• This record comes from PubMed

Care providers' view of the barriers in providing care for adolescents with emotional and behavioral problems

. 2024 ; 15 () : 1302004. [epub] 20241219

Status PubMed-not-MEDLINE Language English Country Switzerland Media electronic-ecollection

Document type Journal Article

OBJECTIVES: Emotional and behavioral problems (EBP) during adolescence are a major public health issue due to its high prevalence and long-lasting consequences. The knowledge of the barriers in providing psychosocial care can be a starting point for subsequent efficiency improvement. Therefore, the aim of this study is to assess which barriers do care providers experience while providing psychosocial care for adolescents with EBP. METHODS: We performed a qualitative assessment that was embedded in the Slovak Care4Youth study mapping the system of care provided for adolescents with EBP. We conducted 25 semi-structured individual and group interviews with a total of 49 care providers from 17 institutions that provided preventive counselling, social, and mental healthcare for adolescents with EBP. We focused on the care provider's perception of barriers in providing care for these adolescents. The interviews were audiotaped and transcribed verbatim. We coded the data using the consensual qualitative research approach in combination with conventional content analysis. RESULTS: We found that care providers experienced several barriers in providing care for adolescents with EBP which relate to six themes-legislative framework and legislative changes; financing of the care system; coordination of care; workforce development, education, methodical guidance and supervision; personnel and institutional capacities; and administrative burden. CONCLUSION: Addressing these barriers within the care system from the "front line" perspective provides clues to efficiently improve the psychosocial care for adolescents with EBP. According to the care providers, the organization and financing of the care system requires adaptation; the burden of the care providers should be reduced; and care providers require quality practical education, training, and methodological guidance.

See more in PubMed

Achenbach T. M., Howell C. T., Quay H. C., Conners C. K. (1991). National survey of problems and competencies among four- to sixteen-year-olds: parents' reports for normative and clinical samples. Monogr. Soc. Res. Child Dev. 56, 1–31, PMID: PubMed

Andersen R. M. (1968). A behavioral model of families’ use of health services. Research series no. 25. Chicago: Center for Health Administration Studies, University of Chicago.

Bains R. M. (2014). African American adolescents and mental health care: a metasynthesis. J. Child Adolesc. Psychiatr. Nurs. 27, 83–92. doi: 10.1111/jcap.12074, PMID: PubMed DOI

Bornstein M. H., Hahn C. S., Suwalsky J. T. D. (2013). Language and internalizing and externalizing behavioral adjustment: developmental pathways from childhood to adolescence. Dev. Psychopathol. 25, 857–878. doi: 10.1017/S0954579413000217 PubMed DOI PMC

Bramesfeld A., Ungewitter C., Böttger D., El Jurdi J., Losert C., Kilian R. (2012). What promotes and inhibits cooperation in mental health care across disciplines, services and service sectors? A qualitative study. Epidemiol. Psychiatr. Sci. 21, 63–72. doi: 10.1017/s2045796011000539, PMID: PubMed DOI

Cole A., Kim H., Lotz K., Munson M. R. (2016). Exploring the perceptions of workers on young adult mental health service (dis)engagement. Soc. Work. Ment. Health 14, 133–148. doi: 10.1080/15332985.2015.1022244 DOI

Cooper P. (2011). Teacher strategies for effective intervention with students presenting social, emotional and behavioral difficulties: An international review. Eur. J. Spec. Needs Educ. 26, 7–86. doi: 10.1080/08856257.2011.543547 DOI

Costello E. J., Maughan B. (2015). Annual research review: optimal outcomes of child and adolescent mental illness. J. Child Psychol. Psychiatry 56, 324–341. doi: 10.1111/jcpp.12371, PMID: PubMed DOI PMC

Dankulincova Z., Bosakova L., Filakovska D., Husarova D., Kopcakova J. (2020). Labyrinth journey: Adolescents with emotional and behavioral problems in the care system. [Cesta labyrintom: Dospievajúci s emocionálnymi problémami a problémami v správaní v systéme starostlivosti]. Košice: Vydavateľstvo ŠafárikPress.

de S., Veldman K. A., Amick B., Bültmann U. (2022). Work functioning among young adults: the role of mental health problems from childhood to young adulthood. Occup. Environ. Med. 79, 217–223. doi: 10.1136/oemed-2021-107819, PMID: PubMed DOI PMC

Dougherty D. M., Lake S. L., Mathias C. W., Ryan S. R., Bray B. C., Charles N. E., et al. . (2015). Behavioral impulsivity and risk-taking trajectories across early adolescence in youths with and without family histories of alcohol and other drug use disorders. Alcohol. Clin. Exp. Res. 39, 1501–1509. doi: 10.1111/acer.12787, PMID: PubMed DOI PMC

