Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori (3rd Floor), 20014, Turku, Finland.
Turku University Hospital, Turku, Finland.
Eur Child Adolesc Psychiatry. 2019 Apr;28(4):521-530. doi: 10.1007/s00787-018-1218-9. Epub 2018 Sep 15.
The use of children's mental health services has increased, but most children with psychiatric problems are still not in contact with these services. This time-trend study assessed changes in considered and reported service use over a 24-year period and studied the factors associated with it using four cross-sectional studies. Information was gathered on 8-year-old children living in the area covered by Turku University Hospital, Finland, at four time points: 986 children in 1989, 891 in 1999, 930 in 2005, and 942 in 2013. The same study design, methods and school districts were used each year and the participation rates varied between 86 and 95%. Parents and teachers completed questionnaires concerning the child's psychiatric symptoms and service use. The considered and reported service use increased continuously during the study period. In 1989, 2.4% of children had used services and in 2013 this was 11.0% (OR 5.0, 95% CI 3.1-8.0). Reported service use also increased among children with comorbid problems, from 18.3 to 50.7% (OR 5.0, 95% CI 2.1-12.0). Psychiatric problems and some family factors were associated with service use, but the increase was not explained by these factors. The increase in child mental health service use may reflect better public awareness of mental health problems, fewer barriers to accessing care and decrease of stigma. Although more children are using mental health services, there are still a large number of children with mental health problems who have not been in contact with services.
儿童心理健康服务的使用有所增加，但大多数有精神问题的儿童仍未接触这些服务。本时间趋势研究评估了在 24 年期间考虑和报告的服务使用变化，并使用四项横断面研究研究了与之相关的因素。在四个时间点收集了芬兰图尔库大学医院覆盖地区 8 岁儿童的信息：1989 年有 986 名儿童，1999 年有 891 名儿童，2005 年有 930 名儿童，2013 年有 942 名儿童。每年都使用相同的研究设计、方法和学区，参与率在 86%至 95%之间变化。父母和教师完成了关于儿童精神症状和服务使用的问卷。在研究期间，考虑和报告的服务使用持续增加。1989 年，有 2.4%的儿童使用过服务，而 2013 年这一比例为 11.0%（OR5.0，95%CI3.1-8.0）。有合并症的儿童报告的服务使用也有所增加，从 18.3%增加到 50.7%（OR5.0，95%CI2.1-12.0）。精神问题和一些家庭因素与服务使用相关，但这些因素并不能解释增加的原因。儿童心理健康服务使用的增加可能反映了公众对心理健康问题的认识提高，获得护理的障碍减少，以及耻辱感的降低。尽管更多的儿童正在使用心理健康服务，但仍有大量有心理健康问题的儿童未接触过服务。
