Institute for Global Health, University College London, London, UK
Institute for Global Health, University College London, London, UK.
BMJ Open. 2021 May 10;11(5):e044929. doi: 10.1136/bmjopen-2020-044929.
To evaluate the quality of adolescent mental health service provision globally, according to the WHO Global Standards of adolescent mental health literacy, appropriate package of services and provider competencies.
Systematic review of 5 databases, and screening of eligible articles, from 1 January 2008 to 31 December 2020.
We focused on quantitative and mixed-method studies that evaluated adolescent mental health literacy, appropriate package of services and provider competencies in mental health services, and that targeted depression, anxiety and post-traumatic stress disorder among adolescents (10-19 years). This included adolescents exposed to interventions or strategies within mental health services.
Study quality was assessed using the National Institutes for Health Study Quality Assessment Tools. Data were extracted and grouped based on WHO quality Standards.
Of the 20 104 studies identified, 20 articles were included. The majority of studies came from high-income countries, with one from a low-income country. Most of the studies did not conceptualise quality. Results found that an online decision aid was evaluated to increase adolescent mental health literacy. Studies that targeted an appropriate package of services evaluated the quality of engagement between the therapist and adolescent, patient-centred communication, mental health service use, linkages to mental health services, health facility culture and intensive community treatment. Provider competencies focused on studies that evaluated confidence in managing and referring adolescents, collaboration between health facility levels, evidence-based practices and technology use.
There is limited evidence on quality measures in adolescent mental health services (as conforms to the WHO Global Standards), pointing to a global evidence gap for adolescent mental health services. There are several challenges to overcome, including a need to develop consensus on quality and methods to measure quality in mental health settings.
CRD42020161318.
根据世界卫生组织（WHO）青少年心理健康素养全球标准、适当的服务包和提供者能力，评估全球青少年心理健康服务提供的质量。
对 2008 年 1 月 1 日至 2020 年 12 月 31 日期间的 5 个数据库进行系统回顾，并筛选合格文章。
我们专注于评估心理健康服务中青少年心理健康素养、适当服务包和提供者能力的定量和混合方法研究，这些研究针对青少年（10-19 岁）的抑郁、焦虑和创伤后应激障碍。这包括在心理健康服务中接受干预或策略的青少年。
使用美国国立卫生研究院研究质量评估工具评估研究质量。根据世界卫生组织质量标准提取和分组数据。
在确定的 20104 项研究中，有 20 项研究被纳入。大多数研究来自高收入国家，其中一项来自低收入国家。大多数研究没有概念化质量。结果发现，一种在线决策辅助工具被评估用于提高青少年心理健康素养。针对适当服务包的研究评估了治疗师与青少年之间的互动质量、以患者为中心的沟通、心理健康服务的使用、与心理健康服务的联系、卫生机构文化和强化社区治疗。提供者能力侧重于评估管理和转介青少年的信心、医疗机构之间的合作、循证实践和技术使用的研究。
关于青少年心理健康服务质量的证据有限（符合世界卫生组织全球标准），表明青少年心理健康服务存在全球证据差距。需要克服一些挑战，包括需要就质量达成共识以及在心理健康环境中衡量质量的方法。
CRD42020161318。
