Factors associated with the identification of child mental health problems in primary care-a systematic review

Eur J Gen Pract. 2019 Jul;25(3):116-127. doi: 10.1080/13814788.2019.1623199. Epub 2019 Jun 27.

Abstract

Background: Although common and often with long-lasting effects, child mental health problems (MHPs) are still under-recognized and under-treated. A better understanding of the factors associated with the identification of MHPs in primary care may improve the recognition of MHPs. Objectives: To review studies on factors associated with the identification of child MHPs in primary care. Methods: Six leading databases were systematically searched until 1 October 2018. Two independent researchers selected articles and extracted data on study characteristics and factors associated with MHP identification. Inclusion criteria were the investigation of factors associated with MHP identification by primary care professionals (PCPs) in children aged 0-18 years. Results: Of the 6215 articles identified, 26 were included. Prevalence rates of PCP-identified MHPs varied between 7 and 30%. PCPs identified 26-60% of children with an increased risk of MHPs as indicated by MHP assessment tools, but associated factors were investigated in relatively few studies. MHPs were more often identified in children with a family composition other than married parents, with worse mental health symptoms, prior MHPs, among boys in elementary school, when contact with PCPs was related to parental psychosocial concerns or routine health check-ups, when PCPs were recently trained in MHPs or when PCPs felt less burdened treating MHPs. Conclusion: MHP identification varied substantially between studies and PCPs and was related to several child, family and practice factors. Future studies should systematically investigate factors associated with MHP identification by PCPs and specifically in children with an increased risk of MHPs according to mental health assessment tools.

Keywords: Children; mental health; primary care.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Health Personnel / organization & administration*
  • Humans
  • Infant
  • Neurodevelopmental Disorders / diagnosis*
  • Neurodevelopmental Disorders / epidemiology
  • Primary Health Care / methods*
  • Risk Assessment / methods
  • Risk Factors

Grants and funding

This work was supported by the Organization for Health Research and Development (ZonMW), the Netherlands, under grant [839110012]. ZonMw had no role in the study design, the collection, analysis, and interpretation of data, the writing of the report or the decision to submit a paper for publication.