Somatic and mental health service use of children and adolescents in Germany (KiGGS-study)

Abstract

Only a limited number of national surveys have investigated both somatic and mental health service use in children and adolescents. The current study aimed to assess service use in Germany as based on at least a single contact with a somatic (pediatrician, general practitioner, nonmedical practitioner) and/or mental health (psychiatrist, psychologist, youth welfare) care specialist within the last 12 months. Questionnaire responses of 6,475 children and adolescents aged 11.0-17.9 years and their parents were analyzed based on data ascertained by the German Child and Adolescent Health Survey (KiGGS) conducted between 2003 and 2006. For assessment of mental symptom loading the Strengths and Difficulties Questionnaire (SDQ) was completed by parents, thus allowing the determination of the relationship between symptom loading and service use. ANOVA and logistic regression were performed to determine help-seeking behavior overall and of different health professional groups upon inclusion of the SDQ Total Difficulties score, gender, age and socio-economic status (SES). A total of 81.9 % of all children and adolescents had used any kind of service within the past 12 months. Seventy-seven percent and 0.8 % used only the somatic and mental health services, respectively; 4.1 % had frequented both services. Amongst youths with a 'borderline' and 'abnormal' Total Difficulties score, 11.8 and 18.6 %, respectively, sought help from mental health partners. Age, SES and Total Difficulties score were predictors of any service use; the logistic regression model explained 7.6 % of the variance. Use of mental health service was significantly predicted by only age and Total Difficulties score, the respective model explained 26.2 % of the variance. The comparison of health services use on an international level is rendered difficult by national differences in health-care provision. Nevertheless, several of our findings are similar to results obtained in other nationally representative surveys.

Child and adolescent psychiatry: which knowledge and skills do primary care physicians need to have? A survey in general practitioners and paediatricians

“…The same may hold true for anorexia nervosa. Although this is a relatively rare condition, GPs are often the first point of contact for the concerned families [66,67], not at least because of the accompanying somatic morbidity. Interestingly, recently emerging mental health topics such as problematic use of new media and non-suicidal selfinjury, that are very present in the current public media, were not among the top 5 knowledge items.…”

“…We tried to reduce this influence using an anonymous approach. Furthermore, the results of our study are influenced by both national [41,66] and local health system peculiarities (e.g. the number of local CAP specialists available, influencing the quantity and the types of disorders seen by PCPs).…”

“…In the majority of health systems, general practitioners (GPs), family physicians and paediatricians are the first to be contacted by families with children or adolescents suffering from somatic as well as mental health problems [51,66,67]. For Germany, recent data show that 92 % of all children and adolescents visit outpatient medical services at least once a year, with 68 % consulting a paediatrician and 34 % consulting a GP [40].…”

Aktueller Stand und zukünftige Entwicklung der prä- und postnatalen Vorsorge- bzw. Screeninguntersuchungen – Evidenz tut Not

“…80 % aller 11-17-jährigen Kinder und Jugendlichen einen Kinderarzt/Allgemeinmediziner bzw. einen Psychologen/Kinder-und Jugendpsychiater und Psychotherapeuten auf, die kinder-und jugendpsychiatrische/-psychologische Inanspruchnahme beträgt 5 % [59].…”

Challenges in children’s enrolment to psychosocial services

“…Numerous studies mainly from Western societies have shown that only a minority of children with mental health problems receive psychosocial care [1][2][3]. In a Finnish time trend study including three cross-sectional cohorts of 8-year-old children born in 1981, 1991 and 1997, it was shown that while only 10 % of children with a high level of psychiatric problems among those born in 1981 had contact with services, the respective figures for those born in 1991 and 1997 were 23 and 27 % [3].…”