Durbin J., Goering P., Streiner D. L., Pink G. (2006). Does systems integration affect continuity of mental health care? Admin. Pol. Ment. Health 33, 705–717. doi: 10.1007/s10488-006-0087-6, PMID: PubMed DOI

Flisher A. J., Kramer R. A., Grosser R. C., Alegria M., Bird H. R., Bourdon K. H., et al. . (1997). Correlates of unmet need for mental health services by children and adolescents. Psychol. Med. 27, 1145–1154. doi: 10.1017/s0033291797005412, PMID: PubMed DOI

Fridman M., Banaschewski T., Sikirica V., Quintero J., Chen K. S. (2017). Access to diagnosis, treatment, and supportive services among pharmacotherapy-treated children/adolescents with ADHD in Europe: data from the caregiver perspective on pediatric ADHD survey. Neuropsychiatr. Dis. Treat. 13, 947–958. doi: 10.2147/ndt.s128752, PMID: PubMed DOI PMC

Garland A. F., Lebensohn-Chialvo F., Hall K. G., Cameron E. R. N. (2017). Capitalizing on scientific advances to improve access to and quality of Children's mental health care. Behav. Sci. Law 35, 337–352. doi: 10.1002/bsl.2296, PMID: PubMed DOI

George M. W., Zaheer I., Kern L., Evans S. W. (2018). Mental health service use among adolescents experiencing emotional/behavioral problems and school impairment. J. Emot. Behav. Disord. 26, 119–128. doi: 10.1177/1063426617710240 DOI

George N., Lee A. H., Gonzalez-Gaspar J., Kwan M. Y. (2024). A systematic review of barriers and facilitators impacting the utilization of mental health services among Asian American youth. Evid. Based Pract. Child Adolesc. Ment. Health, 1–15. doi: 10.1080/23794925.2024.2392250, PMID: PubMed DOI

Glisson C. (2002). The organizational context of children's mental health services. Clin. Child. Fam. Psychol. Rev. 5, 233–253. doi: 10.1023/a:1020972906177 PubMed DOI

HBSC (2023). Tlacova sprava. Dusevne zdravie. Available: at: https://hbscslovakia.com/wp-content/uploads/2023/09/hbsc_ts_dusevne-zdravie.pdf

Hetrick S. E., Simmons M., Thompson A., Parker A. G. (2011). What are specialist mental health clinician attitudes to guideline recommendations for the treatment of depression in young people? Aust. N. Z. J. Psychiatry 45, 993–1001. doi: 10.3109/00048674.2011.619161, PMID: PubMed DOI

Hill C. E., Knox S. (2021). Essentials of consensual qualitative research. Amer. Psychol. Assoc. doi: 10.1037/0000215-000 DOI

Hill C. E., Thompson B. J., Williams E. N. (1997). A guide to conducting consensual qualitative research. Couns. Psychol. 25, 517–572. doi: 10.1177/0011000097254001 DOI

Hsieh H. F., Shannon S. E. (2005). Three approaches to qualitative content analysis. Qual. Health Res. 15, 1277–1288. doi: 10.1177/1049732305276687, PMID: PubMed DOI

Jansen D., Wiegersma P., Ormel J., Verhulst F. C., Vollebergh W. A. M., Reijneveld S. A. (2013). Need for mental health care in adolescents and its determinants: the TRAILS study. Eur. J. Pub. Health 23, 236–241. doi: 10.1093/eurpub/cks087, PMID: PubMed DOI

Jaspers M., de Winter A. F., Huisman M., Verhulst F. C., Ormel J., Stewart R. E., et al. . (2012). Trajectories of psychosocial problems in adolescents predicted by findings from early well-child assessments. J. Adolesc. Health 51, 475–483. doi: 10.1016/j.jadohealth.2012.02.007, PMID: PubMed DOI

Kidia K., Machando D., Mangezi W., Hendler R., Crooks M., Abas M., et al. . (2017). Mental health in Zimbabwe: a health systems analysis. Lancet Psychiatry 4, 876–886. doi: 10.1016/S2215-0366(17)30128-1, PMID: PubMed DOI

Kretschmer T., Hickman M., Doerner R., Emond A., Lewis G., Macleod J., et al. . (2014). Outcomes of childhood conduct problem trajectories in early adulthood: findings from the ALSPAC study. Eur. Child Adolesc. Psychiatry 23, 539–549. doi: 10.1007/s00787-013-0488-5, PMID: PubMed DOI PMC

Kringos D. S., Boerma W. G. W., Bourgueil Y., Cartier T., Hasvold T., Hutchinson A., et al. . (2010). The european primary care monitor: structure, process and outcome indicators. BMC Fam. Pract. 11:81. doi: 10.1186/1471-2296-11-81, PMID: PubMed DOI PMC

