Thesis (M.A.)--University of Toronto, 2004. / Adviser: Jennifer Jenkins.

Proefschrift--Utrecht. / Vita. Includes bibliographical references.

Proefschrift--Utrecht. / Vita. Includes bibliographical references.

Approximately 40% of youth experience psychological problems; however, less than half receive necessary services. Several help-seeking models suggest that for children to receive psychological care parents must: recognize a problem, decide to seek help, and select a service. The parent problem recognition stage has been largely overlooked in the literature and few studies have examined all stages of the process together. The current study aimed to fill gaps in the literature regarding parent problem recognition and explore the help-seeking process for child externalizing problems, anxiety, depression, and sleep difficulties. Data was collected an Amazon’s Mechanical Turk. Participants were 219 parents of children ages 7 to 12 who provided information about help-seeking and child mental health symptoms. Rates of accurate parent problem recognition ranged from 37.6% (sleep) to 66.0% (externalizing concerns). Rates of help-seeking in the current study were low ranging from 42.6% (sleep) to 72.7% (depression) even when parents identified a problem for their child. The severity of the child’s problem and parent past experience with mental health predicted problem identification and help-seeking across most presenting concerns. Specialty mental health services were underutilized across problem areas with over 70% of parents indicating that they had or would seek help from their pediatrician and less than half indicating that they had or would seek help from a therapist or psychologist. Results support previous findings that child psychological problems are under-recognized and under-treated. Future research and clinical work is needed to close the gap between the need for services and service use.

This thesis is a descriptive study of five child day treatment centers in Oregon. Its purpose was to generate hypotheses about the relationships between parent reactions to the day treatment center, the center’s theoretical orientation toward treatment, and the organizational structure of the center. The five centers involved in the study were: Poyama land in Independence, Oregon; the Child Psychiatric Day Center in Portland, Oregon; Mid-Columbia Children’s Center in the The Dalles, Oregon; the Child center in Eugene; and Edgefield Lodge in Troutdale, Oregon. These centers were selected for this study because of their proximity to the Portland area and their requirement that parents be involved in their child’s treatment program. Data were collected by a parent questionnaire, a staff questionnaire, and an interview with the executive director of each program. All three data collection instruments were designed specifically for use in this study.

This research comprises three linked projects stemming from the first project which aimed to define “long-term” pupil absence from school and discover the principal reasons for such absence. The second project focussed on the area of Child and Adolescent Mental Health Services (CAMHS), an issue emerging from the first project. The CAMHS 4-Tier Strategic Framework (or “CAMHS Concept”), including links between CAMHS providers were examined and referral pathways investigated and measured against published criteria. The third project explored the new CAMHS Strategic Framework and considered whether implementation problems were to blame for its lack of transformational impact.

This thesis aimed to examine service contact among children and young people with mental health problems, and has three complementary parts. The first is a secondary analysis of data from the British Child and Adolescent Mental Health Survey (BCAMHS) 2004, which explored mental health related service contact in relation to psychopathology over three years. The second and third parts focussed on young people with ADHD in transition from child services, which is a particularly challenging time. This involved a qualitative interview study of young peoples’ experiences, and an analysis of primary care prescribing of ADHD medication over the transition period using a cohort from the Clinical Practice Research Datalink from 2005-2013. Less than a third of children with a psychiatric disorder in BCAMHS reported contact with child mental health services. Instead, teachers were the most frequently used service, with two-thirds reporting mental health related contact. Interviews with young people with ADHD highlighted themes including concerns around medication management post transition and need for information. The prescribing analysis found that the majority of adolescents on ADHD medication at age 16 stopped during the transition period. This continuing disparity between estimates of symptom persistence and medication persistence suggests that many may be stopping medication from which they could still benefit; as various barriers have been identified to ongoing prescribing. In summary, the findings of these three linked studies suggest common themes in terms of unmet needs and gaps between policy and practice in mental health services for children and young people. One of the chief implications is the need for oversight and policy levers to ensure the implementation of best practice, accompanied by complementary efforts to better understand and overcome other barriers to providing optimal care, including research into knowledge and attitudes of different groups and the provision of targeted training.

