Pathways to mental health services for young people: a systematic review.
Pathways to mental health services for young people: a systematic review.
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DOI：
10.1007/s00127-018-1578-y
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发表时间：
2018-10
影响因子：
4.4
通讯作者：
Iyer SN
中科院分区：
文献类型：
--
作者：
MacDonald K;Fainman-Adelman N;Anderson KK;Iyer SN
虽然尽早获得适当的护理可以最大限度地减少精神疾病的后遗症，但人们对青少年如何获得心理保健知之甚少。因此，我们进行了系统回顾，综合了有关解决青少年一系列心理健康问题的途径的文献。研究是通过搜索电子数据库（MEDLINE、PsycINFO、Embase、HealthSTAR 和 CINAHL）确定的，并辅以前后映射和手动搜索。我们纳入了有关 11 至 30 岁个体心理保健途径的研究。两名审稿人独立筛选文章并提取数据。来自 26 个国家的 45 项研究符合资格标准。这些研究大部分来自为精神病早期阶段提供服务的机构，其他研究则包括针对广泛的心理健康问题的住院和门诊机构。一般来说，青少年获得心理保健的途径很复杂，涉及多种接触，有时还会导致治疗不当延误。在各种情况下，家庭/护理人员、全科医生和急诊室在护理途径中占据显着地位。路径测量几乎没有标准化。除精神病外，青少年获得心理保健的途径仍未得到充分研究。护理研究的途径可能需要重新概念化，以考虑到青少年心理健康表现通常短暂和重叠的性质，以及构成最佳护理的内容可能会有所不同的可能性。尽管存在这些复杂性，但使用标准化方法进行额外研究可以更好地了解青少年和代表他们行事的人的寻求帮助行为；对寻求帮助的服务响应；以及路径的决定因素。这种理解对于正在进行的改变青少年心理保健的举措至关重要。本文的在线版本 (10.1007/s00127-018-1578-y) 包含补充材料，可供授权用户使用。
While early access to appropriate care can minimise the sequelae of mental illnesses, little is known about how youths come to access mental healthcare. We therefore conducted a systematic review to synthesise literature on the pathways to care of youths across a range of mental health problems. Studies were identified through searches of electronic databases (MEDLINE, PsycINFO, Embase, HealthSTAR and CINAHL), supplemented by backward and forward mapping and hand searching. We included studies on the pathways to mental healthcare of individuals aged 11–30 years. Two reviewers independently screened articles and extracted data. Forty-five studies from 26 countries met eligibility criteria. The majority of these studies were from settings that offered services for the early stages of psychosis, and others included inpatient and outpatient settings targeting wide-ranging mental health problems. Generally, youths’ pathways to mental healthcare were complex, involved diverse contacts, and, sometimes, undue treatment delays. Across contexts, family/carers, general practitioners and emergency rooms featured prominently in care pathways. There was little standardization in the measurement of pathways. Except in psychosis, youths’ pathways to mental healthcare remain understudied. Pathways to care research may need to be reconceptualised to account for the often transient and overlapping nature of youth mental health presentations, and the possibility that what constitutes optimal care may vary. Despite these complexities, additional research, using standardized methodology, can yield a greater understanding of the help-seeking behaviours of youths and those acting on their behalf; service responses to help-seeking; and the determinants of pathways. This understanding is critical to inform ongoing initatives to transform youth mental healthcare. The online version of this article (10.1007/s00127-018-1578-y) contains supplementary material, which is available to authorized users.
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