Langer D. A., Wood J. J., Wood P. A., Garland A. F., Landsverk J., Hough R. L. (2015). Mental health service use in schools and non-school-based outpatient settings: comparing predictors of service use. School Ment. Health. 7, 161–173. doi: 10.1007/s12310-015-9146-z, PMID: PubMed DOI PMC

Levesque J. F., Harris M. F., Russell G. (2013). Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int. J. Equity Health 12:18. doi: 10.1186/1475-9276-12-18, PMID: PubMed DOI PMC

Lu W., Todhunter-Reid A., Mitsdarffer M. L., Munoz-Laboy M., Yoon A. S., Xu L. (2021). Barriers and Facilitators for Mental Health Service Use Among Racial/Ethnic Minority Adolescents: A Systematic Review of Literature. Front Public Health 9, 641605. doi: 10.3389/fpubh.2021.641605 PubMed DOI PMC

Luby J. L., Gaffrey M. S., Tillman R., April L. M., Belden A. C. (2014). Trajectories of preschool disorders to full DSM depression at school age and early adolescence: continuity of preschool depression. Am. J. Psychiatry 171, 768–776. doi: 10.1176/appi.ajp.2014.13091198, PMID: PubMed DOI PMC

Mackova J. (2022). Families at risk and the role of the care system. Groningen: University of Groningen (doctoral dissertation)

Mackova J. D., Veselska Z. M., Geckova A., Jansen D. E. M. C., van J., Reijneveld S. A. (2022). The role of parents in the care for adolescents suffering from emotional and behavioral problems. Front. Psychol. 13:1049247. doi: 10.3389/fpsyg.2022.1049247, PMID: PubMed DOI PMC

Martinez J. I., Lau A. S. (2011). Do social networks push families toward or away from youth mental health services? A national study of families in child welfare. J. Emot. Behav. Disord. 19, 169–181. doi: 10.1177/1063426610377898, PMID: PubMed DOI PMC

Nanninga M., Jansen D., Knorth E. J., Reijneveld S. A. (2015). Enrolment of children and adolescents in psychosocial care: more likely with low family social support and poor parenting skills. Eur. Child Adolescent Psychiatry Suppl. 24, 407–416. doi: 10.1007/s00787-014-0590-3, PMID: PubMed DOI

Nanninga M., Jansen D., Knorth E. J., Reijneveld S. A. (2018). Enrolment of children in psychosocial care: problems upon entry, care received, and outcomes achieved. Eur. Child Adolescent Psychiatry Suppl. 27, 625–635. doi: 10.1007/s00787-017-1048-1, PMID: PubMed DOI PMC

Nanninga M., Reijneveld S. A., Knorth E. J., Jansen D. (2016). Expectations of barriers to psychosocial care: views of parents and adolescents in the community. Eur. Child Adolescent Psychiatry Suppl. 25, 107–117. doi: 10.1007/s00787-015-0717-1, PMID: PubMed DOI PMC

National Institute for Health and Care Excellence (2013). Antisocial behaviour and conduct disorders in children and young people (NICE guideline no.158), Available at: https://www.nice.org.uk/guidance/cg158/evidence/conduct-disorders-in-children-and-young-people-full-guideline-189848413 (Accessed August 1, 2023).

NUDZ (2023). Narodni monitoring dusevniho zdravi deti: 40 % vykazuje znamky stredni az tezke deprese, 30 % uzkosti. Odbornici pripravuji preventivni opatreni. Tiskova zprava, 10. (2023). Available at: https://www.nudz.cz/media-pr/tiskove-zpravy/narodni-monitoring-dusevniho-zdravi-deti-40-vykazuje-znamky-stredni-az-tezke-deprese-30-uzkosti-odbornici-pripravuji-preventivni-opatreni

Ogundele M. O. (2018). Behavioural and emotional disorders in childhood: a brief overview for paediatricians. World J. Clin. Pediatr. 7, 9–26. doi: 10.5409/wjcp.v7.i1.9, PMID: PubMed DOI PMC

Ormel J., Oerlemans A. M., Raven D., Laceulle O. M., Hartman C. A., Veenstra R., et al. . (2017). Functional outcomes of child and adolescent mental disorders, current disorder most important but psychiatric history matters as well. Psychol. Med. 47, 1271–1282. doi: 10.1017/S0033291716003445, PMID: PubMed DOI

Oruche U. M., Downs S., Holloway E., Draucker C., Aalsma M. (2014). Barriers and facilitators to treatment participation by adolescents in a community mental health clinic. J. Psychiatr. Ment. Health Nurs. 21, 241–248. doi: 10.1111/jpm.12076, PMID: PubMed DOI

