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. 2018 Oct;53(10):1005-1038.
doi: 10.1007/s00127-018-1578-y. Epub 2018 Aug 22.

Pathways to mental health services for young people: a systematic review

Kathleen MacDonald  1   2 , Nina Fainman-Adelman  1   2 , Kelly K Anderson  3   4 , Srividya N Iyer  5   6
Affiliations

Pathways to mental health services for young people: a systematic review

Kathleen MacDonald et al. Soc Psychiatry Psychiatr Epidemiol. 2018 Oct.

Abstract

Purpose: While early access to appropriate care can minimise the sequelae of mental illnesses, little is known about how youths come to access mental healthcare. We therefore conducted a systematic review to synthesise literature on the pathways to care of youths across a range of mental health problems.

Methods: Studies were identified through searches of electronic databases (MEDLINE, PsycINFO, Embase, HealthSTAR and CINAHL), supplemented by backward and forward mapping and hand searching. We included studies on the pathways to mental healthcare of individuals aged 11-30 years. Two reviewers independently screened articles and extracted data.

Results: Forty-five studies from 26 countries met eligibility criteria. The majority of these studies were from settings that offered services for the early stages of psychosis, and others included inpatient and outpatient settings targeting wide-ranging mental health problems. Generally, youths' pathways to mental healthcare were complex, involved diverse contacts, and, sometimes, undue treatment delays. Across contexts, family/carers, general practitioners and emergency rooms featured prominently in care pathways. There was little standardization in the measurement of pathways.

Conclusions: Except in psychosis, youths' pathways to mental healthcare remain understudied. Pathways to care research may need to be reconceptualised to account for the often transient and overlapping nature of youth mental health presentations, and the possibility that what constitutes optimal care may vary. Despite these complexities, additional research, using standardized methodology, can yield a greater understanding of the help-seeking behaviours of youths and those acting on their behalf; service responses to help-seeking; and the determinants of pathways. This understanding is critical to inform ongoing initatives to transform youth mental healthcare.

Keywords: Help-seeking behaviour; Mental health services; Pathways to care; Treatment delays; Youth mental health.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow chart of included studies
See this image and copyright information in PMC

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References

    1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62:593–602. doi: 10.1001/archpsyc.62.6.593. - DOI - PubMed
    1. Erskine H, Moffitt TE, Copeland W, Costello E, Ferrari A, Patton G, Degenhardt L, Vos T, Whiteford H, Scott J. A heavy burden on young minds: the global burden of mental and substance use disorders in children and youth. Psychol Med. 2015;45(7):1551–1563. doi: 10.1017/S0033291714002888. - DOI - PMC - PubMed
    1. Farmer EMZ, Burns BJ, Phillips SD, Angold A, Costello EJ. Pathways into and through mental health services for children and adolescents. Psychiatr Serv. 2003;54:60–66. doi: 10.1176/appi.ps.54.1.60. - DOI - PubMed
    1. Arnett JJ. Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–480. doi: 10.1037/0003-066X.55.5.469. - DOI - PubMed
    1. McGorry P. Transition to adulthood: the critical period for pre-emptive, disease-modifying care for schizophrenia and related disorders. Schizophr Bull. 2011;37(3):524–530. doi: 10.1093/schbul/sbr027. - DOI - PMC - PubMed

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