Kovess-Masfety Viviane, Van Engelen Julia, Stone Lisanne, Otten Roy, Carta Mauro Giovanni, Bitfoi Adina, Koc Ceren, Goelitz Dietmar, Lesinskiene Sigita, Mihova Zlatka, Fermanian Christophe, Pez Ondine, Husky Mathilde
Dr. Kovess-Masfety is with the Department of Psychology, Paris Descartes University, and with the EHESP French School of Public Health, where Dr. Fermanian and Dr. Pez are affiliated, both in Paris. Ms. Van Engelen, Dr. Stone, and Dr. Otten are with Radboud University, Nijmegen, Gelderland, the Netherlands. Dr. Carta is with the Department of Public Health, Center of Liaison Psychiatry, Cagliari University, Cagliari, Italy. Dr. Bitfoi is with the Romanian League for Mental Health, Bucharest, Romania. Ms. Koc is with the Yeniden Health and Education Society, Istanbul, Turkey. Dr. Goelitz is with Friedrich-Alexander University Erlangen-Nurnberg, Germany. Dr. Lesinskiene is with the School of Medicine, University of Vilnius, Lithuania. Dr. Mihova is with the Department of Psychology, New Bulgaria University, Sofia, Bulgaria. Dr. Husky is with the Department of Psychology, University of Bordeaux, France.
Psychiatr Serv. 2017 Aug 1;68(8):789-795. doi: 10.1176/appi.ps.201600409. Epub 2017 Apr 3.
The aim of this study was to examine the determinants of use of mental health services for children across Europe, with a specific focus on differences in the availability of mental health resources.
Data were drawn from the School Children Mental Health in Europe Project. Parent- and teacher-reported child mental health status was based on the Strengths and Difficulties Questionnaire. Sociodemographic characteristics of parents and children, as well as academic performance and use of mental health services in the previous 12 months, were collected. Countries were categorized as having high versus low mental health resources. The sample comprised 4,894 schoolchildren in seven countries.
Across Europe, only 25.6% of children with a mental disorder had received mental health services in the previous 12 months, including 31.5% in high-resources countries and 18.9% in low-resources countries (p=.001) (N=4,867). The presence of any mental disorder, maternal psychological distress, gender, living in a single-parent home, and low academic performance were determinants of service use. The effect of resources group on the likelihood of receiving services remained significant when the analyses controlled for all predictors (odds ratio=1.41, p<.01). Determinants differed between groups-maternal psychological distress was associated with service use in high-resources countries, and gender was associated with service use in low-resources countries.
The findings point to a substantial portion of unmet need across Europe and to major differences in access to care in low- versus high-resources countries. Efforts are needed to address unmet need among children with mental disorders, especially in low-resources countries.
本研究旨在探讨欧洲儿童心理健康服务利用的决定因素，特别关注心理健康资源可及性的差异。
数据取自欧洲学童心理健康项目。家长和教师报告的儿童心理健康状况基于优势与困难问卷。收集了家长和儿童的社会人口学特征，以及过去12个月的学业成绩和心理健康服务利用情况。国家被分为心理健康资源丰富和匮乏两类。样本包括七个国家的4894名学童。
在欧洲，过去12个月中只有25.6%的精神障碍儿童接受了心理健康服务，其中资源丰富国家为31.5%，资源匮乏国家为18.9%（p = 0.001）（N = 4867）。是否患有任何精神障碍、母亲的心理困扰、性别、生活在单亲家庭以及学业成绩低是服务利用的决定因素。在对所有预测因素进行控制的分析中，资源组对接受服务可能性的影响仍然显著（优势比 = 1.41，p < 0.01）。不同组之间的决定因素有所不同——母亲的心理困扰与资源丰富国家的服务利用相关，而性别与资源匮乏国家的服务利用相关。
研究结果表明欧洲存在大量未满足的需求，且资源匮乏国家与资源丰富国家在获得护理方面存在重大差异。需要努力解决精神障碍儿童中未满足的需求，特别是在资源匮乏国家。
