Unmet Need for Specialty Mental Health Services Among Children Across Europe
Abstract
Objective:
Methods:
Results:
Conclusions:
Methods
Participants
Level of resources | Source | GPsa | Psychiatrists | Child psychiatrists | Psychologists |
---|---|---|---|---|---|
High | |||||
Germany | Samele et al., 2013 (15); Margraf, 2014 (16) (for psychologists) | 65.9 | 15.2 | 5.0 | 56.2 |
Italy | Samele et al., 2013 (15) | 75.8 | 7.8 | 3.1 | 68.3 |
The Netherlands | Samele et al., 2013 (15); Boer, 2013 (17) | 73.0 | 18.8 | 2.7 | 100.0 |
Lithuania | Braddick et al., 2009 (4); Samele et al., 2013 (15) | 74.0 | 17.8 | 3.2 | 7.7 |
Low | |||||
Bulgaria | Braddick et al., 2009 (4); Samele et al., 2013 (15) | 63.2 | 6.7 | .3 | .9 |
Romania | Braddick et al., 2009 (4); Samele et al., 2013 (15) | 67.7 | 6.4 | 1.2 | 4.5 |
Turkey | Tatar et al., 2011 (32); Ministry of Health, 2006 (18); and World Health Organization, 2010 (19) | 56.2 | 1.0 | .3 | 1.0 |
Measures
Child mental health status.
Use of mental health services.
Determinants of service use.
Data Analysis
Results
Descriptive Statistics
Use of mental health services | ||||||||
---|---|---|---|---|---|---|---|---|
Characteristic | N | % | N | % | p | OR | 95% CI | p |
Country’s mental health resources | .009 | |||||||
High resources | 2,582 | 55.0 | 218 | 8.4 | 1.33 | 1.08–1.65 | .010 | |
Low resources (reference) | 2,285 | 45.0 | 148 | 6.5 | ||||
Total | 4,867 | 366 | 7.5 | |||||
Parent characteristic | ||||||||
Maternal education level | .476 | |||||||
High school or less (reference) | 571 | 13.3 | 39 | 6.9 | .479 | |||
High school graduate | 1,590 | 37.1 | 116 | 7.3 | 1.07 | .73–1.56 | ||
College or more | 1,633 | 38.1 | 122 | 7.5 | 1.09 | .75–1.59 | ||
Other | 492 | 11.5 | 27 | 5.5 | .78 | .47–1.30 | ||
Marital status | .001 | |||||||
Single | 701 | 14.8 | 85 | 12.1 | 1.96 | 1.51–2.53 | .001 | |
In a relationship (reference) | 4,029 | 85.1 | 265 | 6.6 | ||||
Maternal psychological distress | .001 | |||||||
Yes | 825 | 17.7 | 110 | 13.3 | 2.26 | 1.78–2.87 | .001 | |
No (reference) | 3,832 | 82.3 | 244 | 6.4 | ||||
Child characteristic | ||||||||
Gender | .001 | |||||||
Boy | 2,446 | 50.3 | 229 | 9.4 | 1.72 | 1.38–2.14 | .001 | |
Girl (reference) | 2,421 | 49.7 | 137 | 5.7 | ||||
Age | .550 | |||||||
5.0–8.7 years | 2,237 | 53.9 | 162 | 7.2 | 1.07 | .86–1.32 | .550 | |
8.8–13.0 years (reference) | 2,612 | 46.1 | 201 | 7.7 | ||||
Academic performance | .001 | |||||||
Low | 689 | 14.7 | 105 | 15.2 | 2.77 | 2.17–3.53 | .001 | |
Average or high (reference) | 3,998 | 85.3 | 267 | 6.1 | ||||
Any disordera | .001 | |||||||
Yes | 557 | 11.4 | 142 | 25.6b | 6.28 | 4.97–7.93 | .001 | |
No (reference) | 4,309 | 88.5 | 223 | 5.2 | ||||
Conduct disorder | .001 | |||||||
Yes | 377 | 7.8 | 97 | 25.9 | 5.50 | 4.23–7.15 | .001 | |
No (reference) | 4,483 | 92.2 | 267 | 6.0 | ||||
Emotional disorder | .001 | |||||||
Yes | 158 | 3.2 | 38 | 24.0 | 4.22 | 2.88–6.19 | .001 | |
No (reference) | 4,702 | 96.7 | 326 | 7.0 | ||||
Hyperactivity | .001 | |||||||
Yes | 96 | 2.0 | 38 | 39.5 | 8.87 | 5.80–13.55 | .001 | |
No (reference) | 4,767 | 98.0 | 326 | 6.9 |
Predictors of Mental Health Service Use Across Europe
High resources (N=2,379) | Low resources (N=2,008) | Total (N=4,387) | High vs. low mental health resources | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Predictor | AORb | p | 95% CI | AORb | p | 95% CI | AORb | p | 95% CI | AORb | p | 95% CI |
Any disorder (reference: none | 5.61 | .001 | 3.95–7.97 | 3.38 | .001 | 2.15–5.30 | 4.61 | .001 | 3.50–6.07 | 1.71 | .042 | 1.01–2.87 |
Single parent marital status (reference: in a relationship) | 1.35 | .113 | .93–1.94 | 1.57 | .060 | .98–2.50 | 1.44 | .012 | 1.08–1.92 | .95 | .869 | .52–1.72 |
Maternal psychological distress (reference: none) | 1.96 | .001 | 1.39–2.77 | 1.30 | .228 | .85–2.00 | 1.65 | .001 | 1.26–2.16 | 1.63 | .075 | .95–2.80 |
Male (reference: female) | 1.35 | .063 | .98–1.85 | 1.60 | .018 | 1.08–2.37 | 1.45 | .003 | 1.13–1.85 | .90 | .689 | .55–1.48 |
Low academic performance (reference: average or high) | 1.43 | .056 | .99–2.07 | 1.45 | .121 | .91–2.32 | 1.41 | .019 | 1.06–1.89 | 1.25 | .432 | .72–2.17 |
Countries with high mental health resources (reference: low resources) | 1.41 | .005 | 1.11–1.79 |
High resources (N=2,379) | Low resources (N=2,008) | Total (N=4,387) | High vs. low mental health resources | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Disorder | AOR | p | 95% CI | AOR | p | 95% CI | AOR | p | 95% CI | AOR | p | 95% CI |
ADHD (reference: no ADHD) | 5.81 | .001 | 3.30–10.24 | 1.8 | .319 | .56–5.77 | 4.56 | .001 | 2.78–7.48 | 3.21 | .070 | 1.66–4.31 |
Conduct disorder (reference: no conduct disorder) | 4.43 | .001 | 2.85–6.28 | 2.70 | .001 | 1.63–4.47 | 3.56 | .001 | 2.61–4.85 | 1.61 | .114 | .89–2.88 |
Emotional disorder (reference: no emotional disorder) | 3.72 | .001 | 2.15–6.44 | 2.96 | .001 | 1.52–5.74 | 3.29 | .001 | 2.16–5.00 | 1.42 | .422 | .61–3.31 |
Discussion
Conclusions
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