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澳大利亚儿童因情绪和行为问题接受服务的情况:第二次澳大利亚儿童与青少年心理健康与幸福状况调查结果

Service use by Australian children for emotional and behavioural problems: Findings from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing.

作者信息

Johnson Sarah E, Lawrence David, Hafekost Jennifer, Saw Suzy, Buckingham William J, Sawyer Michael, Ainley John, Zubrick Stephen R

机构信息

Telethon Kids Institute, The University of Western Australia, West Perth, WA, Australia

Telethon Kids Institute, The University of Western Australia, West Perth, WA, Australia.

出版信息

Aust N Z J Psychiatry. 2016 Sep;50(9):887-98. doi: 10.1177/0004867415622562. Epub 2016 Jan 14.

Abstract

OBJECTIVE

To identify the proportion of children and adolescents in Australia and the proportion of those with mental disorders who used services for emotional and behavioural problems, the type of services used and what characteristics were associated with service use.

METHOD

During 2013-2014, a national face-to-face household survey of mental health and wellbeing (Young Minds Matter) was conducted, involving 6310 parents and carers of 4- to 17-year-olds (55% of eligible households) and self-report surveys from 2967 11- to 17-year-olds in these households (89% of eligible youth). The survey identified 12-month mental disorders based on the Diagnostic Interview Schedule for Children-Version IV and asked about service use for emotional or behavioural problems in the previous 12 months.

RESULTS

Overall, 17.0% of all 4- to 17-year-olds used services for emotional or behavioural problems in the previous 12 months. Of those with mental disorders, 56.0% used services (48.9% of 4- to 11-year-olds; 65.1% of 12- to 17-year-olds). Service use was highest among 4- to 17-year-olds with major depressive disorder (79.6%) and lowest for those with attention-deficit/hyperactivity disorder (52.7%). Two-fifths (41.2%), 72.5% and 87.6% of those with mild, moderate and severe disorders used services. General practitioners, psychologists, paediatricians and counsellors/family therapists were the most commonly accessed health service providers. Two-fifths with mental disorders had attended school services. About 5% of adolescents reported use of online personal support or counselling for help with their problems. From multivariate models, service use was higher in sole carer families, but also among those living in the least socially and economically disadvantaged compared to the most disadvantaged areas.

CONCLUSION

Rates of service use for mental disorders in Australia's children and adolescents appear to have increased substantially. Health services and schools are the major providers of services for emotional and behavioural problems, but telephone counselling and online services have become well-established parts of the service environment.

摘要

目的

确定澳大利亚儿童和青少年的比例,以及患有精神障碍且使用过针对情绪和行为问题服务的人群比例、所使用服务的类型,以及与服务使用相关的特征。

方法

在2013 - 2014年期间,开展了一项关于心理健康和幸福的全国性面对面家庭调查(“关注青少年心灵”),涉及6310名4至17岁儿童的父母和照料者(占符合条件家庭的55%),以及这些家庭中2967名11至17岁青少年的自我报告调查(占符合条件青少年的89%)。该调查根据《儿童诊断访谈量表第四版》确定过去12个月内的精神障碍,并询问过去12个月内针对情绪或行为问题的服务使用情况。

结果

总体而言,在过去12个月内,所有4至17岁儿童中有17.0%使用过针对情绪或行为问题的服务。在患有精神障碍的儿童中,56.0%使用过服务(4至11岁儿童中为48.9%;12至17岁儿童中为65.1%)。在患有重度抑郁症的4至17岁儿童中服务使用率最高(79.6%),而在患有注意力缺陷/多动障碍的儿童中最低(52.7%)。患有轻度、中度和重度障碍的儿童中,分别有五分之二(41.2%)、72.5%和87.6%使用过服务。全科医生、心理学家、儿科医生和咨询师/家庭治疗师是最常就诊的医疗服务提供者。五分之二患有精神障碍的儿童曾接受过学校服务。约5%的青少年报告使用过在线个人支持或咨询来解决他们的问题。根据多变量模型,在单亲家庭中服务使用率较高,而且与最社会经济弱势地区相比,生活在社会经济最不弱势地区的人群中服务使用率也较高。

结论

澳大利亚儿童和青少年精神障碍的服务使用率似乎大幅上升。医疗服务机构和学校是情绪和行为问题服务的主要提供者,但电话咨询和在线服务已成为服务环境中成熟的组成部分。

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