Zachrisson Henrik D, Rödje Kjetil, Mykletun Arnstein
Div. Mental Health, Norwegian Institute of Public Health, PO Box 4404, 0403, Nydalen, Oslo.
BMC Public Health. 2006 Feb 16;6:34. doi: 10.1186/1471-2458-6-34.
Only a minority of adolescents reporting symptoms above case-levels on screenings for mental health seeks and receives help from specialist health services. The objective of this study was to a) examine help-seeking for symptoms of anxiety and depression in relation to symptom load dimensionally, b) identify the level of specialization in mental health among service-providers, and c) identify associations between mental health problems and contact with different types of health services.
This cross-sectional school-based study (response-rate 88%, n = 11154) is based on Norwegian health surveys among 15 and 16 year olds.
We found a dose-response association between symptom-load and help seeking. Only 34% of individuals with mental symptom-load above 99th percentile reported help-seeking in the last 12 months. Forty percent of help seekers were in contact with specialists (psychiatrists or psychologists), the remaining were mainly in contact with GPs. Mental health problems increased help seeking to all twelve service providers examined.
It might not be reasonable to argue that all adolescents with case-level mental health problems are in need of treatment. However, concerning the 99th percentile, claiming treatment need is less controversial. Even in the Norwegian context where mental health services are relatively available and free of charge, help-seeking in individuals with the highest symptom-loads is still low. Most help seekers achieved contact with health care providers, half of them at a non specialized level. Our results suggest that adolescents' recognition of mental health problems or intention to seek help for these are the major "filters" restricting treatment.
在心理健康筛查中报告症状高于病例水平的青少年中，只有少数人寻求并获得了专科医疗服务的帮助。本研究的目的是：a）从维度上考察焦虑和抑郁症状的求助情况与症状负荷的关系；b）确定服务提供者的心理健康专业化水平；c）确定心理健康问题与接触不同类型医疗服务之间的关联。
这项基于学校的横断面研究（应答率88%，n = 11154）基于对挪威15岁和16岁青少年的健康调查。
我们发现症状负荷与求助之间存在剂量反应关系。在过去12个月中，症状负荷高于第99百分位的个体中，只有34%报告寻求过帮助。40%的求助者接触过专科医生（精神科医生或心理学家），其余主要接触全科医生。心理健康问题增加了与所有12家接受调查的服务提供者的接触。
认为所有有病例水平心理健康问题的青少年都需要治疗可能不合理。然而，对于第99百分位的情况，声称有治疗需求争议较小。即使在挪威，心理健康服务相对容易获得且免费，症状负荷最高的个体的求助率仍然很低。大多数求助者与医疗服务提供者取得了联系，其中一半是在非专科层面。我们的结果表明，青少年对心理健康问题的认识或寻求帮助的意愿是限制治疗的主要“过滤器”。
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