Enrolment of children in psychosocial care: problems upon entry, care received, and outcomes achieved

Abstract

Psychosocial care systems have been designed so that specific problems are treated by specific care types. There is insufficient evidence as to which problem types are actually presented to the various care types. This study assessed types and severity of problems among children and adolescents upon enrolment in psychosocial care, compared to children not enrolled; also outcomes after 3 and 12 months, overall and per care type. We obtained data on a cohort of 1382 Dutch children aged 4–18 years (response rate 56.6%), included upon enrolment in psychosocial care, and on 443 not-enrolled children (response rate 70.3%), all from one region. Results showed that enrolled children had more problems than children not enrolled in care. In child and adolescent mental healthcare (CAMH), relatively many children had internalizing problems, and in child and adolescent social care (CASC) relatively many children had externalizing, parenting, family and multiple problems. Regardless of the type of problem, care duration in preventive child healthcare (PCH) was relatively short; and in CASC and CAMH longer. After 3 and 12 months, rates of problem solution were highest in PCH. These rates were also substantial among children not in care. To conclude, our findings show that the system of psychosocial care functions as intended regarding the distribution of problems across care types. Extended demarcation of clients by problem type and severity towards type and contents of care may further improve the system.

Trajectories of care for children and adolescents with psychosocial problems: a 3‐year prospective cohort study

“…Overall, our findings suggest a properly functioning triage in the care system: first children and adolescents with longer trajectories experienced a lower rate of problem reduction and second after short treatment, problem reduction continued at follow‐up. These findings correspond with earlier research by Nanninga, Jansen, Knorth, and Reijneveld (), who found that the system of psychosocial care functions as intended regarding the distribution of type and severity of problems across care types (Nanninga et al., ). Overall, increased provision of care does thus not automatically lead to reduction of problems, and although overall psychosocial problems are reduced, a substantial subgroup has longer lasting problems.…”

The role of functional health literacy in long-term treatment outcomes in psychosocial care for adolescents

“…Psychosocial problems were assessed with the Dutch self-report and parent-report versions of the Strengths and Difficulties Questionnaire (SDQ) [ 25 – 28 ]. The SDQ consists of 25 items, measuring internalizing [Cronbach’s α parents = 0.78 (T1, T2, T3), adolescents = 0.75 (T1), 0.76 (T2), and 0.73 (T3)] and externalizing problems [Cronbach’s α parents = 0.83 (T1, T2, T3), adolescents = 0.74 (T1), 0.76 (T2), and 0.73 (T3)] [ 29 ]. The total difficulties score (TDS) ranges from 0 to 40, with higher scores indicating more problems.…”

When fear does not serve survival: anxiety disorders viewed within a developmentally appropriate context

“…Regardless of whether the barriers belong more to an institutional or individual/cultural type, they may prevent youth from getting diagnosed and treated in a timely and proper manner. This can happen even if services are organized and functioning as intended according to type and severity of problems [5].…”