Reaume Shannon, Dubin Joel, Perlman Christopher, Ferro Mark
University of Waterloo, Waterloo, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2025 Mar 25. doi: 10.1007/s00127-025-02877-5.
To estimate six-month prevalence of child mental health service contacts and quantify associations between child health status and mental health service contacts, including number of types of contacts.
Data come from 6,242 children aged 4-17 years in the Ontario Child Health Study. A list of chronic conditions developed by Statistics Canada measured physical illness. The Emotional Behavioural Scales assessed mental illness. Child health status was categorized as healthy, physical illness only, mental illness only, and multimorbid (≥ 1 physical and ≥ 1 mental illness). Mental health service contact was aggregated to general medicine, urgent medicine, specialized mental health, school-based, alternative, and any contact (≥ 1 of the aforementioned contacts). Regression models quantified associations between health status and type of mental health contact, including number of types of contacts.
Weighted prevalence estimates showed 261,739 (21.4%) children had mental health-related service contact, with school-based services being the most common contact amongst all children, regardless of health status. Children with multimorbidity had higher odds for every mental health contact than healthy controls (OR range: 4.00-6.70). A dose-response was observed, such that the number of contacts increased from physical illness only (OR = 1.49, CI: 1.10-1.99) to mental illness only (OR = 3.39, CI: 2.59-4.44) to multimorbidity (OR = 4.13, CI: 2.78-6.15).
Over one-fifth of children had mental health-related service contact and contacts were highest among children with multimorbidity. Types of mental health contacts for children with multimorbidity are diverse, with further research needed to elucidate the barriers and facilitators of mental health use.
估计儿童心理健康服务接触的六个月患病率，并量化儿童健康状况与心理健康服务接触之间的关联，包括接触类型的数量。
数据来自安大略儿童健康研究中的6242名4至17岁儿童。加拿大统计局制定的慢性病清单用于衡量身体疾病。情绪行为量表用于评估精神疾病。儿童健康状况分为健康、仅患身体疾病、仅患精神疾病和多病共存（≥1种身体疾病和≥1种精神疾病）。心理健康服务接触被汇总为普通医学、急诊医学、专门心理健康、学校、替代以及任何接触（上述接触中的≥1种）。回归模型量化了健康状况与心理健康接触类型之间的关联，包括接触类型的数量。
加权患病率估计显示，261,739名（21.4%）儿童有与心理健康相关的服务接触，无论健康状况如何，学校服务是所有儿童中最常见的接触类型。多病共存的儿童与健康对照组相比，每次心理健康接触的几率更高（OR范围：4.00 - 6.70）。观察到剂量反应，即接触次数从仅患身体疾病（OR = 1.49，CI：1.10 - 1.99）增加到仅患精神疾病（OR = 3.39，CI：2.59 - 4.44）再到多病共存（OR = 4.13，CI：2.78 - 6.15）。
超过五分之一的儿童有与心理健康相关的服务接触，多病共存的儿童接触次数最多。多病共存儿童的心理健康接触类型多样，需要进一步研究以阐明心理健康服务利用的障碍和促进因素。
