Strengthening CAMHS and reducing child and adolescent mental health inequalities in Europe

Khanal, Kamal Prasad; Anagnostopoulou, Nefeli; Aleksić, Branko; Anagnostopoulos, Dimitrios; Skokauskas, Norbert

doi:10.1007/s00787-021-01788-5

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…Reports show that adolescents in some regions, such as the Nordic countries and the Netherlands, show better levels of mental wellbeing than those in the UK [82,83], for example. There is acknowledged inequality in service provision and accessibility in the UK, and in general thresholds have gone up so that young people are waiting months to years for initial assessment for a mental health concern (by which point problems have become severe) [84], and this will apply to other regions. It is likely, therefore, that some young people presenting for GD intervention have already experienced years of untreated psychological distress which may or may not have preceded their GD.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

A PRISMA systematic review of adolescent gender dysphoria literature: 2) mental health

Thompson

Sarovic

Wilson

et al. 2022

PLOS Glob Public Health

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It is unclear whether the literature on adolescent gender dysphoria (GD) provides sufficient evidence to inform clinical decision making adequately. In the second of a series of three papers, we sought to review published evidence systematically regarding the extent and nature of mental health problems recorded in adolescents presenting for clinical intervention for GD. Having searched PROSPERO and the Cochrane library for existing systematic reviews (and finding none), we searched Ovid Medline 1946 –October week 4 2020, Embase 1947–present (updated daily), CINAHL 1983–2020, and PsycInfo 1914–2020. The final search was carried out on the 2nd November 2020 using a core strategy including search terms for ‘adolescence’ and ‘gender dysphoria’ which was adapted according to the structure of each database. Papers were excluded if they did not clearly report on clinically-likely gender dysphoria, if they were focused on adult populations, if they did not include original data (epidemiological, clinical, or survey) on adolescents (aged at least 12 and under 18 years), or if they were not peer-reviewed journal publications. From 6202 potentially relevant articles (post deduplication), 32 papers from 11 countries representing between 3000 and 4000 participants were included in our final sample. Most studies were observational cohort studies, usually using retrospective record review (21). A few compared cohorts to normative or population datasets; most (27) were published in the past 5 years. There was significant overlap of study samples (accounted for in our quantitative synthesis). All papers were rated by two reviewers using the Crowe Critical Appraisal Tool v1·4 (CCAT). The CCAT quality ratings ranged from 45% to 96%, with a mean of 81%. More than a third of the included studies emerged from two treatment centres: there was considerable sample overlap and it is unclear how representative these are of the adolescent GD community more broadly. Adolescents presenting for GD intervention experience a high rate of mental health problems, but study findings were diverse. Researchers and clinicians need to work together to improve the quality of assessment and research, not least in making studies more inclusive and ensuring long-term follow-up regardless of treatment uptake. Whole population studies using administrative datasets reporting on GD / gender non-conformity may be necessary, along with inter-disciplinary research evaluating the lived experience of adolescents with GD.

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Section: Plos Global Public Healthmentioning

confidence: 99%

A PRISMA systematic review of adolescent gender dysphoria literature: 2) mental health

Thompson

Sarovic

Wilson

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

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

Carbonell,

Georgieva,

Navarro-Pérez

et al. 2023

Adolescent Res Rev

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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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Strengthening CAMHS and reducing child and adolescent mental health inequalities in Europe

Cited by 2 publications

References 15 publications

A PRISMA systematic review of adolescent gender dysphoria literature: 2) mental health

A PRISMA systematic review of adolescent gender dysphoria literature: 2) mental health

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

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