Pace C. S., Muzi S., Frigerio A., Morganti W., Bianchi V., Rogier G. (2023). Twenty years of emotional-behavioral problems of community adolescents living in Italy measured through the Achenbach system of empirically based assessment (ASEBA): a systematic review and meta-analysis. Front. Psych. 14:1161917. doi: 10.3389/fpsyt.2023.1161917, PMID: PubMed DOI PMC

Paclikova K., Dankulincova Z., Madarasova A., Van Dijk J. P., Reijneveld S. A. (2020). Adolescent enrollment in psychosocial care: do parents make a difference? Int. J. Environ. Res. Public Health 17:7066. doi: 10.3390/ijerph17197066, PMID: PubMed DOI PMC

Paton K., Hiscock H. (2019). Strengthening care for children with complex mental health conditions: views of Australian clinicians. PLoS One 14:e0214821. doi: 10.1371/journal.pone.0214821, PMID: PubMed DOI PMC

Pedrini L., Colasurdo G., Costa S., Fabiani M., Ferraresi L., Franzoni E., et al. . (2012). The characteristics and activities of child and adolescent mental health services in Italy: a regional survey. BMC Psychiatry 12:7. doi: 10.1186/1471-244x-12-7, PMID: PubMed DOI PMC

Pfefferle S. G. (2007). Pediatrician perspectives on children's access to mental health services: consequences and potential solutions. Admin. Pol. Ment. Health 34, 425–434. doi: 10.1007/s10488-007-0122-2, PMID: PubMed DOI

Plaistow J., Masson K., Koch D., Wilson J., Stark R. M., Jones P. B., et al. . (2014). Young people's views ofUKmental health services. Early Interv. Psychiatry 8, 12–23. doi: 10.1111/eip.12060, PMID: PubMed DOI

Powell K., Huxley E., Townsend M. L. (2021). Mental health help seeking in young people and carers in out of home care: a systematic review. Child Youth Serv. Rev. 127:106088. doi: 10.1016/j.childyouth.2021.106088, PMID: PubMed DOI

Raudino A., Woodward L. J., Fergusson D. M., Horwood L. J. (2012). Childhood conduct problems are associated with increased partnership and parenting difficulties in adulthood. J. Abnorm. Child Psychol. 40, 251–263. doi: 10.1007/s10802-011-9565-8, PMID: PubMed DOI

Reijneveld S. A., Wiegersma P. A., Ormel J., Verhulst F. C., Vollebergh W. A. M., Jansen D. (2014). Adolescents' use of care for behavioral and emotional problems: types, trends, and determinants. PLoS One 9:11. doi: 10.1371/journal.pone.0093526, PMID: PubMed DOI PMC

Sacco R., Camilleri N., Eberhardt J., Umla-Runge K., Newbury-Birch D. (2022). A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe. Eur. Child Adolesc. Psychiatry 33, 2877–2894. doi: 10.1007/s00787-022-02131-2, PMID: PubMed DOI PMC

Stringaris A., Lewis G., Maughan B. (2014). Developmental pathways from childhood conduct problems to early adult depression: findings from the ALSPAC cohort. Br. J. Psychiatry 205, 17–23. doi: 10.1192/bjp.bp.113.134221, PMID: PubMed DOI PMC

Suter E., Arndt J., Arthur N., Parboosingh J., Taylor E., Deutschlander S. (2009). Role understanding and effective communication as core competencies for collaborative practice. J. Interprof. Care 23, 41–51. doi: 10.1080/13561820802338579, PMID: PubMed DOI

Thomée S., Malm D., Christianson M., Hurtig A. K., Wiklund M., Waenerlund A. K., et al. . (2016). Challenges and strategies for sustaining youth-friendly health services - a qualitative study from the perspective of professionals at youth clinics in northern Sweden. Reprod Health Dec 13:147. doi: 10.1186/s12978-016-0261-6, PMID: PubMed DOI PMC

Vasileva M., Petermann F. (2017). Mental health needs and therapeutic service utilization of young children in foster care in Germany. Child Youth Serv. Rev. 75, 69–76. doi: 10.1016/j.childyouth.2017.02.022 DOI

VERBI Software . (2021). MAXQDA 2022 [computer software]. VERBI Software. Available at: maxqda.com (Accessed August 1, 2023).

Verhage V., Reijneveld S. A., Wunderink Ch., Grietens H., Almansa J., Jansen D. (2021). Care improves self-reported daily functioning of adolescents with emotional and behavioural problems. Eur. Child Adolesc. Psychiatry 31, 1685–1693. doi: 10.1007/s00787-021-01812-8 PubMed DOI PMC

WHO (2010). Monitoring the building block of health systems: A handbook of indicatiors and their measuement strategies. Geneva: WHO Document Production Services.

Find record

Citation metrics

Loading data ...

Archiving options

Loading data ...