Service use in adolescents at risk of depression and self-harm: prospective longitudinal study

Purpose Although depression and self-harm are common mental health problems in adolescents, there are barriers to accessing help. Using a community-based sample, this study investigates predictors of service contacts for adolescents at high risk of depression and self-harm. Methods Three thousand se...

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Bibliographic Details
Published in:Social Psychiatry and Psychiatric Epidemiology Vol. 49; no. 8; pp. 1231 - 1240
Main Authors: Sayal, Kapil, Yates, Nichola, Spears, Melissa, Stallard, Paul
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2014
Springer
Springer Nature B.V
Subjects:
Adolescent
Adolescent Health Services - statistics & numerical data
Adult and adolescent clinical studies
Biological and medical sciences
Child
Child psychopathology
Depression
Depression - epidemiology
Depression - psychology
Depression, Mental
Depressive Disorder - epidemiology
Depressive Disorder - psychology
Epidemiology
Female
Follow-Up Studies
Health care industry
Health Care Surveys
Health Services Accessibility
Humans
Male
Medical sciences
Medicine
Medicine & Public Health
Mental health
Mental Health Services - statistics & numerical data
Miscellaneous
Mood disorders
Odds Ratio
Original Paper
Primary Health Care - statistics & numerical data
Prospective Studies
Psychiatric services
Psychiatry
Psychological aspects
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Risk factors
Schools
Self destructive behavior
Self-Injurious Behavior - epidemiology
Self-Injurious Behavior - psychology
Socioeconomic Factors
Surveys and Questionnaires
United Kingdom - epidemiology
Young Adult
British Isles
Depression
Adolescents
Self-harm
Health services
Service use
Primary care
Human
Mood disorder
Self injury
Primary health care
Mental health
Health service
Follow up study
Adolescent
Risk factor
Self destruction
Public health
ISSN:0933-7954, 1433-9285, 1433-9285
Online Access:Get full text
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Summary:Purpose Although depression and self-harm are common mental health problems in adolescents, there are barriers to accessing help. Using a community-based sample, this study investigates predictors of service contacts for adolescents at high risk of depression and self-harm. Methods Three thousand seven hundred and forty-nine (3,749) 12- to 16-year-olds in UK secondary (high) schools provided baseline and 6 months’ follow-up data on mood, self-harm and service contacts with a range of primary and secondary healthcare services. Results Although most adolescents at high risk of depression or self-harm had seen their general practitioner (GP) in the previous 6 months, less than one-third had used primary or secondary healthcare services for emotional problems. 5 % of adolescents who reported self-harm had seen specialist child and adolescent mental health services in the previous 6 months. In longitudinal analyses, after adjustment for confounders, both depression and self-harm predicted the use of any healthcare services [adjusted odds ratio (AOR) = 1.34 (95 % CI 1.09, 1.64); AOR = 1.38 (95 % CI 1.02, 1.86), respectively] and of specialist mental health services [AOR = 5.48 (95 % CI 2.27, 13.25); AOR = 2.58 (95 % CI 1.11, 6.00), respectively]. Amongst those with probable depression, 79 % had seen their GP and 5 % specialist mental health services in the preceding year. Conclusions Most adolescents at high risk of depression or self-harm see their GP over a 6-month period although only a minority of them access specialist mental health services. Their consultations within primary care settings provide a potential opportunity for their identification and for signposting to appropriate specialist services.
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ISSN:0933-7954
1433-9285
1433-9285
DOI:10.1007/s00127-014-0843-y