Reardon Tessa, Harvey Kate, Baranowska Magdalena, O'Brien Doireann, Smith Lydia, Creswell Cathy
School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
Eur Child Adolesc Psychiatry. 2017 Jun;26(6):623-647. doi: 10.1007/s00787-016-0930-6. Epub 2017 Jan 4.
A minority of children and adolescents with mental health problems access treatment. The reasons for poor rates of treatment access are not well understood. As parents are a key gatekeeper to treatment access, it is important to establish parents' views of barriers/facilitators to accessing treatment. The aims of this study are to synthesise findings from qualitative and quantitative studies that report parents' perceptions of barriers/facilitators to accessing treatment for mental health problems in children/adolescents. A systematic review and narrative synthesis were conducted. Forty-four studies were included in the review and were assessed in detail. Parental perceived barriers/facilitators relating to (1) systemic/structural issues; (2) views and attitudes towards services and treatment; (3) knowledge and understanding of mental health problems and the help-seeking process; and (4) family circumstances were identified. Findings highlight avenues for improving access to child mental health services, including increased provision that is free to service users and flexible to their needs, with opportunities to develop trusting, supportive relationships with professionals. Furthermore, interventions are required to improve parents' identification of mental health problems, reduce stigma for parents, and increase awareness of how to access services.
少数有心理健康问题的儿童和青少年能够获得治疗。治疗可及率低的原因尚不清楚。由于父母是治疗可及性的关键把关人，因此了解父母对获得治疗的障碍/促进因素的看法非常重要。本研究的目的是综合定性和定量研究的结果，这些研究报告了父母对儿童/青少年心理健康问题治疗障碍/促进因素的看法。进行了系统评价和叙述性综合分析。该评价纳入了44项研究并进行了详细评估。确定了与（1）系统/结构问题；（2）对服务和治疗的看法和态度；（3）对心理健康问题和寻求帮助过程的知识和理解；以及（4）家庭情况相关的父母感知到的障碍/促进因素。研究结果突出了改善儿童心理健康服务可及性的途径，包括增加对服务使用者免费且能灵活满足其需求的服务提供，以及有机会与专业人员建立信任、支持性的关系。此外，需要采取干预措施来提高父母对心理健康问题的识别能力，减少父母的耻辱感，并提高对如何获得服务的认识。
