Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA 01003, United States of America.
Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA 01003, United States of America.
Clin Psychol Rev. 2024 Dec;114:102504. doi: 10.1016/j.cpr.2024.102504. Epub 2024 Sep 24.
The aim of this umbrella review is to summarize evidence on factors that influence help-seeking and service utilization for professional mental healthcare among young people ages 0-30. The CINAHL, Cochrane, Epistemonikos, MEDLINE, PsycINFO, PubMed, and Web of Science databases were searched in December 2023 for systematic reviews in English. The search yielded 26 eligible reviews, all of which are medium or high quality. Primary study overlap was rare. Using an established framework, we organize intrapersonal (n = 37), interpersonal (n = 14), institutional (n = 9), community (n = 7), and public policy (n = 6) factors. The most frequently reviewed factor at each level is trust of professionals (intrapersonal), close others' support for treatment (interpersonal), cost (institutional), availability (community), and insurance (public policy). Stigma is widely referenced (18 reviews) and classified as multi-dimensional. Narrative synthesis reveals population-specific variability (e.g., rural, racial/ethnic minority, refugees, immigrants) in the importance of many factors. To develop interventions and healthcare systems sensitive to young people's needs, we recommend promoting stigma-reduction campaigns, and targeting trustworthiness, affordability, anonymity, accessibility, and mental health literacy. Identifying commonalities and differences across populations and contexts assists in the design of nuanced and efficient treatment delivery systems for young people, who are at a critical time for their mental health.
本综述旨在总结影响 0-30 岁年轻人寻求专业心理健康服务的因素的证据。2023 年 12 月,我们在 CINAHL、Cochrane、Epistemonikos、MEDLINE、PsycINFO、PubMed 和 Web of Science 数据库中检索了英文系统评价。检索共产生了 26 篇符合条件的综述,均为中高质量。原始研究的重叠很少。我们使用既定框架将个体内(n=37)、人际间(n=14)、机构(n=9)、社区(n=7)和公共政策(n=6)因素进行了分类。在每个层面上,被审查最多的因素是对专业人员的信任(个体内)、亲近他人对治疗的支持(人际间)、费用(机构)、可及性(社区)和保险(公共政策)。污名化被广泛引用(18 篇),并被归类为多维度。叙述性综合揭示了许多因素在特定人群中的重要性存在差异(例如,农村、少数族裔、难民、移民)。为了制定针对年轻人需求的干预措施和医疗保健系统,我们建议开展减少污名化的宣传活动,并针对可信度、负担能力、匿名性、可及性和心理健康素养进行干预。识别不同人群和背景之间的共性和差异有助于设计针对年轻人的细致和高效的治疗提供系统,因为年轻人正处于心理健康的关键时期。