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Caring for Children and Youth with Ongoing Mental Health Problems: Perspectives of Family Physicians, Nurse Practitioners, Social Workers and Psychologists in Primary Health Care

Publication: Canadian Journal of Community Mental Health
18 January 2021

Abstract

Few studies have examined a diversity of professionals’ perspectives in providing children’s mental health (CMH) care, particularly for ongoing-complex problems. Based on interviews with 16 primary healthcare (PHC) providers, care for ongoing-complex CMH problems depended on provider interest and scope of practice. Most providers felt PHC is where ongoing-complex CMH problems should be cared for, where providers can emphasize advocacy, coordination, and ongoing monitoring; few felt able to provide this type of care. A comprehensive approach for incorporating PHC with specialized MH services is needed. Defining a care coordinator would be a clear step toward improving collaboration and care.

Résumé

Peu d’études se sont penchées sur les différents points de vue des professionnels impliqués dans la prestation de soins de santé mentale chez les enfants (SME), notamment pour ce qui est des problèmes jugés complexes et permanents. À la lumière d’entretiens réalisés auprès de 16 prestataires de soins de santé primaires (SSP), il apparaît que la prise en charge des problèmes complexes et permanents de SME dépend de l’intérêt du prestataire de soins et de son champ de pratique. La plupart des prestataires de soins estiment que les SSP sont la sphère de services où les problèmes complexes et permanents de SME doivent être traités, et où les prestataires de soins peuvent mettre l’emphase sur la promotion, la coordination et le suivi permanent. Mais peu de prestataires se sentent en mesure de fournir ce type de soins. Une approche globale s’avère donc nécessaire pour intégrer les SSP aux services spécialisés en santé mentale. L’institution d’un coordinateur de soins constituerait une étape déterminante vers un renforcement de la collaboration entre les prestataires de soins et une amélioration des soins à proprement parler.

