Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
BMC Health Serv Res. 2024 Nov 28;24(1):1502. doi: 10.1186/s12913-024-11892-2.
Adolescents' involvement in their mental healthcare is considered a fundamental human right. However, there is a lack of consensus regarding the extent and nature of user involvement and limited research on user involvement in adolescent mental healthcare has previously been identified. Given the evolving focus on this area, this study explores the experiences with, the effectiveness of, and safety issues related to adolescents' user involvement in mental healthcare.
We conducted a systematic review, updating our original review with current research evidence relating to adolescents' involvement in mental healthcare at individual and organizational levels. Searches across six databases, screening of reference lists, and suggestions from experts within the field helped to identify 5,527 records, of which 251 full text articles were screened. Established guidelines were used for data extraction, critical appraisal, and reporting of results.
Collectively, the literature searches resulted in 36 eligible studies, of which 28 provided qualitative data and eight provided quantitative data. The quantitative studies identified the importance of personal help and online tools to support adolescents' involvement in their mental healthcare. A few qualitative studies suggested shared decision-making is associated with improved self-reported mental health and treatment satisfaction. No studies focused on safety issues. A thematic synthesis of qualitative studies yielded four themes at the individual level and two themes at the organizational level. The findings highlight the growing recognition of adolescents' right to be involved and their capacity to take part in decision-making, emphasizing shared decision-making, two-way communication, and trust as key components of a collaborative relationship fundamental to user involvement. Further facilitators for user involvement at both individual and organizational levels are described.
The significance of user involvement in adolescent mental healthcare is underscored by a sense of increased empowerment and services tailored to meet adolescents' needs. The evidence gathered from qualitative studies suggests involving adolescents in their treatment contributed to greater motivation for treatment, higher attendance rates, and treatment continuation. User involvement should emphasize adolescents' preferences and a collaborative relationship that incorporates shared decision-making. Further implications for future practice and research are discussed.
青少年参与自身的精神卫生保健被视为一项基本人权。然而，对于用户参与的程度和性质，目前尚未达成共识，而且之前已经确定，关于青少年参与精神卫生保健的研究有限。鉴于人们对这一领域的关注不断变化，本研究探讨了青少年在精神卫生保健中参与的经历、效果和与安全相关的问题。
我们进行了系统评价，用最新的研究证据更新了我们最初关于青少年在个人和组织层面参与精神卫生保健的审查。在六个数据库中进行搜索、筛选参考文献列表以及征求该领域专家的建议，有助于确定 5527 条记录，其中 251 篇全文文章进行了筛选。使用既定指南进行数据提取、批判性评估和结果报告。
文献搜索共产生 36 项符合条件的研究，其中 28 项提供了定性数据，8 项提供了定量数据。定量研究确定了个人帮助和在线工具对支持青少年参与其精神卫生保健的重要性。一些定性研究表明，共同决策与改善自我报告的心理健康和治疗满意度有关。没有研究关注安全问题。对定性研究的主题综合分析得出了个人层面的四个主题和组织层面的两个主题。研究结果强调了青少年参与的权利和他们参与决策的能力得到了越来越多的认可，强调共同决策、双向沟通和信任是用户参与的基本协作关系的关键组成部分。进一步描述了个人和组织层面促进用户参与的因素。
青少年精神卫生保健中用户参与的重要性在于增强了自主权，并且服务更符合青少年的需求。从定性研究中收集的证据表明，让青少年参与治疗有助于提高治疗动机、提高出勤率和治疗连续性。用户参与应强调青少年的偏好和协作关系，其中包括共同决策。进一步讨论了对未来实践和研究的影响。
