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Übersicht

Inanspruchnahme von Hilfe und Versorgung bei psychischen Auffälligkeiten im Kindergartenalter

Ein systematisches Review zu Barrieren und Prädiktoren

Published Online:November 29, 2018https://doi.org/10.1026/0942-5403/a000269

Abstract

Zusammenfassung. Trotz Gefahr der Chronifizierung ist die Inanspruchnahme professioneller Unterstützung beim Vorliegen von psychischen Auffälligkeiten im Kindergartenalter gering. In der vorliegenden Übersichtsarbeit wird die Studienlage zu subjektiven Barrieren aus Elternperspektive sowie zu Prädiktoren der Inanspruchnahme von Unterstützungsmaßnahmen zusammengefasst. Neben äußeren Hindernissen benennen Eltern mangelnde Kenntnisse über das Hilfesystem sowie negative Überzeugungen gegenüber Inanspruchnahme als Barrieren. Als elternbezogene Prädiktoren der Inanspruchnahme zeigen sich v. a. positive Einstellungen bzw. Vorbehalte gegenüber Inanspruchnahme sowie eigenes elterliches Inanspruchnahmeverhalten bei psychischen Schwierigkeiten. Ein höheres Alter der Kinder, die Schwere der Psychopathologie sowie Entwicklungsverzögerungen sind kindbezogene Prädiktoren. Als Hauptprädiktor stellt sich die elterliche Problemerkennung und Sorge heraus. Die Rolle der Fachkräfte in der Kindertagesbetreuung sollte in zukünftigen Studien systematischer berücksichtigt werden.


Use of Mental Health Services in Preschool Age: A Systematic Review of Barriers and Predictors

Abstract. Untreated psychopathology in early childhood tends to become chronic. Despite relevant rates of psychopathology in preschool children, the rates of mental health service use for this age group are even lower than for older children. Estimates indicate that less than 20 % of preschool children with psychopathological problems receive professional help. The present article aims to extend and refine previous findings by reviewing 14 empirical studies on predictors and barriers of preschool children’s mental health service use and the role of early education and care professionals in daycare centers. The review was carried out based on PRISMA guidelines. Results show that parents name systematic barriers, a lack of knowledge about mental health service facilities, and negative views and attitudes toward services and treatment as the main hindrances for service use. The examined studies exhibit a heterogeneity of goals, methods, theoretical models, and results. Therefore, predictors were arranged in three categories: first, predictors of attitudes toward possible service use; second, predictors of parents’ appraisal of their children’s behavior, followed by problem recognition; and third, predictors of actual service use. Predictors can be differentiated in child-related, parent-related, and environmental factors. The attitude toward service use seems to be influenced both by anticipated results of treatment and by subjective norms, that is, the suspected opinions in the social environment. Predictors for actual mental health service use are problem recognition and parental worries, older age of children, greater psychopathology, developmental delays, and presence of a diagnosis. Further predictors of service use for children are parental psychopathology and parental mental health service use as well as family conflicts. Although professionals in daycare centers seem to play a crucial but ambivalent role in the process of service use, only few studies include them. Based on the findings, an empirical model of mental health service use in preschool age is deducted. Further studies that focus on the age group of preschool children are required to enhance the understanding of the complex process of mental health service use in early childhood. Thereby future studies should choose a multimodal approach including different sources of information, especially professionals in daycare centers. In practice, barriers to service use, whether structural barriers or perceived barriers, should be minimized to improve access to treatment for children in need.

