Verhoog S, Eijgermans D G M, Fang Y, Bramer W M, Raat H, Jansen W
Department of Public Health, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands.
The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
Eur Child Adolesc Psychiatry. 2024 Jul;33(7):2051-2065. doi: 10.1007/s00787-022-02077-5. Epub 2022 Sep 21.
Determinants at the contextual level are important for children's and adolescents' mental health care utilization, as this is the level where policy makers and care providers can intervene to improve access to and provision of care. The objective of this review was to summarize the evidence on contextual determinants associated with mental health care utilization in children and adolescents. A systematic literature search in five electronic databases was conducted in August 2021 and retrieved 6439 unique records. Based on eight inclusion criteria, 74 studies were included. Most studies were rated as high quality (79.7%) and adjusted for mental health problems (66.2%). The determinants that were identified were categorized into four levels: organizational, community, public policy or macro-environmental. There was evidence of a positive association between mental health care utilization and having access to a school-based health center, region of residence, living in an urban area, living in an area with high accessibility of mental health care, living in an area with high socio-economic status, having a mental health parity law, a mental health screening program, fee-for-service plan (compared to managed care plan), extension of health insurance coverage and collaboration between organizations providing care. For the other 35 determinants, only limited evidence was available. To conclude, this systematic review identifies ten contextual determinants of children's and adolescents' mental health care utilization, which can be influenced by policymakers and care providers. Implications and future directions for research are discussedPROSPERO ID: CRD42021276033.
情境层面的决定因素对于儿童和青少年的心理健康护理利用非常重要，因为这是政策制定者和护理提供者可以进行干预以改善护理可及性和提供情况的层面。本综述的目的是总结与儿童和青少年心理健康护理利用相关的情境决定因素的证据。2021年8月在五个电子数据库中进行了系统的文献检索，共检索到6439条独特记录。根据八项纳入标准，纳入了74项研究。大多数研究被评为高质量（79.7%），并对心理健康问题进行了调整（66.2%）。确定的决定因素分为四个层面：组织层面、社区层面、公共政策或宏观环境层面。有证据表明，心理健康护理利用与以下因素之间存在正相关：可使用校内健康中心、居住地区、居住在城市地区、居住在心理健康护理可及性高的地区、居住在社会经济地位高的地区、拥有心理健康平权法、心理健康筛查项目、按服务收费计划（与管理式护理计划相比）、扩大医疗保险覆盖范围以及提供护理的组织之间的合作。对于其他35个决定因素，仅有有限的证据。总之，本系统综述确定了儿童和青少年心理健康护理利用的十个情境决定因素，政策制定者和护理提供者可以对其施加影响。文中讨论了研究的意义和未来方向。国际前瞻性系统评价注册平台标识符：CRD42021276033 。
