Hiscock Harriet, Connolly Ann-Siobhan, Dunlop Katie, Perera Prescilla, O'Loughlin Rachel, Brown Stephanie J, Krieser David M, West Adam, Chapman Pauline, Lawford Robyn, Cheek John A
Health Services Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Health Services Research Unit, The Royal Children's Hospital, Parkville, Victoria, Australia.
J Paediatr Child Health. 2020 Jul;56(7):1114-1120. doi: 10.1111/jpc.14835. Epub 2020 Feb 26.
The number of children and young people presenting to emergency departments (EDs) with anxiety and depression is increasing. We aimed to determine parent perspectives on: (i) barriers to accessing non-ED mental health services; and (ii) improving access in the paediatric mental health service system.
Qualitative study with parents of children and young people aged 0-19 years who attended one of four EDs across Victoria between October 2017 and September 2018 and received a primary diagnosis of anxiety or depression.
child or young person without a parent/guardian, or presented with self-harm or suicide attempt. Eligible participants completed semi-structured phone interviews. Interviews were recorded and transcripts were coded and analysed using content analysis.
A total of 72 parents completed interviews. The average child age was 14 years (standard deviation 2.5) and two thirds identified as female (64%). A total of 57% of children and young people presented with a primary diagnosis of anxiety. Parents reported barriers in accessing care including: service shortages and inaccessibility, underresourced schools, lack of clinician mental health expertise, lack of child-clinician rapport, inconsistent care, financial constraints, lack of mental health awareness among parents, and stigma. Parents want expanded and improved access to services, more respite and support services, supportive schools, and improved mental health education for parents.
Parents of children and young people attending the ED for anxiety and depression are generally dissatisfied with services for child mental health. Solutions that enable parents to better care for their child in the community are needed to improve care.
前往急诊科就诊的焦虑和抑郁儿童及青少年人数正在增加。我们旨在确定家长对于以下方面的看法：（i）获取非急诊科心理健康服务的障碍；以及（ii）改善儿科心理健康服务系统中的服务可及性。
对2017年10月至2018年9月期间在维多利亚州四家急诊科之一就诊且被初步诊断为焦虑或抑郁的0至19岁儿童及青少年的家长进行定性研究。
没有家长/监护人陪同的儿童或青少年，或有自我伤害或自杀未遂情况的。符合条件的参与者完成了半结构化电话访谈。访谈进行了录音，转录本使用内容分析法进行编码和分析。
共有72位家长完成了访谈。儿童的平均年龄为14岁（标准差2.5），三分之二为女性（64%）。共有57%的儿童及青少年被初步诊断为焦虑症。家长报告了获取护理方面的障碍，包括：服务短缺且难以获得、学校资源不足、临床医生缺乏心理健康专业知识、儿童与临床医生之间缺乏融洽关系、护理不一致、经济限制、家长缺乏心理健康意识以及污名化。家长希望扩大并改善服务的可及性，增加喘息和支持服务，有支持性的学校，并改善家长的心理健康教育。
因焦虑和抑郁前往急诊科就诊的儿童及青少年的家长普遍对儿童心理健康服务不满意。需要采取能够让家长在社区更好地照顾孩子的解决方案来改善护理。
