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Trajectory of mental health and service use Among Brazilian and British children/adolescents: a follow-up study

Grant number: 18/12747-7
Support type:Scholarships abroad - Research
Effective date (Start): August 10, 2018
Effective date (End): February 01, 2019
Field of knowledge:Humanities - Psychology
Principal Investigator:Cristiane Silvestre de Paula
Grantee:Cristiane Silvestre de Paula
Host: Sara Evans-Lacko
Home Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Presbiteriana Mackenzie (UPM). Instituto Presbiteriano Mackenzie. São Paulo , SP, Brazil
Local de pesquisa : University of London, England  

Abstract

INTRODUCTION:Mental health problems are usually chronic with early onset, and among 25% to 75% of the adulthood psychiatric disorders could be prevented and/or minimized if appropriately treated during childhood/adolescence. At the same time, early interventions have been shown to be more effective to treat mental health problems than delayed interventions, as well as contributing to the promotion of academic performance, improving social relationships with colleagues and family members, and as preventing substance abuse, among other damaging things that can have determining consequences in the course of people's lives. In addition, children and adolescents with mental health problems who are not adequately assisted miss the opportunity to develop their full potential at a crucial stage of their development.However, most children/adolescents with mental health problems around the world do not receive adequate treatment that includes prevention, promotion, and rehabilitation. It is a new area, so there is still no consensus on the exact rate of children and adolescents who are unable to access the formal health/education system, neither on the profile and quality of care received.Even in countries with well-structured public health systems with universal and free of charge care for all citizens, such as Brazil and the United Kingdom, a significant proportion of children/adolescents with mental health problems not receive treatment. Therefore, studies that help to understand the factors involved in this process are important since they can contribute to the improvement of public policies that lead to greater inclusion. The objectives of this proposal are: (1) to describe and compare the profile of the formal service use (health, education, justice and social assistance) and informal services use between of Brazilian and British children and adolescents, and (2) to identify barriers and facilitators in help-seeking and service use for mental health problems in childhood/adolescence, verifying if these barriers/facilitators are related to personal, familial and social characteristics of the subjects, comparing the Brazilian with the British sample.METHODStudy design: Multicenter Cohort Study. Local: São Paulo - SP, Porto Alegre - RS and London metropolitan area, United Kingdom. A random sample of children/adolescents recruited from schools, which were evaluated in two moments. In the first phase of the study, 2,500 Brazilian children and adolescents and 407 British children/adolescents participated. Between 18 and 24 months later, 1,413 children/adolescents from Brazil and 407 children/adolescents from British were reassessed.Instruments/measures: The Strength and Difficulties Questionnaire (SDQ) was used to assess mental health problems.The Service Assessment for Children and Adolescents (SACA) questionnaire was used to measure services use, type of treatment and barriers/facilitators of care.To collect personal, familial and social information of the sample, a Questionnaire for family demographic characterization was elaborated for our team, and the ABEP Questionnaire on family socioeconomic condition was also used.EXPECTED RESULTS:We will establish the frequency of service use for child/adolescent mental health problems, detailing the profile of care, by type of service and type of professional, in Brazil and in the United Kingdom.Through multifactorial analyzes, we will identify barriers and facilitators of treatment access for mental health problems among Brazilian and British children and adolescents.