The Hodgepodge Reality: A Qualitative Systematic Review of the Challenges and Barriers in Child and Adolescent Mental Health Care Systems

IF 4.7 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Adolescent Research Review Pub Date : 2023-12-13 DOI:10.1007/s40894-023-00227-7
Ángela Carbonell, Sylvia Georgieva, José-Javier Navarro-Pérez, Virginia Prades-Caballero
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Abstract

The literature to date has documented the presence of challenges and barriers in mental health systems and services for children and adolescents worldwide. However, studies addressing this reality often do so in a fragmented, residual, incomplete, or generalized way, therefore hindering a comprehensive understanding of this complex phenomenon. The aim of this qualitative systematic review is to analyze the barriers and challenges affecting global mental health care for children and adolescents. Searches were made in the Web of Science, Scopus, and PubMed databases between 2018 and 2022 using terms connected with mental health, childhood, adolescence, and health systems. The search resulted in the extraction of 9075 articles, of which 51 were considered eligible for inclusion and complied with quality indicators. A number of closely related structural, financial, attitudinal, and treatment barriers that limited the quality of life and well-being of children and adolescents with mental health needs were found. These barriers included inadequate public policies, operational deficiencies, insufficient insurance coverage, privatization of services, stigma, lack of mental health literacy, lack of training, overburdened care, dehumanization of care, and lack of community and integrated resources. The analysis of these barriers displays that this treatment gap reflects the historical injustice towards mental illness and the disregard for real needs in these crucial stages, perpetuating a systematic lack of protection for the mental health of children and adolescents. The complexity of the disorders and the absence of public resources have resulted in a hodgepodge of mental health services for children and adolescents that fails to provide the continuing specialist health care they need.

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大杂烩现实:对儿童和青少年心理健康护理系统的挑战和障碍的定性系统回顾
迄今为止的文献记载了全世界儿童和青少年心理健康系统和服务中存在的挑战和障碍。然而,针对这一现实情况的研究往往是零散的、残缺的、不完整的或笼统的,因此阻碍了对这一复杂现象的全面了解。本定性系统综述旨在分析影响全球儿童和青少年心理健康护理的障碍和挑战。在 2018 年至 2022 年期间,使用与心理健康、儿童、青少年和卫生系统相关的术语在 Web of Science、Scopus 和 PubMed 数据库中进行了检索。搜索结果提取了 9075 篇文章,其中 51 篇被认为符合纳入条件并符合质量指标。我们发现了一些与之密切相关的结构性障碍、经济障碍、态度障碍和治疗障碍,这些障碍限制了有心理健康需求的儿童和青少年的生活质量和福祉。这些障碍包括公共政策不完善、运作缺陷、保险覆盖面不足、服务私有化、污名化、缺乏心理健康知识、缺乏培训、护理负担过重、护理非人性化以及缺乏社区和综合资源。对这些障碍的分析表明,这种治疗差距反映了历史上对精神疾病的不公正,以及在这些关键阶段对实际需求的忽视,使儿童和青少年的心理健康长期得不到系统的保护。疾病的复杂性和公共资源的匮乏导致了儿童和青少年精神健康服务的大杂烩,无法为他们提供所需的持续性专科医疗服务。
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来源期刊
Adolescent Research Review
Adolescent Research Review PSYCHOLOGY, DEVELOPMENTAL-
CiteScore
10.40
自引率
0.00%
发文量
17
期刊介绍: Adolescent Research Review publishes articles that review important contributions to the understanding of adolescence.  The Review draws from the many subdisciplines of developmental science, psychological science, education, criminology, public health, medicine, social work, and other allied disciplines that address the subject of youth and adolescence. The editors are especially interested in articles that bridge gaps between disciplines or that focus on topics that transcend traditional disciplinary boundaries.  Reviews must be cutting edge and comprehensive in the way they advance science, practice or policy relating to adolescents.
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