Bevaart Floor, Mieloo Cathelijne L, Wierdsma André, Donker Marianne C H, Jansen Wilma, Raat Hein, Verhulst Frank C, van Oort Floor V A
Soc Psychiatry Psychiatr Epidemiol. 2014 May;49(5):733-42. doi: 10.1007/s00127-013-0761-4.
Empirical research on mental health care use and its determinants in young school-aged children is still scarce. In this study, we investigated the role of ethnicity, socioeconomic position (SEP) and perceived severity by both parents and teachers on mental health care use in 5- to 8-year old children with emotional and/or behavioural problems.
Data from 1,269 children with a high score([P90) on the Strengths and Difficulties Questionnaire (SDQ) in the school year 2008–2009 were linked to psychiatric case register data over the years 2010–2011. Cox proportional hazards models were used to predict mental health care use from ethnicity, SEP and perceived severity of the child's problems.
During the follow-up period, 117 children with high SDQ scores (9.2 %) had used mental health care for the first time. Ethnic minority children were less likely to receive care than Dutch children (HR Moroccan/Turkish:0.26; 95 % CI 0.13-0.54, HR other ethnicity: 0.26; 95 %CI 0.12-0.58). No socioeconomic differences were found.After correction for previous care use, ethnicity and parental perceived severity, impact score as reported by teachers was significantly associated with mental healthcare use (HR 1.58; 95 % CI 1.01–2.46).
Ethnicity is an important predictor of mental health care use in young children. Already in the youngest school-aged children, ethnic differences in the use of mental health care are present.A distinct predictor of care use in this age group is severity of emotional and behavioural problems as perceived by teachers. Therefore, teachers may be especially helpful in the process of identifying young children who need specialist mental health care.
关于小学低年级儿童心理健康护理利用情况及其决定因素的实证研究仍然匮乏。在本研究中，我们调查了种族、社会经济地位（SEP）以及父母和教师感知的严重程度在有情绪和/或行为问题的5至8岁儿童心理健康护理利用方面所起的作用。
将2008 - 2009学年优势与困难问卷（SDQ）得分较高（[P90]）的1269名儿童的数据与2010 - 2011年期间的精神病病例登记数据相联系。使用Cox比例风险模型从种族、SEP和儿童问题的感知严重程度预测心理健康护理的利用情况。
在随访期间，117名SDQ得分较高的儿童（9.2%）首次使用了心理健康护理。少数族裔儿童比荷兰儿童接受护理的可能性更小（风险比[HR] 摩洛哥/土耳其裔：0.26；95%置信区间[CI] 0.13 - 0.54，HR其他种族：0.26；95% CI 0.12 - 0.58）。未发现社会经济差异。在校正先前的护理使用情况、种族和父母感知的严重程度后，教师报告的影响得分与心理健康护理的使用显著相关（HR 1.58；95% CI 1.01 - 2.46）。
种族是幼儿心理健康护理利用的重要预测因素。在最年幼的学龄儿童中，心理健康护理利用方面的种族差异就已存在。该年龄组护理利用的一个明显预测因素是教师所感知的情绪和行为问题的严重程度。因此，教师在识别需要专业心理健康护理的幼儿过程中可能特别有帮助。
