Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study
Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study
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DOI：
10.1192/bjp.bp.110.081448
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发表时间：
2010-12-01
影响因子：
10.5
通讯作者：
Simonoff, Emily
中科院分区：
文献类型：
--
作者：
Sayal, Kapil;Tischler, Victoria;Simonoff, Emily
背景儿童和青少年的心理健康问题在初级保健中很常见。目的探讨影响情绪或行为困难儿童父母求助的因素。方法采用小组讨论的方法，对34名来自非专科社区的关心儿童心理健康的父母进行小组讨论。结果大多数儿童都有临床上明显的心理健康症状或相关的功能障碍。预约制度是一个关键障碍，因为许多家长认为，预约时间短，没有足够的时间来解决孩子的困难。持续的护理和与全科医生(GP)的信任关系证实了他们的担忧，被认为有助于寻求帮助。父母重视那些对孩子和家庭状况表现出兴趣的全科医生。寻求帮助的障碍包括尴尬、精神健康问题的耻辱，以及对被贴上标签或接受诊断的担忧。一些父母担心被认为是贫穷的父母，如果他们寻求帮助，他们的孩子会被从家庭中带走。结论初级保健是有情绪和行为困难的儿童和青少年及其家庭的关键资源。初级保健服务应当能够随时接触到对儿童和家庭感兴趣的保健专业人员，并提供足够长的预约时间，使父母感到能够讨论其心理健康问题。
BackgroundChild and adolescent mental health problems are common in primary care. However, few parents of children with mental health problems express concerns about these problems during consultations.AimsTo explore the factors influencing parental help-seeking for children with emotional or behavioural difficulties.MethodFocus group discussions with 34 parents from non-specialist community settings who had concerns about their child's mental health. All groups were followed by validation groups or semi-structured interviews.ResultsMost children had clinically significant mental health symptoms or associated impairment in function. Appointment systems were a key barrier, as many parents felt that short appointments did not allow sufficient time to address their child's difficulties. Continuity of care and trusting relationships with general practitioners (GPs) who validated their concerns were perceived to facilitate help-seeking. Parents valued GPs who showed an interest in their child and family situation. Barriers to seeking help included embarrassment, stigma of mental health problems, and concerns about being labelled or receiving a diagnosis. Some parents were concerned about being judged a poor parent and their child being removed from the family should they seek help.ConclusionsPrimary healthcare is a key resource for children and young people with emotional and behavioural difficulties and their families. Primary care services should be able to provide ready access to health professionals with an interest in children and families and appointments of sufficient length so that parents feel able to discuss their mental health concerns.