Issn Print: 0196-206X
Publication Date: 2001/08/01
Identification and management of psychosocial problems by preventive child health care
Excerpt
Brugman E, Reijneveld SA, Verhulst FC, Verloove-Vanhorick SP: Identification and management of psychosocial problems by preventive child health care. Arch Pediatr Adolesc Med 155:462, 2001.BrugmanEReijneveldSAVerhulstFCVerloove-VanhorickSPIdentification and management of psychosocial problems by preventive child health care.Arch Pediatr Adolesc Med1554622001
Psychosocial problems, including behavioral, emotional, and educational issues are highly prevalent among children and can significantly interfere with their functioning. In the Netherlands, publicly funded, preventive health care is provided unasked to all children by community physicians and nurses (child health care professionals, CHPs). The purposes of this study were to (1) assess the degree to which CHPs identify and manage psychosocial problems among 4480 children, ages 5 to 15 years, and to (2) assess the child-related factors associated with identification of psychosocial problems and referral to mental health services by the CHPs. The study used standardized interviews of parents and children and parent-completed Child Behavior Checklists (CBCL) as part of routine preventive health assessments. CHPs identified one or more psychosocial problems in 25% of children. The severity of psychosocial problems was rated as mild in 52% of these cases, moderate in 37% of cases, and severe in 11%. At the time of the study, 2% of all children were being treated by a mental health professional, 2% by another medical professional, and 1% by other professionals. The CHPs undertook management strategies in 85% of the nontreated children with identified problems, including advice and reassurance (62%), consultations with schools, colleagues, or official authorities (45%), referral to another professional (21%), and follow-up (19%). The identification of psychosocial problems and subsequent referral were six times more likely in children with serious parent-reported problem behaviors according to the CBCL total problem score. The CHPs identified no psychosocial problems in 43% of children with a CBCL total problem score in the clinical range. They also identified a psychosocial problem in 21% of the children with normal CBCLs. The authors conclude that child health professionals providing preventive services to children and adolescents can identify psychosocial problems frequently and undertake actions for most of them. They further suggest that screening for psychosocial problems may be a promising option toward reducing these problems, but that accurate identification must be enhanced.
Facebook
Twitter
LinkedIn
Email
