Gronholm Petra C, Ford Tamsin, Roberts Ruth E, Thornicroft Graham, Laurens Kristin R, Evans-Lacko Sara
Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom.
PLoS One. 2015 Mar 26;10(3):e0120004. doi: 10.1371/journal.pone.0120004. eCollection 2015.
Many children and adolescents experiencing mental health problems do not receive appropriate care. Strategies to encourage appropriate access to services might be improved by a more detailed understanding of service use determinants within this group. In view of caregivers' key role in young people's pathways to care, this study aimed to advance understanding of caregiver-related characteristics that influence service use among young people.
We interviewed 407 primary caregivers of young people aged 9-18 years, recruited from a Greater London (United Kingdom) community sample. Caregivers reported on young people's service use in health care sector and/or education settings, and caregivers' intended stigmatising behaviours, help-seeking attitudes, and personal service use. Logistic regression analyses examined the relationship between these caregiver characteristics and young people's service use, controlling for young people's clinical and socio-demographic factors.
Caregivers' intended stigmatising behaviours in particular exerted a strong influence on young people's service use within each service setting. The impact of this characteristic interacted with caregivers' service use in influencing young people's service use across health care and education settings and health care settings specifically. For young people's service use within education settings, caregivers' intended stigmatising behaviours score had a main effect.
This study highlights the key role caregivers' attitudes and experiences hold in young people's service use. The findings indicate that strategies aiming to bridge the gap between young people's service needs and utilisation might be improved by targeting stigma amongst caregivers.
许多有心理健康问题的儿童和青少年未得到适当的护理。通过更详细地了解该群体中服务利用的决定因素，鼓励适当获得服务的策略可能会得到改进。鉴于照顾者在年轻人获得护理途径中的关键作用，本研究旨在增进对影响年轻人服务利用的照顾者相关特征的理解。
我们采访了407名9至18岁年轻人的主要照顾者，他们来自英国大伦敦地区的社区样本。照顾者报告了年轻人在医疗保健部门和/或教育环境中的服务利用情况，以及照顾者预期的污名化行为、求助态度和个人服务利用情况。逻辑回归分析检验了这些照顾者特征与年轻人服务利用之间的关系，并控制了年轻人的临床和社会人口学因素。
照顾者预期的污名化行为尤其对每个服务环境中年轻人的服务利用产生了强烈影响。这一特征的影响与照顾者的服务利用相互作用，影响了年轻人在医疗保健和教育环境以及特定医疗保健环境中的服务利用。对于年轻人在教育环境中的服务利用，照顾者预期的污名化行为得分具有主要影响。
本研究强调了照顾者的态度和经历在年轻人服务利用中的关键作用。研究结果表明，旨在弥合年轻人服务需求与利用之间差距的策略，可能通过针对照顾者中的污名化现象而得到改进。
