Mental health care use in adolescents with and without mental disorders.
The aim of the study was to estimate the proportion of adolescents with and without a psychiatric diagnosis receiving specialist mental health care and investigate their problem levels as well as utilization of other types of mental health care to detect possible over- and undertreatment. Care utilization data were linked to psychiatric diagnostic data of 2230 adolescents participating in the TRAILS cohort study, who were assessed biannually starting at age 11. Psychiatric diagnoses were established at the fourth wave by the Composite International Diagnostic Interview. Self-, parent- and teacher-reported emotional and behavioral problems and self-reported mental health care use were assessed at all four waves. Of all diagnosed adolescents, 35.3 % received specialist mental health care. This rate increased to 54.5 % when three or more disorders were diagnosed. Almost a third (28.5 %) of specialist care users had no psychiatric diagnosis; teachers gave them relatively high ratings on attention and impulsivity subscales. Diagnosed adolescents without specialist mental health care also reported low rates of other care use. We found no indication of overtreatment. Half of the adolescents with three or more disorders do not receive specialist mental health care nor any other type of care, which might indicate unmet needs.
University Medical Center Groningen, University Center Psychiatry, University of Groningen, House Code CC 72, PO Box 30.001, 9700 RB, Groningen, The Netherlands. f.jorg@umcg.nl.
Frederike
F
Jörg
University Medical Center Groningen, University Center Psychiatry, University of Groningen, House Code CC 72, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Ellen
E
Visser
University Medical Center Groningen, University Center Psychiatry, University of Groningen, House Code CC 72, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Johan
J
Ormel
University Medical Center Groningen, Department of Health Sciences, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Sijmen A
SA
Reijneveld
University Medical Center Groningen, University Center Psychiatry, University of Groningen, House Code CC 72, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Catharina A
CA
Hartman
University Medical Center Groningen, University Center Psychiatry, University of Groningen, House Code CC 72, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Albertine J
AJ
Oldehinkel
D000293:Adolescent; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys / Q000639:trends; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D008603:Mental Health / Q000639:trends*; D008605:Mental Health Services / Q000639:trends*; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011446:Prospective Studies; D057566:Self Report / Q000706:statistics & numerical data*
Adolescents; Cohort study; Health services needs and demand; Mental disorders