Help Seeking Process among Children Attending Psychiatry Clinic in Tirana, Albania

Article excerpt

Objective: The goal of this study was to investigate all the potential routes to Child/Adolescent Psychiatry Clinic-University Hospital Center (CAPC-UHC) in Tirana. The article provides demographic data, as well as further information on the types and amounts of services children/adolescents received during the process of seeking help related to different diagnoses .

Method: The study was conducted in CAPC-UHC in Tirana, during September 2006-September 2007. Data were collected from 162 children and their parents using Strengths and Difficulties Questionnaire (SDQ) and Pathways Encounter Form. The sample consisted of 53.1% (86) males and 46.9% (76) females. The mean age was 9.5 + 4.4 years .

Results: Out of the total number of cases that sought care to CAPC; 55, 6% were referred by parents themselves, while the rest were referred by others. There was a significant effect of gender to intervals from the onset of problem to the first career (F = 10.803, p=0.001), as well as a significant effect of gender to total time intervals from the onset till the specialist of child mental health problem (F = 6.742, p=0.01).

Conclusions: This is the first study investigating the help seeking process to psychiatric care in CAPC Tirana-Albania and may serve as a good start in generating evidence based on child/adolescent mental health service. Further multicentre studies will enhance the values of the findings, since the present study was performed in a single service, and in a setting lacking previous works with similar scope that could have served as references.

Keywords: Child, Delivery of health care, Health behavior, Mental health, Time factor

Iran J Psychiatry 2011; 6:106-111

Childhood psychiatric disorders are common and may often be associated with heavy use of health services. Up to one third of children and adolescents attending primary care and pediatric department have clinically significant psychopathology (1).

Epidemiological data is essential for the placement and development of a public policy as well as various programs to improve mental health in children and adolescents.

Goldberg and Huxley's (1992) Pathways to Care Model conceptualized the selection processes involved in the presentation, recognition, and referral of adults with psychiatric disorders. It enables observable levels of service use to be differentiated and has been successfully applied on children (2).In Zwaanswijk and colleagues' model (3), GP recognition sometimes followed mental health service use (as the GP does not have a gate-keeping role in

some countries). Pathways for children are more complex as they rely on adults such as parents and teachers to identify their problems and initiate service use. A vast amount of different pathway studies on children/adolescent mental health problems has been

done (4, 5, 6, 7, 8, 9, 10, 11, 12, 13) and reported, but as the organization of and interface between primary and specialist care vary across countries, research findings may be only partially transferable .

As of now, in Albania there exists only one child/adolescent mental health service (CAPC) and serves as both in and out patient service, where are only 15 beds in this facility. About 35% of the Albanian population is under 19 years old (1.108.458) (14), which means that if we consider a minimum of 10% of children having a mental health problem, about 110.845 of the children are in need for mental health care.

Centers offering primary care and child consultation are widely dispersed and accessible, mostly in urban areas; however, communication between general practitioners and psychiatrists is usually infrequent. There is under diagnosis of and low use of specialist services. As a result, a small number of children with mental health problems have access to the appropriate services.

In Albania there has been almost no children and adolescents mental health research and there is a need for data to support services, a need on assessment as well as on epidemiological data relevant to local circumstances. …