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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Vydáno v:	Social Psychiatry and Psychiatric Epidemiology Ročník 49; číslo 8; s. 1231 - 1240
Hlavní autoři:	Sayal, Kapil, Yates, Nichola, Spears, Melissa, Stallard, Paul
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2014 Springer Springer Nature B.V
Témata:	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
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Shrnutí:	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.
Bibliografie:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Article-1 ObjectType-Feature-2 content type line 23
ISSN:	0933-7954 1433-9285 1433-9285
DOI:	10.1007/s00127-014-0843-y