Boukje M Dijkstra, Paul J T Rood, Steven Teerenstra, Anne M F Rutten, Crista Leerentveld, Dominique C Burgers-Bonthuis, Barbara Festen-Spanjer, Toine Klarenbeek, Mark Van Den Boogaard, Esther Ewalds, Lisette Schoonhoven, Johannes G Van Der Hoeven, Lilian C M Vloet
Effect of a Standardized Family Participation Program in the ICU: A Multicenter Stepped-Wedge Cluster Randomized Controlled Trial
Critical care medicine
worldwide minority disordered childrenadolescents receives mental health assistance order improve service access important investigate factors influence process leading receiving care data frequency barriers mental health service use mhsu among brazilian childrenadolescents extremely scarce needed guide public policy establish frequency mhsu among 6to16yearold psychiatric disorders four brazilian regions identify structuralpsychosocialdemographic barriers associated childadolescent mhsu multicenter crosssectionalstudy involving four towns four five brazilian regions town representative sample elementary public school students randomly selected sample 1721 childadolescent mhsu defined seen psychologistpsychiatristneurologist previous 12 months standardized instruments measured 1 childrenadolescent characteristics 11 schedule affective disorders schizophrenia schoolage children ksadsplpsychiatric disorders 12 ten questions screenneurodevelopment problems 13 two subtests wisciiiestimated iq 14 academic performance testschool performance 2 factors related mothersmain caregivers selfreporting questionnaireanxietydepression 3 family brazilian researchcompaniesassociations questionnaireses 198 childrenadolescents psychiatric disorder used mental health services previous 12 months multiple logistic regression modeling identified five factors associated lower rates mhsu female gender adequate school performance mothermain caregiver living partner lower ses residing deprived brazilian regions regardless presence psychiatric disordersneurodevelopmental problems small proportion childrenadolescents psychiatric disorders seen mental health specialist previous 12 months structuralpsychosocialdemographic factors associated uneven access service certain groups childrenadolescents results call attention urgent need implement programs help reduce large unmet mental health need inequalities must considered policy makers planning strategies address barriers care