Literatur

  • Alexander, K. E., Brijnath, B. & Mazza, D. (2013). „Can they really identify mental health problems at the age of three?“ Parent and practitioner views about screening young children’s social and emotional development. The Australian and New Zealand Journal of Psychiatry, 47, 538 – 545. First citation in articleCrossref, Google Scholar

  • Ali, M. M., Teich, J., Lynch, S. & Mutter, R. (2018). Utilization of Mental Health Services by Preschool-Aged Children with Private Insurance Coverage. Administration And Policy In Mental Health, 45, 731 – 740. First citation in articleCrossref, Google Scholar

  • Anders, Y. (2013). Stichwort: Auswirkungen frühkindlicher institutioneller Betreuung und Bildung. Zeitschrift für Erziehungswissenschaft, 16, 237 – 275. First citation in articleCrossref, Google Scholar

  • Belfer, M. L. (2008). Child and adolescent mental disorders: the magnitude of the problem across the globe. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 49, 226 – 236. First citation in articleCrossref, Google Scholar

  • Dougherty, L. R., Smith, V. C., Bufferd, S. J., Kessel, E., Carlson, G. A. & Klein, D. N. (2015). Preschool irritability predicts child psychopathology, functional impairment, and service use at age nine. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 56, 999 – 1007. First citation in articleCrossref, Google Scholar

  • Egger, H. L. & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 47, 313 – 337. First citation in articleCrossref, Google Scholar

  • Ellingson, K. D., Briggs-Gowan, M. J., Carter, A. S. & Horwitz, S. M. (2004). Parent identification of early emerging child behavior problems: Predictors of sharing parental concern with health providers. Archives of Pediatrics & Adolescent Medicine, 158, 766 – 772. First citation in articleCrossref, Google Scholar

  • Girio-Herrera, E., Owens, J. S. & Langberg, J. M. (2013). Perceived barriers to help-seeking among parents of at-risk Kindergarteners in rural Communities. Journal of Clinical Child and Adolescent Psychology, 42, 68 – 77. First citation in articleCrossref, Google Scholar

  • Godoy, L. & Carter, A. S. (2013). Identifying and addressing Mental Health Risks and Problems in Primary Care Pediatric Settings: A Model to promote developmental and cultural competence. The American Journal of Orthopsychiatry, 83, 73 – 88. First citation in articleCrossref, Google Scholar

  • Godoy, L., Carter, A. S., Silver, R. B., Dickstein, S. & Seifer, R. (2014). Mental health screening and consultation in primary care: The role of child age and parental concerns [corrected]. Journal of Developmental and Behavioral Pediatrics, 35, 334 – 343. First citation in articleCrossref, Google Scholar

  • Godoy, L., Mian, N. D., Eisenhower, A. S. & Carter, A. S. (2014). Pathways to service receipt: Modeling parent help-seeking for childhood mental health problems. Administration and Policy in Mental Health, 41, 469 – 479. First citation in articleCrossref, Google Scholar

  • Goldberg, D. P. & Huxley, P. (1992). Common mental disorders: A bio-social model. London: Tavistock/Routledge. First citation in articleGoogle Scholar

  • Haller, A.-C., Klasen, F., Petermann, F., Barkmann, C., Otto, C. & Schlack, R., et al. (2016). Langzeitfolgen externalisierender Verhaltensauffälligkeiten. Kindheit und Entwicklung, 25, 31 – 40. First citation in articleLink, Google Scholar

  • Harwood, M. D., O’Brien, K. A., Carter, C. G. & Eyberg, S. M. (2009). Mental health services for preschool children in primary care: a survey of maternal attitudes and beliefs. Journal of Pediatric Psychology, 34, 760 – 768. First citation in articleCrossref, Google Scholar

  • Hintzpeter, B., Metzner, F., Pawils, S., Bichmann, H., Kamtsiuris, P. & Ravens-Sieberer, U., et al. (2014). Inanspruchnahme von ärztlichen und psychotherapeutischen Leistungen durch Kinder und Jugendliche mit psychischen Auffälligkeiten: Ergebnisse der BELLA-Studie. Kindheit und Entwicklung, 23, 229 – 238. First citation in articleLink, Google Scholar

  • Hofstra, M. B., Van der Ende, J. & Verhulst, F. C. (2000). Continuity and change of psychopathology from childhood into adulthood: A 14-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 850 – 858. First citation in articleCrossref, Google Scholar

