Are Mental Health Services for Children Distributed According to Needs?

Blais, Régis; Breton, Jean-Jacques; Fournier, Mylène; St-Georges, Marie; Berthiaume, Claude

doi:10.1177/070674370304800306

Cited by 14 publications

(12 citation statements)

References 16 publications

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“…Papers from LMICs included several from Thailand [ 12 , 27 , 28 ], Mexico [ 29 ], Chile [ 30 ] and Brazil [ 8 , 31 ]. Studies from high-income countries tended to focus on access to specialised services and procedures such as mental health services [ 22 , 23 ], and procedures for circulatory disease [ 22 , 25 ]. They also focused on distinct populations such as children [ 23 ], the elderly [ 24 ] and psychiatric patients [ 22 ] rather than the population as a whole.…”

Section: Resultsmentioning

confidence: 99%

“…Studies from high-income countries tended to focus on access to specialised services and procedures such as mental health services [ 22 , 23 ], and procedures for circulatory disease [ 22 , 25 ]. They also focused on distinct populations such as children [ 23 ], the elderly [ 24 ] and psychiatric patients [ 22 ] rather than the population as a whole. Two studies showed that despite systems of free universal coverage, there was greater inequity, measured in terms of waiting times and receipt of procedures, for interventions which were non-urgent or elective, or for which there was a lack of clearly defined treatment protocols [ 21 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

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Achieving equity within universal health coverage: a narrative review of progress and resources for measuring success

Rodney

Hill

2014

Int J Equity Health

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IntroductionEquity should be implicit within universal health coverage (UHC) however, emerging evidence is showing that without adequate focus on measurement of equity, vulnerable populations may continue to receive inadequate or inferior health care. This study undertakes a narrative review which aims to: (i) elucidate how equity is contextualised and measured within UHC, and (ii) describe tools, resources and lessons which will assist decision makers to plan and implement UHC programmes which ensure equity for all.MethodsA narrative review of peer-reviewed literature published in English between 2005 and 2013, retrieved from PubMed via the search words, ‘universal health coverage/care’ and ‘equity/inequity’ was performed. Websites of key global health organizations were also searched for relevant grey literature. Papers were excluded if they failed to focus on equity (of access, financial risk protection or health outcomes) as well as focusing on one of the following: (i) the impact of UHC programmes, policies or interventions on equity (ii) indicators, measurement, monitoring and/or evaluation of equity within UHC, or (iii) tools or resources to assist with measurement.ResultsEighteen journal articles consisting mostly of secondary analysis of country data and qualitative case studies in the form of commentaries/reviews, and 13 items of grey literature, consisting largely of reports from working groups and expert meetings focusing on defining, understanding and measuring inequity in UHC (including recent drafts of global/country monitoring frameworks) were included.DiscussionThe literature advocates for progressive universalism addressing monetary and non-monetary barriers to access and strengthening existing health systems. This however relies on countries being effectively able to identify and reach disadvantaged populations and estimate unmet need. Countries should assess the new WHO/WB-proposed framework for its ability to adequately track the progress of disadvantaged populations in terms of achieving equitable access, effective coverage and financial risk protection within their own settings.ConclusionsRecently published resources contextualise equity as a measurable component of UHC and propose several useful indicators and frameworks. Country case-studies also provide useful lessons and recommendations for planning and implementing equitable UHC which will assist other countries to consider their own requirements for UHC monitoring and evaluation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-014-0072-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Achieving equity within universal health coverage: a narrative review of progress and resources for measuring success

Rodney

Hill

2014

Int J Equity Health

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“…Based on the literature on mental health service use, we included the predictors of child sex (Bussing et al 2003;Sourander et al 2008;Zimmerman 2005), psychological adjustment (McMiller and Weisz 1996), parents' perceived impact of child illness , single parent status (Briggs-Gowan et al 2000), parents' emotional adjustment (Verhulst and Van der Ende 1997), and their history of mental health service use (Wu et al 1999(Wu et al , 2001. We also considered the availability of mental health services within the community, which has been recognized as relevant to service planning and delivery (Bai et al 2009;Blais et al 2003), but has not been included in previous studies of help-seeking. Third, we examined what happened at each agency that parents contacted.…”

Section: The Current Studymentioning

confidence: 99%

Help-Seeking for Children with Mental Health Problems: Parents’ Efforts and Experiences

Reid

Cunningham

Tobon

et al. 2010

Adm Policy Ment Health

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Parents who contacted 1 of 15 children's mental health agencies in Ontario, Canada reported on where and why they were seeking mental health services for their 4- to 17-year-old children. Parents contacted an average of four agencies (± 1.7; range = 1-14) in the previous year. Approximately one-half of parents were looking for either multiple types of treatment, or help for different problems, across agencies. The complex pattern of help-seeking evidenced in our study likely increases the burden on the mental health care system and on families, and may reduce the likelihood that families will connect with the most appropriate treatment.

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“…Multiple aspects of treating children with mental health problems require improvement, including overcoming barriers to care and increasing service use (Blais, Breton, Fournier, St.-Georges, & Berthiaume, 2003;McKay, McCadam, & Gonzales, 1996). Recent estimates, based on a combination of epidemiological studies indicate that of the 14% of children with mental health disorders, only 18% of children receive specialized services for their difficulties (Waddell, Offord, Shepherd, Hua, & McEwan, 2002).…”

mentioning

confidence: 99%

Profiles and Service Utilization for Children Accessing a Mental Health Walk-In Clinic versus Usual Care

Barwick

Urajnik

Sumner³

et al. 2013

Journal of Evidence-Based Social Work

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Many children and adolescents with mental health problems do not receive the treatment they need. Unmet need raises questions about specific barriers that may prevent service use, and/or the characteristics of children and families who are less likely to receive care. Brief interventions or single-session psychotherapy delivered in a highly accessible manner are methods of addressing the problems associated with waitlists and limited access to care. In the current study the authors offer an exploratory evaluation of the West End Walk-In Counseling Centre for children and youth with psychosocial problems. Children 4 to 18 years of age who accessed the Walk-In Counseling Centre and a comparison group of clients who accessed usual care were assessed at intake, post-treatment, and 3-month follow-up on demographic characteristics, behavioral/emotional adjustment and functioning, client satisfaction, and service use. Children in the walk-in group had more severe behavioral/emotional adjustment and functioning than usual care clients at baseline. At post-treatment, walk-in clients had lower scores on Total Mental Health Problems and Internalizing Behaviors, and exhibited fewer problems across all scales at follow-up. Walk-in clients found the wait time for service more reasonable and at follow-up, felt the service addressed concerns and had higher regard for counselor availability and cultural sensitivity of the service than usual care clients. Service utilization, assessed at post-treatment and 3-month follow-up, showed that both groups were more likely to access mental health and education services rather than health or child welfare services, and were more likely to have used services in the 12 months prior to service than the 3 months following service completion. Walk-in clients had steeper rates of improvement compared to usual care clients despite equivalence in psychosocial functioning at baseline. The walk-in model may be an effective alternative to usual care, particularly for those clients only willing to wait up to 2 weeks for service.

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Are Mental Health Services for Children Distributed According to Needs?

Cited by 14 publications

References 16 publications

Achieving equity within universal health coverage: a narrative review of progress and resources for measuring success

Achieving equity within universal health coverage: a narrative review of progress and resources for measuring success

Help-Seeking for Children with Mental Health Problems: Parents’ Efforts and Experiences

Profiles and Service Utilization for Children Accessing a Mental Health Walk-In Clinic versus Usual Care

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