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一项关于儿童心理健康联络服务对儿童和青少年身心健康、利益相关者体验及服务层面结果影响的混合方法系统评价。

A mixed methods systematic review of the impact of paediatric mental health liaison services on children and young people's mental and physical health, stakeholder experience, and service-level outcomes.

作者信息

Avery Miriam, Kirk Sue, Pryjmachuk Steven

机构信息

University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Greater Manchester, England.

University of Manchester, Greater Manchester, England.

出版信息

Eur Child Adolesc Psychiatry. 2025 Jul 15. doi: 10.1007/s00787-025-02815-5.

Abstract

Children and young people (CYP) with physical and mental health needs commonly present to acute hospitals. Although evidence shows liaison services providing mental health assessment and intervention to adult acute hospitals users improve outcomes, there is no evidence review for Paediatric Mental Health Liaison (PMHL). A mixed-methods, integrative, systematic review, using Joanna Briggs Institute (JBI) guidance, was conducted to identify evidence for PMHL service impacts on stakeholder experience and health and service level outcomes in the acute hospital setting.Keyword searches of relevant databases including Medline and PsycINFO plus citation searching identified 10,111 records; 415 papers were eligible for full-text screening. 53 papers describing mental health services/interventions provided to CYP aged 0-25 in acute hospital settings and reporting data on health and service-level outcomes, or stakeholder experiences were included. Service description, outcomes, and stakeholder experience data were extracted from included papers. Quantitative findings were 'qualitized' and analysed thematically. Quality appraisal used JBI tools.Studies were mostly cross-sectional (n = 27) or quasi-experimental (n = 13), from the US (n = 28) or England (n = 11). Service descriptions ranged from multidisciplinary teams covering entire hospitals to single mental health professionals integrated into one physical health department. Presence of PMHL services improve length of stay and healthcare costs/utilization, but evidence has methodological limitations. Evidence for PMHL services' impact on health outcomes is also positive but weak. PMHL services are valued by physical healthcare staff and parents/carers, but CYP views were underrepresented. Further work needs to establish outcomes important to CYP and families.Prospero Registration Number: CRD42022383611.

摘要

有身心健康需求的儿童和青少年(CYP)经常前往急症医院就诊。尽管有证据表明,为成年急症医院患者提供心理健康评估和干预的联络服务可改善治疗效果,但尚无针对儿童心理健康联络(PMHL)的证据综述。本研究采用混合方法、综合性系统综述,遵循乔安娜·布里格斯研究所(JBI)指南,以确定PMHL服务对急症医院环境中利益相关者体验以及健康和服务层面结果的影响证据。通过对包括Medline和PsycINFO在内的相关数据库进行关键词搜索以及引文检索,共识别出10111条记录;415篇论文符合全文筛选条件。纳入了53篇描述在急症医院环境中为0至25岁CYP提供的心理健康服务/干预措施,并报告健康和服务层面结果或利益相关者体验数据的论文。从纳入的论文中提取服务描述、结果和利益相关者体验数据。对定量研究结果进行“定性化”处理并进行主题分析。质量评估使用JBI工具。研究大多为横断面研究(n = 27)或准实验研究(n = 13),来自美国(n = 28)或英国(n = 11)。服务描述范围从覆盖整个医院的多学科团队到融入一个身体健康科室的单一心理健康专业人员。PMHL服务的存在可改善住院时间和医疗保健成本/利用率,但证据存在方法学局限性。PMHL服务对健康结果影响的证据也呈阳性但较弱。PMHL服务受到物理医疗保健人员以及父母/照顾者的重视,但CYP的观点代表性不足。需要进一步开展工作,以确定对CYP及其家庭重要的结果。国际系统评价注册平台注册号:CRD42022383611。

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