  • Horwitz, S. M., Gary, L. C., Briggs-Gowan, M. J. & Carter, A. S. (2003). Do needs drive services use in young children? Pediatrics, 112, 1373 – 1378. First citation in articleCrossref, Google Scholar

  • Irlbauer-Müller, V., Eichler, A., Stemmler, M., Moll, G. H. & Kratz, O. (2016). Elterliche Belastung und die Zuverlässigkeit von Elternangaben in der Diagnostik psychisch und verhaltensauffälliger Kinder und Jugendlicher. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 44, 1 – 7. First citation in articleGoogle Scholar

  • Jungmann, T., Koch, K. & Böhm, J. (2017). Verhaltensauffälligkeiten in Kindertagesstätten aus Eltern- und Fachkraftperspektive im KOMPASS-Projekt. Frühe Bildung, 6, 25 – 32. First citation in articleLink, Google Scholar

  • Kasik, L. & Gál, Z. (2016). Parents’ and teachers’ opinions of preschool children’s social problem-solving and behavioural problems. Early Child Development and Care, 186, 1632 – 1648. First citation in articleCrossref, Google Scholar

  • Kasüschke, D. & Fröhlich-Gildhoff, K. (2008). Frühpädagogik heute: Herausforderungen an Disziplin und Profession. Köln: Link. First citation in articleGoogle Scholar

  • Kazdin, A. E., Holland, L., Crowley, M. & Breton, S. (1997). Barriers to Treatment Participation Scale: Evaluation and validation in the context of child outpatient treatment. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 38, 1051 – 1062. First citation in articleCrossref, Google Scholar

  • Klein, J. & Knesebeck, O. von dem (2016). Soziale Unterschiede in der ambulanten und stationären Versorgung. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz, 59, 238 – 244. First citation in articleCrossref, Google Scholar

  • Kmet, L., Lee, R. & Cook, L. (2014). Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Edmonton: Alberta Heritage Foundation for Medical Research (AHFMR). First citation in articleGoogle Scholar

  • Kuschel, A., Heinrichs, N., Bertram, H., Naumann, S. & Hahlweg, K. (2007). Wie gut stimmen Eltern und Erzieherinnen in der Beurteilung von Verhaltensproblemen bei Kindergartenkindern überein? Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 35, 51 – 58. First citation in articleLink, Google Scholar

  • Lavigne, J., Arend, R., Rosenbaum, D., Binns, H. J., Burns, A. & Christoffel, K. K., et al. (1998). Mental health service use among young children receiving pediatric primary care. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 1175 – 1183. First citation in articleCrossref, Google Scholar

  • Lavigne, J. V., Binns, H. J., Arend, R., Rosenbaum, D., Christoffel, K. K. & Hayford, J. R., et al. (1998). Psychopathology and health care use among preschool children: A retrospective analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 262 – 270. First citation in articleCrossref, Google Scholar

  • Lavigne, J. V., Lebailly, S. A., Hopkins, J., Gouze, K. R. & Binns, H. J. (2009). The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. Journal of Clinical Child and Adolescent Psychology, 38, 315 – 328. First citation in articleCrossref, Google Scholar

  • Lehmkuhl, G., Köster, I. & Schubert, I. (2009). Ambulante Versorgung kinder- und jugendpsychiatrischer Störungen—Daten einer versichertenbezogenen epidemiologischen Studie. Praxis der Kinderpsychologie und Kinderpsychiatrie, 58, 170 – 185. First citation in articleCrossref, Google Scholar

  • Moher, D., Liberati, A., Tetzlaff, J. & Altman, D. (2011). Bevorzugte Report Items für systematische Übersichten und Meta-Analysen: Das PRISMA-Statement. Deutsche medizinische Wochenschrift, 136, e9-e15. First citation in articleCrossref, Google Scholar

  • Muthny, F. A. & Bermejo, I. (2009). Zur Bedeutung interkultureller Aspekte in der Medizin – eine Einführung. Köln: Deutscher Ärzte-Verlag. First citation in articleGoogle Scholar

