Barriers to managing child and adolescent mental health problems: a systematic review of primary care practitioners’ perceptions

摘要

Background: Mental health problems are common and typically have an early onset. Effective treatments for mental health problems in childhood and adolescence are available yet only a minority of affected children access them. This is of serious concern, considering the far-reaching and long-term negative consequences of such problems. Primary care is usually the first port of call for concerned parents so it is important to understand how primary care practitioners (PCPs) manage childhood mental health problems and the barriers they face. udAim: To ascertain PCP’s perceptions of barriers preventing effective management of childhood mental health problemsudDesign: A systematic review of qualitative and quantitative literature udMethod: A database search of peer-reviewed articles using PsycInfo, MEDLINE, EMBASE and Web of Science, until October 2014, was conducted. Additional studies were identified through hand-searching and forward-citation searches. Studies needed to have at least one search term in four categories: (i) primary care, (ii) childhood/adolescence, (iii) mental health and (iv) barriers.udResults: A total of 4151 articles were found, of which 43 were included (30 quantitative and 13 qualitative). The majority of the barriers related to identification, management and/or referral. Considerable barriers included a lack of providers and resources, extensive waiting lists and financial restrictions.udConclusion: The identification of a broad range of significant barriers highlights the need to strengthen the ability to deal with these common difficulties in primary care. There is a particular need for tools and training to aid accurate identification and management, and for more efficient access to specialist services.