Leahy Dorothy, Schaffalitzky Elisabeth, Saunders Jean, Armstrong Claire, Meagher David, Ryan Patrick, Dooley Barbara, McNicholas Fiona, McGorry Patrick, Cullen Walter
Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
SCU/CSTAR Centre, University of Limerick, Limerick, Ireland.
Early Interv Psychiatry. 2018 Apr;12(2):202-216. doi: 10.1111/eip.12303. Epub 2015 Dec 22.
Youth suicide in Ireland is now the second highest in the European Union. General practitioners (GPs), as the health-care professional most often consulted by young people, have a central role in early detection of youth mental health problems. However, evidence regarding the perspectives of young people and health-care workers towards screening and treatment for such issues in primary care in Ireland is lacking.
This study aimed to examine the role of GP in providing early intervention and treatment for youth mental health problems.
A mixed methods study that involved qualitative interviews with health-care workers from primary care, secondary care and community agencies (n = 37) and young people (n = 20) in two of Ireland's most socioeconomically disadvantaged areas and a national cross-sectional survey of GPs (n = 175) were carried out.
GP satisfaction rates were low in regard to postgraduate training received in child and adolescent mental health (17%) and substance use (21%). Key barriers to treatment included the attitude of patients/families, lack of specialist staff, poor service availability and time. Access to services (66%), knowing which interventions can be initiated in primary care (44%), having appropriate time and space (47%) and access to a youth worker (42%) were the interventions most commonly identified that would facilitate screening and treatment.
The research outlined potential implications for clinical practice, research and education such as promoting awareness of mental health and the role of the GP in helping these issues, education of practitioners and improving access to psychological treatments.
爱尔兰的青少年自杀率目前在欧盟中排名第二。全科医生(GPs)作为年轻人最常咨询的医疗保健专业人员,在青少年心理健康问题的早期发现中起着核心作用。然而,关于爱尔兰年轻人和医护人员对初级保健中此类问题的筛查和治疗的看法的证据却很缺乏。
本研究旨在探讨全科医生在为青少年心理健康问题提供早期干预和治疗方面的作用。
开展了一项混合方法研究,包括对来自爱尔兰两个社会经济最贫困地区的初级保健、二级保健和社区机构的医护人员(n = 37)以及年轻人(n = 20)进行定性访谈,以及对全科医生(n = 175)进行全国性横断面调查。
全科医生对儿童和青少年心理健康方面(17%)以及药物使用方面(21%)接受的研究生培训的满意度较低。治疗的主要障碍包括患者/家庭的态度、缺乏专科工作人员、服务可及性差和时间问题。获得服务(66%)、知道在初级保健中可以启动哪些干预措施(44%)、有适当的时间和空间(47%)以及有青年工作者可联系(42%)是最常被确定的有助于筛查和治疗的干预措施。
该研究概述了对临床实践、研究和教育的潜在影响,例如提高对心理健康的认识以及全科医生在帮助解决这些问题中的作用、对从业者进行教育以及改善心理治疗的可及性。