Prevention of mental health problems: rationale for a universal approach
Prevention of mental health problems: rationale for a universal approach
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DOI：
10.1136/adc.2006.100776
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发表时间：
2007-01-01
影响因子：
5.2
通讯作者：
Wake, M.
中科院分区：
文献类型：
--
作者：
Bayer, J. K.;Hiscock, H.;Wake, M.
背景和目的：心理健康问题是现代社区中影响多达20%的儿童的公共卫生问题。外部化和内部化问题的风险因素可能发生在婴儿期。高风险的婴儿生活在父母有心理健康问题，药物滥用，关系冲突，社会孤立，经济问题或婴儿气质困难的压力家庭中。虽然目前的预防方案以高风险群体为服务对象，但这种针对性可能会使家庭蒙受耻辱，并错过许多有需要的儿童。增加针对所有家庭的普遍预防方案可以解决这些问题。这项调查评估了患病率的婴儿参加初级保健服务的交付点为普及prevention.Design：调查的母亲6个月大的婴儿参加6个政府领域的墨尔本，维多利亚，澳大利亚，2004年8月至9月之间的健康儿童诊所。一项简短的调查测量社会人口特征和以下家庭风险：产妇抑郁症，焦虑，压力，物质滥用，家庭暴力，社会孤立和婴儿气质difficulties.Results：调查完成了733名母亲，占69%的婴儿出生的初级保健服务。其中，39%的婴儿被归类为有发展心理健康问题的风险。被归类为风险的婴儿的百分比是没有显着不同的社会经济水平（低，42%，中，40%，高，35%）。结论：大量的婴儿参加常规的普遍初级保健的发展心理健康问题的风险。这种初级保健环境可以提供一个理想的平台，通过普遍提供的，以证据为基础的育儿计划，防止早期外部化和内部化的问题。
Background and objective: Mental health problems are a public health issue affecting as many as 20% of children in modern communities. Risk factors for externalising and internalising problems can occur in infancy. Infants at high risk live in stressed families with parent mental health problems, substance misuse, relationship conflict, social isolation, financial problems or infant temperamental difficulty. Although current prevention programmes target services to high-risk groups, targeting can stigmatise families and miss many children in need. The addition of universal prevention programmes for all families could address these concerns. This survey assessed the prevalence of infants at risk attending a primary care service as a delivery point for universal prevention.Design: Survey of mothers of 6-month-old infants attending well-child clinics across six government areas of Melbourne, Victoria, Australia, between August and September 2004. A brief survey measured sociodemographic characteristics and the following family risks: maternal depression, anxiety, stress, substance misuse, violence at home, social isolation and infant temperamental difficulty.Results: The survey was completed by 733 mothers, representing 69% of infant births presented to the primary care service. Of these, 39% of infants were classified as at risk for developing mental health problems. The percentage of infants classified as at risk was not markedly dissimilar across socioeconomic levels ( low, 42%; middle, 40%; high, 35%).Conclusions: A substantial number of infants attending routine universal primary care are at risk of developing mental health problems. This primary care setting could provide an ideal platform for preventing early externalising and internalising problems via a universally offered, evidence-based parenting programme.