A research project submitted to the Faculty of Arts, University of Witwatersrand, Johannesburg in partial fulfillment of the requirements for the Degree Masters of Arts in Community-based Counselling Psychology by Coursework and Research Report / This research project aimed to explore how parents understand the causes, symptoms, existing sources of support and treatment options for adolescent mental health needs, as well as how these factors are impacted upon by broader social norms and cultural beliefs systems. Six parents of adolescent children were interviewed, using a semi-structured interview format. A thematic content analysis was used to analyse the data. Four themes emerged relating to: 1) parental causal attributions 2) symptom identification, 3) treatment seeking and sources of support, and 4) socio-cultural beliefs and stigma. The findings obtained indicated that parental perceptions of adolescent mental health were framed by social norms and cultural belief systems. The stigmatisation of adolescent mental health significantly impacted on the ways in which parents managed adolescent mental health difficulties. As a result of the stigmatised beliefs, parents placed emphasis on avoiding any behaviour which could potentially expose their adolescent children’s emotional difficulties. In this regard, parents adopted an unrealistic optimism regarding their adolescent children’s susceptibility to mental health difficulties. The causes of adolescent mental health difficulties were attributed to controllable factors, which were external to the adolescent. Parents also significantly reduced the symptom severity and in most cases attributed concerning adolescent emotional behaviours to normal adolescent development. Parents seemed to have limited knowledge and awareness of adolescent mental health difficulties, which inadvertently facilitated a lack of support seeking behaviours and treatment utilisation by parents. / MT 2018

MMed, Psychiatry, Faculty of Health Sciences, University of the Witwatersrand / Introduction: National and international child and adolescent mental healthcare policy and action advocate that the health and well-being of children in South Africa should be increasingly given greater attention. Child and adolescent services have recently been established at Rahima Moosa Hospital. The purpose of this study was to describe the scope, capacity and diagnostic profile of existing child and adolescent mental health and psychiatric services at Rahima Moosa Hospital within the context of the available infrastructure and service rendering and to describe the demographic and clinical profile of the users. Method: A descriptive, retrospective clinical audit study of the data from users‟ clinical files was performed. The study population comprised all users treated at the Rahima Moosa Hospital over a one-year period from January to December 2007. Descriptive statistical analyses of demographic and socio-economic variables were made and these variables were compared with the presenting clinical problems. P-values of less than 0.05 were regarded as significant. Odds ratios were also calculated for variables that showed a statistically significant association. Results: During this period a total of 303 users attended this clinic. Their age, gender, race and catchment area was reviewed. Socio-economic variables that were described included caregiver of user, placement, parents‟ well being and marital status, educational level of caregiver and household income. Most common disorders were Attention Deficit Hyperactivity Disorder (ADHD), Mood, Anxiety, Elimination, Attachment, Disruptive behaviour disorders and V-code diagnoses. Although not regarded as psychiatric diagnoses, V-codes are problems that are the focus of clinical attention. These include 5 sexual abuse, academic problems and parent-child relationship difficulties. Statistical comparisons between demographic data and disorders revealed that being male increased the likelihood of presenting with AHDH and disruptive behaviour disorders; being female increased the likelihood of being sexually abused. Race showed a significant association with parent-child relationship difficulties. Regarding socio-economic variables, the identity of the caregiver of the child influenced the risk of disruptive behaviour disorders, sexual abuse, neglect and academic problems. Placement was a risk factor for disruptive behaviour disorders, sexual abuse, neglect and academic problems. Whether the mother of a user was alive or deceased was related to ADHD and disruptive behaviour and whether the father of a user was alive or deceased was related to sexual abuse and academic problems. The education level of the caregiver showed a significant association with sexual abuse, neglect and academic problems; the marital status of the parents showed a significant association with bereavement. Household income was associated with sexual abuse, neglect and academic problems. Type of housing showed an association with the risk of sexual abuse. Discussion: This study clearly demonstrates the huge impact that socio-economic circumstances have on the prevalence of childhood disorders; hence the urgent need for government and social welfare departments to improve on the socio-economic status of communities. Job creation and employment will lead to better outcomes and help lower the incidences of childhood illnesses. The focus should be on preventative measures, that is, improving the social well-being of both children and their parents, which will result in lower prevalence of disease. Moreover, interventions in schools and children‟s homes should be 6 implemented. The provision of psycho-education for the group in the catchment with regard to identification of mental health problems can contribute to the early detection of mental illness and early intervention leading to a reduction in disease. Conclusion: In spite of government‟s initiative to prioritise child and adolescent mental health services in South Africa, further endeavours are required to improve psychiatric services among this section of the population, including more clinics and child psychiatry training posts and extended social work services. Socio-economic factors influence the prevalence of childhood disorders. Hence, modifying the environment to which these children are exposed is an integral part of the holistic treatment approach

Thesis PlanB (M.S.)--University of Wisconsin--Stout, 2009. / Includes bibliographical references.