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Background: Although a great deal of evidence is available on the patterns and determinants of unmet health care needs among adolescents with mental health problems, little is known about the factors that influence the need for care. The aim of this study is to assess the occurrence of need for care for mental problems in adolescents and the determinants of this need., Methods: Data were obtained from three assessment waves of TRAILS (TRacking Adolescents' Individual Lives Survey) (N = 1406). Need for care was assessed at age 16/17 (parent report). Determinants concerned previous health care utilization, emotional and behavioral problems (child behavior checklist and youth self-report) and child and family characteristics., Results: Of the 1406 parents, 409 parents (29%) reported that their child needed help for mental problems. Of these adolescents, only 29% received specialized mental health treatment. The determinants of need for mental health care at age 16/17 were family break-up and parental internalizing problems (age 10/11), parent-reported internalizing and externalizing (age 10/11 and 13/14) and receiving specialized help (age 13/14)., Conclusion: A substantial proportion of all adolescents need care for their mental problems, according to their parent. There is also a large group of adolescents with mental health problems according to their parents, but for whom no parental reported need for care is expressed. The findings stress the importance of early interventions focusing on raising parental and child awareness of mental health problems.

Introduction Globally an estimated 1 in 16 women per year experience an unwanted pregnancy (UWP). In the Netherlands, general practitioners (GPs) play an important role in providing care for women with UWP; however, it is unknown how many of these women consult their GP about the pregnancy. UWPs are a major life experience with a possible influence on mental health. Data that GPs register about UWPs, psychosocial problems, and contraceptive use could give more insight into care needs. Aims To create an overview of (i) the prevalence of UWPs in general practice, (ii) the prevalence of psychosocial problems in women with UWP, and (iii) contraceptive use of women with UWP. Methods GP registration data were analysed from 58 general practices located in Northern Netherlands between 2015 and 2019. Patient files were checked for registration of ICPC and ATC codes concerning pregnancy, psychosocial health, and contraceptive use. Chi-square and Fisher's exact test were used to calculate differences between women with a UWP and women with a wanted pregnancy (WP). An analysis of registration dates was conducted to determine when the psychosocial problems were registered in relation to the pregnancy. Results Of female patients of reproductive age, 1.6% had a UWP and 11.8% had a WP. Women with a UWP reported statistically significantly more psychosocial problems. Furthermore, statistically significantly more contraceptive methods were prescribed to women with UWP compared with both women with WP and women without pregnancy. Discussion and conclusion The finding that women with UWP experience more psychosocial problems can be used to improve aftercare and can be incorporated into current guidelines for GPs. [ABSTRACT FROM AUTHOR]

Background: Care for children and adolescents with psychosocial problems is aimed at reducing problems. There may be a relationship between the intensity and duration of care provision and improvement of these outcomes, but evidence on this issue is lacking. We therefore examined the association between care trajectories based on duration and intensity of care for children, and the reduction in psychosocial problems after 3 years. Methods: We obtained a cohort of all children entering psychosocial care in one region (n = 1,378), the TAKECARE cohort, and followed it for 3 years, with five assessment rounds. Retention in the final round was 85.8%. Psychosocial problems were measured using the parent report of the Total Difficulty Score of the Strength and Difficulties Questionnaire (SDQ‐TDS). We constructed trajectories for intensity of care using growth mixture modelling and assessed the association between duration and intensity of care trajectories and SDQ‐TDS after 3 years. Results: After 3 months 60.6% of children and adolescents were receiving care, after 1 year 38.7% were receiving care and after 3 years 26.0%. Regarding intensity of care, three trajectories were found: one with minimal intensity during all 3 years, a second with initially medium intensity and strong reduction within 1 year, and a third with high intensity and a reduction after 1 year. Although the psychosocial problems of children and adolescents were reduced during the 3‐year period, the rate of decline was relatively less marked for children and adolescents with longer care trajectories. Conclusion: Overall, children and adolescents with psychosocial problems who received care had improved outcomes at follow‐up. However, increased provision of care does not automatically lead to reduction of problems, and although overall psychosocial problems are reduced, a substantial subgroup has longer lasting problems. [ABSTRACT FROM AUTHOR]

Expectations concerning barriers to children's psychosocial care seem to be major drivers when seeking help, but validated questionnaires measuring expectations are not available. Therefore, this study examined the psychometric properties of the parent and adolescent versions of the Barriers to Treatment Participation Scale-Expectancies (BTPS-exp), in terms of consistency, structure, parent-child agreement, and validity. The authors obtained data via questionnaires on 1,382 Dutch children aged 4-18 years (response rate 56.6%) enrolled in psychosocial care, and on 666 children (response rate 70.3%) from the community. Internal consistencies of the BTPS-exp total and subscales of both versions were good (lowest Cronbach's alpha = .85). Fit of the data with the assumed scale structure was acceptable. Correlation coefficients between the parent and adolescent scores were low (Pearson's r total scale = 0.25). Parents expecting multiple barriers was significantly more likely in non-Dutch ethnicity (odds ratio [OR] = 1.4; 95% confidence interval [CI] [1.1, 1.9]), in lower parental educational levels (primary education: OR = 3.0; 95% CI [1.5, 6.1]; lower-level secondary education: OR = 2.0; 95% CI [1.3, 3.1], both vs. university), in single parent families (1.3; 1.1-1.6), in case of child psychosocial problems (OR = 1.3; 95% CI [1.0, 1.5]) and in adolescents with psychosocial problems (OR = 2.1; 95% CI [1.4, 3.1]). Expecting multiple barriers did not affect the association between psychosocial problems and care enrollment. The authors conclude that the BTPS-exp has good psychometric properties regarding reliability and structure and is reasonably valid. Parents and adolescents have their own separate views, implying that it is valuable to assess both. Use of the scale might be helpful in providing direction to improve access to psychosocial care for children and adolescents. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Background: Data regarding the impact of early risk factors on later involvement in bullying are scarce. We investigated the impact of preschool behaviors, family characteristics (socio-economic status, family breakup) and parental mental health on bullying and victimization at age 11 (T1) and age 13.5 (T2). Methods: longitudinal data from a subsample of the TRacking Adolescents' Individual Lives Survey (TRAILS) (T1: N = 982; T2: N = 977). TRAILS is a prospective study of adolescent mental health in a mixed urban and rural region of the Netherlands. At T1 parents reported on family characteristics, parental mental health and retrospectively on children's preschool behavior at age 4-5. Schoolmates reported involvement of adolescents in bullying or victimization at T1 and T2. Results: Children with preschool anxiety were less likely to be bully/victim at T1. Children with preschool aggressiveness were more likely to be bully (T1), bully/victim (T1 and T2) and victim (T2) and children with good preschool motor functioning were more likely to be bully (T1) and less likely to be victim (T1 and T2). Children from low socioeconomic status families were more likely be to be bully, victim, or bully/victim and less likely to be uninvolved both at T1 and T2. Finally, children from intact two parent families were more likely to be uninvolved at T2. Conclusion: Preschool behavioral, emotional and motor problems, socioeconomic status, and family breakup are related to involvement in bullying at a later age. Prevention of bullying and its consequences can be enhanced by focusing on risk groups in early life. [ABSTRACT FROM AUTHOR]