data ◽  
Service Provision ◽  
Health Service Provision ◽  
Mental Health Service Provision

Mental health in general practice: assessment of current state and future needs

2005 ◽  
Vol 22 (3) ◽  
pp. 83-86 ◽  
Author(s):  
Mimi Copty ◽  
David L Whitford
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Health Services ◽  
Postgraduate Training ◽  
Mental Health Problems ◽  
Health Problems ◽  
Psychiatric Services ◽  
Psychological Therapies

AbstractObjectives: To determine the extent of mental health services provided in the community in one Irish health board area. To examine the influence of postgraduate mental health training of GPs on provision of mental health services.Method: Questionnaire and focus group methods were employed to determine views on mental health service provision. Data analysis was with parametric and non-parametric tests of association including student's t and chi-squared tests. Thematic analysis of the focus groups was carried out.Results: Twenty-five per cent of patients attending general practice have mental health problems and over 95% of these problems are dealt with in primary care. Only 32% of GPs had received postgraduate training in psychological therapies. GPs with postgraduate training in psychological therapies were more likely to estimate a higher proportion of their patient population with mental health problems and less likely to refer to psychiatric services. A need for support from other health care professionals in primary care was also identified.Conclusion: The majority of patients with mental health problems are treated in primary care. Further training of GPs and increased resources would improve mental health care in primary care and lead to fewer referrals to psychiatric services.

scholarly journals Factors associated with the identification of child mental health problems in primary care—a systematic review

2019 ◽  
Vol 25 (3) ◽  
pp. 116-127 ◽  
Author(s):  
Nynke R. Koning ◽  
Frederike L. Büchner ◽  
Marjolein E.A. Verbiest ◽  
Robert R.J.M. Vermeiren ◽  
Mattijs E. Numans ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Primary Care ◽  
Child Mental Health ◽  
Mental Health Problems ◽  
Health Problems ◽  
Factors Associated

scholarly journals Parenting stress during infancy is a risk factor for mental health problems in 3-year-old children

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nayantara Hattangadi ◽  
Katherine T. Cost ◽  
Catherine S. Birken ◽  
Cornelia M. Borkhoff ◽  
Jonathon L. Maguire ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Parenting Stress ◽  
Child Mental Health ◽  
Mental Health Problems ◽  
Health Problems ◽  
Research Network ◽  
Care Practice ◽  
The Impact ◽  
Preschool Aged Children

Abstract Background Although research on the relationship between parent and child mental health is growing, the impact of early parenting stress on preschool-aged children’s mental health remains unclear. The objective was to evaluate the association between parenting stress during infancy and mental health problems in 3-year-old children. Methods A prospective cohort study of healthy preschool-aged children recruited from 9 primary care practices in Toronto, Canada was conducted through the TARGet Kids! primary care practice-based research network. Parenting stress was measured when children were between 0 to 16 months of age, using the Parent Stress Index Short Form, PSI-SF. Parent-reported child mental health problems were measured at 36 to 47 months using the preschool Strengths and Difficulties Questionnaire, total difficulties score (TDS). Hierarchical linear regression analysis was used to investigate the association between standardized PSI-SF and TDS, adjusted for child age, sex, temperament, sleep duration and household income. To strengthen clinical interpretation, analysis was repeated using adjusted multivariable logistic regression (TDS dichotomized at top 20%). Results A total of 148 children (mean ± SD age, 37.2 ± 1.7 months, 49% male) were included in the analysis. Parenting stress during infancy (11.4 ± 3.1 months of age) was significantly associated with mental health problems in 3-year-old children (β = 0.35; 95% CI = 0.20–0.49, p < 0.001). Higher parenting stress was also associated with increased odds of higher TDS (OR = 2.26, 95% CI = 1.69–2.83, p < 0.01). Conclusion Healthy preschool-aged children with parents reporting parenting stress during infancy had a 2 times higher odds of mental health problems at 3 years.

Disclosure of mental health problems in general practice: The gradual emergence of latent topics and resources for achieving their consideration

2015 ◽  
Vol 11 (2) ◽  
pp. 189-202 ◽  
Author(s):  
Christel Tarber ◽  
Lisbeth Frostholm
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practice ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Common Mental Disorders ◽  
Somatic Symptoms ◽  
Psychological Problems ◽  
Loss Of Face ◽  
Latent Topics

Common mental disorders often go undetected in primary care. Sharpening general practitioners’ (GPs’) attention to potential signs thereof is therefore crucial. This conversation-analytic study arises from the observation that the consideration of psychological problems in new-concern visits can be achieved by way of ‘gradual topic emergence’. This entails that the problem is not presented directly, but adjunct to somatic symptoms, and is hinted at by way of generic, ambiguous complaints, and furthermore by expressions of frustration and uncertainty and talk about lifeworld problems. It is argued that these materials are ‘trouble-premonitory’, alerting the GP to the presence of an underlying problem that can then be addressed through further inquiry. The patient logic behind this approach is to assure the GP’s recipiency and thus ratification of the problem’s medical legitimacy. It allows the patient to introduce a potentially delicate problem ‘off the record’, thus guarding the patient against the loss of face that could result from no uptake by the GP. The results of the study point to the importance of GPs being receptive to such interactional clues to psychological problems provided by patients.

scholarly journals Using vignettes to assess contributions to the work of addressing child mental health problems in primary care

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Lawrence S. Wissow ◽  
Waleed Zafar ◽  
Kate Fothergill ◽  
Anne Ruble ◽  
Eric Slade
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Child Mental Health ◽  
Mental Health Problems ◽  
Health Problems

Access to mental health care in an inner-city health district. I: Pathways into and within specialist psychiatric services

1997 ◽  
Vol 170 (4) ◽  
pp. 312-316 ◽  
Author(s):  
M. J. Commander ◽  
S. P. Sashi Dharan ◽  
S. M. Odell ◽  
P. G. Surtees
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Inner City ◽  
Mental Health Problems ◽  
Psychiatric Morbidity ◽  
Psychiatric Services ◽  
Specialist Services ◽  
Epidemiological Surveys

BackgroundNeeds for mental health care are likely to be high in urban areas. Purchasers must assess the extent to which these are being met. The pathways to care model provides a framework for this purpose.MethodEpidemiological surveys of adults living in deprived multi-ethnic innercity catchment area were undertaken in psychiatric services, primary care and community settings. Estimated prevalence rates were calculated and the association between clinical and demographic factors and the use of psychiatric services examined.ResultsAround a third of people with mental health problems did not consult a GP. and half failed to have their problems recognised by their doctor. Access to psychiatric services and especially to inpatient care was highly restricted. Diagnosis and ethnicity had a marked influence on the use of specialist services.ConclusionsMany people with psychiatric morbidity are not receiving treatment either from primary care or specialist services. High levels of severe morbidity and compulsory admissions highlight the pressures placed on inner-city psychiatric services.

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