Wahdi Amirah Ellyza, Astrini Yufan Putri, Setyawan Althaf, Fine Shoshanna L, Ramaiya Astha, Li Mengmeng, Wado Yohannes D, Loi Vu Manh, Maravilla Joemer C, Scott James G, Wilopo Siswanto Agus, Erskine Holly E
Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Child Adolesc Psychiatry Ment Health. 2025 Jul 31;19(Suppl 1):84. doi: 10.1186/s13034-025-00924-2.
Mental disorders are prevalent and their onset is highest during adolescence. However, there are limited data on adolescent mental health service utilization in low- and middle-income countries.
Data were from the National Adolescent Mental Health Surveys (NAMHS), nationally representative household surveys of adolescents aged 10-17 years and their primary caregiver conducted in Kenya, Indonesia, and Vietnam. All primary caregivers were asked whether their adolescent used any services providing support or counselling for emotional or behavioural problems in the past 12 months. Mental disorders were assessed using the Diagnostic Interview Schedule for Children, Version 5 (DISC-5). The prevalence of service use was calculated among those with mental disorders, subthreshold mental disorders, and no mental disorder. The prevalence of service use among those with either a diagnostic or subthreshold mental disorder was compared by demographic characteristics and broad mental disorder type. All estimates were weighted using population weights for each country and presented with 95% confidence intervals (CI).
Very few adolescents with a mental disorder (Kenya: 11.9%, 95% CI: 9.3-15.1; Indonesia: 4.7%, 95% CI: 1.9-11.1; Vietnam: 8.2%; 95% CI: 3.9-16.4) or a subthreshold mental disorder (Kenya: 10.8%, 95% CI: 9.1-12.9; Indonesia: 2.2%, 95% CI: 1.1-4.5; Vietnam: 8.5%; 95% CI: 5.0-14.1) accessed services that provide support or counselling for emotional or behavioural problems in the past 12 months. In Kenya, being older (aOR 1.41, 95% CI; 1.07-1.86) and female (aOR 1.77, 95% CI; 1.34-2.34) were associated with increased odds of service use, while having internalising disorders only (aOR 0.45, 95% CI; 0.30-0.65) was associated with decreased odds of service use. No difference by demographic characteristics or mental disorder type was seen in Indonesia and Vietnam.
Only a small proportion of adolescents with a diagnostic or subthreshold mental disorder accessed services for mental health in Kenya, Indonesia, and Vietnam. These findings indicate the need for greater support for adolescents with mental disorders and provide critical context for governments and relevant in-country stakeholders when reviewing the availability and accessibility of adolescent mental health services.
精神障碍普遍存在，且在青少年时期发病率最高。然而，关于低收入和中等收入国家青少年心理健康服务利用情况的数据有限。
数据来自全国青少年心理健康调查（NAMHS），这是在肯尼亚、印度尼西亚和越南对10至17岁青少年及其主要照料者进行的具有全国代表性的家庭调查。所有主要照料者均被问及他们的青少年在过去12个月内是否使用过任何为情绪或行为问题提供支持或咨询的服务。使用儿童诊断访谈量表第5版（DISC - 5）评估精神障碍。计算在患有精神障碍、亚阈值精神障碍和无精神障碍者中服务利用的患病率。按人口统计学特征和宽泛的精神障碍类型比较诊断或亚阈值精神障碍者中服务利用的患病率。所有估计值均使用每个国家的人口权重进行加权，并给出95%置信区间（CI）。
在过去12个月内，极少有患有精神障碍（肯尼亚：11.9%，95%CI：9.3 - 15.1；印度尼西亚：4.7%，95%CI：1.9 - 11.1；越南：8.2%；95%CI：3.9 - 16.4）或亚阈值精神障碍（肯尼亚：10.8%，95%CI：9.1 - 12.9；印度尼西亚：2.2%，95%CI：1.1 - 4.5；越南：8.5%；95%CI：5.0 - 14.1）的青少年获得过为情绪或行为问题提供支持或咨询的服务。在肯尼亚，年龄较大（调整后比值比[aOR]1.41，95%CI：1.07 - 1.86）和女性（aOR 1.77，95%CI：1.34 - 2.34）与服务利用几率增加相关，而仅患有内化性障碍（aOR 0.45，95%CI：0.30 - 0.65）与服务利用几率降低相关。在印度尼西亚和越南，未观察到人口统计学特征或精神障碍类型方面的差异。
在肯尼亚、印度尼西亚和越南，只有一小部分诊断或亚阈值精神障碍的青少年获得了心理健康服务。这些发现表明需要为患有精神障碍的青少年提供更多支持，并为政府和国内相关利益攸关方在审查青少年心理健康服务的可及性和可得性时提供关键背景信息。
