Contextual determinants associated with children’s and adolescents’ mental health care utilization: a systematic review

Abstract

Determinants at the contextual level are important for children’s and adolescents’ mental health care utilization, as this is the level where policy makers and care providers can intervene to improve access to and provision of care. The objective of this review was to summarize the evidence on contextual determinants associated with mental health care utilization in children and adolescents. A systematic literature search in five electronic databases was conducted in August 2021 and retrieved 6439 unique records. Based on eight inclusion criteria, 74 studies were included. Most studies were rated as high quality (79.7%) and adjusted for mental health problems (66.2%). The determinants that were identified were categorized into four levels: organizational, community, public policy or macro-environmental. There was evidence of a positive association between mental health care utilization and having access to a school-based health center, region of residence, living in an urban area, living in an area with high accessibility of mental health care, living in an area with high socio-economic status, having a mental health parity law, a mental health screening program, fee-for-service plan (compared to managed care plan), extension of health insurance coverage and collaboration between organizations providing care. For the other 35 determinants, only limited evidence was available. To conclude, this systematic review identifies ten contextual determinants of children’s and adolescents’ mental health care utilization, which can be influenced by policymakers and care providers. Implications and future directions for research are discussedPROSPERO ID: CRD42021276033.

The Provision of Psychosocial Support to Students in Jordan: Teachers' Knowledge, Attitudes, Skills, Practices, and Perceived Barriers

“…For example, the provision of psychosocial support in schools is influenced by students themselves, teachers, society, parents, and the whole environment. This model was applied to identify the factors that influence the implementation of a structured education program for diabetes 18 and the contextual determinants associated with children's and adolescents' mental health care utilization 6 . Another explanation of the practices' gaps in communication, is that teachers reported low perceived skills in networking with community sources and parents, in the current study.…”

“…5 In addition, several contextual factors could influence the utilization of mental health services among children and adolescents, including their socioeconomic status, the availability of screening programs, stigma, and others. 6,7 One national study in Jordan found that the primary barriers to seeking help among Syrian Refugees and Jordanians include feelings of helplessness, lack of financial means, unawareness and poor recognition of mental health problems, cost of treatment, the need for privacy, and stigma. 5 Thus, implementing interventions in other settings such as school-based interventions is considered a more accessible, acceptable, and sustainable option to reach a larger population of students.…”

“…While it is important to address the high prevalence of mental disorders in children and adolescents and to implement mental health interventions within the formal health system, it is also critical to recognize that not all children and adolescents receive the specialized care they need 5 . In addition, several contextual factors could influence the utilization of mental health services among children and adolescents, including their socioeconomic status, the availability of screening programs, stigma, and others 6,7 . One national study in Jordan found that the primary barriers to seeking help among Syrian Refugees and Jordanians include feelings of helplessness, lack of financial means, unawareness and poor recognition of mental health problems, cost of treatment, the need for privacy, and stigma 5 .…”

Psychology Professionals in Educational Contexts: An Unavoidable Necessity

“…Se considera esencial rescatar una visión radicalmente psicológica de los problemas de salud mental, situando las "raíces" de la conducta en el contexto intersubjetivo, interpersonal y socio-cultural. Resultaría obvio defender que los determinantes sociales (y del entorno escolar, por tanto) tienen un impacto en la salud mental de las personas y en el uso de los servicios socio-sanitarios (Verhoog et al, 2022). Asimismo, la conducta humana obedece más a razones que a causas, y esas razones se tienen que comprender en el contexto biográfico de la persona.…”