  • New, M., Razzino, B., Lewin, A., Schlumpf, K. & Joseph, J. (2002). Mental health service use in a community head start population. Archives of Pediatrics & Adolescent Medicine, 156, 721 – 727. First citation in articleCrossref, Google Scholar

  • Oh, E. & Bayer, J. (2015). Parents’ help‐seeking processes for early childhood mental health problems. Child and Adolescent Mental Health, 20, 149 – 154. First citation in articleCrossref, Google Scholar

  • Oh, E. & Bayer, J. K. (2017). Predicting parents’ intentions to seek help for young children’s mental health. International Journal of Mental Health Promotion, 19, 38 – 49. First citation in articleCrossref, Google Scholar

  • Oh, E., Mathers, M., Hiscock, H., Wake, M. & Bayer, J. (2015). Professional help seeking for young children with mental health problems. Australian Journal of Psychology, 67, 187 – 195. First citation in articleCrossref, Google Scholar

  • Pavuluri, M. N., Luk, S. L. & McGee, R. (1996). Help-seeking for behavior problems by parents of preschool children: A community study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 215 – 222. First citation in articleCrossref, Google Scholar

  • Peitz, G. (2004). Wenn bei Kindern Verhaltensauffälligkeiten diagnostiziert werden: Risiken für die Erziehungspartnerschaft von Familie und Kindergarten. Psychologie in Erziehung und Unterricht, 51, 258 – 272. First citation in articleGoogle Scholar

  • Reardon, T., Harvey, K., Baranowska, M., O’Brien, D., Smith, L. & Creswell, C. (2017). What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies. European Child and Adolescent Psychiatry, 26, 623 – 647. First citation in articleCrossref, Google Scholar

  • Sayal, K. (2006). Annotation: Pathways to care for children with mental health problems. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 47, 649 – 659. First citation in articleCrossref, Google Scholar

  • Schliwen, A. (2015). Versorgung, Angebot und Inanspruchnahme ambulanter hausärztlicher Leistungen im kleinräumigen regionalen Vergleich. Frankfurt a. M.: Lang. First citation in articleGoogle Scholar

  • Schölkopf, M. & Pressel, H. (2014). Das Gesundheitswesen im internationalen Vergleich (2. Aufl.). Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft. First citation in articleGoogle Scholar

  • SVR-Gesundheit – Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen (2001). Bedarfsgerechtigkeit und Wirtschaftlichkeit (Band III: Über-‍, Unter- und Fehlversorgung. Gutachten 2000/2001. Ausführliche Zusammenfassung). Bonn: SVR-Gesundheit. First citation in articleGoogle Scholar

  • Turner, E. A. & Liew, J. (2010). Children’s adjustment and child mental health service use: The role of parents’ attitudes and personal service use in an upper middle class sample. Community Mental Health Journal, 46, 231 – 240. First citation in articleCrossref, Google Scholar

  • Wichstrøm, L., Belsky, J., Jozefiak, T., Sourander, A. & Berg-Nielsen, T. S. (2014). Predicting service use for mental health problems among young children. Pediatrics, 133, 1054 – 1060. First citation in articleCrossref, Google Scholar

  • Wichstrøm, L., Berg-Nielsen, T. S., Angold, A., Egger, H. L., Solheim, E. & Sveen, T. H. (2012). Prevalence of psychiatric disorders in preschoolers. Journal Of Child Psychology and Psychiatry, and Allied Disciplines, 53, 695 – 705. First citation in articleCrossref, Google Scholar

  • Zwaanswijk, M., Verhaak, P. F. M., Bensing, J. M., Ende, J. van der & Verhulst, F. C. (2003). Help seeking for emotional and behavioural problems in children and adolescents: A review of recent literature. European Child and Adolescent Psychiatry, 12, 153 – 161. First citation in articleCrossref, Google Scholar