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References

Abba-Aji A., Hay K., Kelland J., Mummery C., Urichuk L., Gerdes C., Snaterse M., Chue P., Lal S., Joober R., Boksa P., Malla A., Iyer S. N., and Shah J. L. 2019 Transforming youth mental health services in a large urban centre: ACCESS Open Minds Edmonton Early Intervention Psychiatry 13 Suppl 1 14 -19
Angermeyer M. C., Matschinger H., and Riedel-Heller S. G. 1999 Whom to ask for help in case of a mental disorder? Preferences of the lay public Social Psychiatry and Psychiatric Epidemiology 34 4 202 -210
Ashcroft R. 2015 Ontario’s Family Health Teams: Politics within the model Canadian Social Work Review 32 1–2 117 -132
Ashcroft R., McMillan C., Ambrose-Miller W., McKee R., and Brown J. B. 2018 The emerging role of social work in primary health care: A survey of social workers in Ontario family health teams Health & Social Work 43 2 109 -117
Ashcroft R., Silveira J., and Mckenzie K. 2016 A qualitative study on incentives and disincentives for care of common mental disorders in Ontario family health teams Healthcare Policy 12 1 84 -96
Baker-Ericzen M. J., Jenkins M. M., and Brookman-Frazee L. 2010 Clinician and parent perspectives on parent and family contextual factors that impact community mental health services for children with behavior problems Child Youth Care Forum 39 6 397 -419
Bodenheimer T., Wagner E. H., and Grumbach K. 2002 Improving primary care for patients with chronic illness JAMA 288 14 1775 -1779
Bonavita V. and De Simone R. 2008 Towards a definition of comorbidity in the light of clinical complexity Neurological Sciences 29 Supple 1 S99 -102
Bower P. and Sibbald B. 2000 Systematic review of the effect of on-site mental health professionals on the clinical behaviour of general practitioners BMJ 320 7235 614 -617
Boylan K., Vaillancourt T., Boyle M., and Szatmari P. 2007 Comorbidity of internalizing disorders in children with oppositional defiant disorder European Child & Adolescent Psychiatry 16 8 484 -494
Brown J. B., Ryan B. L., and Thorpe C. 2016 Processes of patient-centred care in family health teams: A qualitative study CMAJ Open 4 2 E271 -E276
Browne T., Darnell J., Savage T. E., and Brown A. 2015 Social workers as patient navigators: A review of the literature Social Work Research 39 3 158 -166
Burka S. D., Van Cleve S. N., Shafer S., and Barkin J. L. 2014 Integration of pediatric mental health care: An evidence-based workshop for primary care providers Journal of Pediatric Health Care 28 1 23 -34
Bussing R., Mason D. M., Bell L., Porter P., and Garvan C. 2010 Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample Journal of the American Academy of Child and Adolescent Psychiatry 49 6 595 -605
Canadian Collaborative Mental Health Initiative. (2006). Establishing collaborative initiatives between mental health and primary care services for children and adolescents. A companion to the CCMHI planning and implementation toolkit for health care providers and planners (ISBN 1-897268-09-2). http://www.ccmhi.ca/en/products/toolkits/documents/EN_CompanionToolkitforChildrenandAdolescents.pdf
Cappelli, M., & Leon, S. L. (2017). Paving the path to connected care: Strengthening the interface between primary care and community-based child and youth mental health services. http://www.excellenceforchildandyouth.ca/sites/default/files/resource/policy_primary_care.pdf
Cawthorpe D. 2005 Primary care physician ability to identify pediatric mental health issues Canadian Child and Adolescent Psychiatry Review 14 4 99 -102
Cawthorpe D. 2013 A novel population-based health index for mental disorder Permanente Journal 17 2 50 -54
Cawthorpe D. 2018 A 16-year cohort analysis of autism spectrum disorder-associated morbidity in a pediatric population Front Psychiatry 9 635
Christenson J. D., Crane D. R., Malloy J., and Parker S. 2016 The cost of oppositional defiant disorder and disruptive behavior: A review of the literature Journal of Child and Family Studies 25 9 2649 -2658 https://doi.org/10.1007/s10826-016-0430-9
Cicchetti D. and Toth S. L. 2009 The past achievements and future promises of developmental psychopathology: The coming of age of a discipline Journal of Child Psychology and Psychiatry 50 1–2 16 -25
Clinton J., Feller A. F., and Williams R. C. 2016 The importance of infant mental health Paediatric Child Health 21 5 239 -241
Cloutier P., Cappelli M., Glennie J. E., Charron G., and Thatte S. 2010 Child and youth mental health service referrals: Physicians’ knowledge of mental health services and perceptions of a centralized intake model Healthcare Policy 5 3 e144 -e161
College of Family Physicians of Canada. (2019). A new vision for Canada: Family Practice—The Patient’s Medical Home 2019. https://www.cfpc.ca/A_Vision_for_Canada/
College of Family Physicians of Canada, Canadian Medical Association, & Canada, Royal College of Physicians and Surgeons of Canada. (2017). National Physician Survey. Retrieved from www.nationalphysiciansurvey.ca
Craven M. A., Cohen M., Campbell D., Williams J., and Kates N. 1997 Mental health practices of Ontario family physicians: A study using qualitative methodology Canadian Journal of Psychiatry 42 9 943 -949
de Voursney D. and Huang L. N. 2016 Meeting the mental health needs of children and youth through integrated care: A systems and policy perspective Psychological Services 13 1 77 -91
Dube A., Iancu P., Tranchant C. C., Doucet D., Joachin A., Malchow J., Robichaud S., Hache M., Godin I., Bourdon L., Bourque J., Iyer S. N., Malla A., and Beaton A. M. 2019 Transforming child and youth mental health care: ACCESS Open Minds New Brunswick in the rural Francophone region of the Acadian Peninsula Early Intervention in Psychiatry 13 Suppl 1 29 -34
Duncan L., Boyle M. H., Abelson J., and Waddell C. 2018 Measuring children’s mental health in Ontario: Policy issues and prospects for change Journal of the Canadian Academy of Child and Adolescent Psychiatry 27 2 88 -98
DuPaul G. J., Evans S. W., Mautone J. A., Owens J. S., and Power T. J. 2019 Future directions for psychosocial interventions for children and adolescents with ADHD Journal of Clinical Child & Adolescent Psychology 1 -12
Epstein, M. H., Kutash, K., & Duchnowski, A. (2005). Outcomes for children and youth with emotional disorders and their families: Programs and evaluation best practices (2nd ed.). Austin, TX: Pro-Ed.
Faraone S. V., Biederman J., and Mick E. 2006 The age-dependent decline of attention deficit hyperactivity disorder: A meta-analysis of follow-up studies Psychological Medicine 36 2 159 -165
Farmer E. M., Burns B. J., Phillips S. D., Angold A., and Costello E. J. 2003 Pathways into and through mental health services for children and adolescents Psychiatric Services 54 1 60 -66
Farmer J. E., Clark M. J., Drewel E. H., Swenson T. M., and Ge B. 2011 Consultative care coordination through the medical home for CSHCN: A randomized controlled trial Maternal and Child Health Journal 15 7 1110 -1118
Fredheim T., Danbolt L., Haavet K., Kjonsber K., and Lien L. 2013 Collaboration between general practitioners and mental health care professionals: A qualitative study International Journal of Mental Health Systems 5 1 -7
Fried E. I. and Robinaugh D. J. 2020 Systems all the way down: Embracing complexity in mental health research BMC Medicine 18 205
Georgiades K., Duncan L., Wang L., Comeau J., Boyle M. H., and 2014 Ontario Child Health Study Team 2019 Six-month prevalence of mental disorders and service contacts among children and youth in Ontario: Evidence from the 2014 Ontario Child Health Study Canadian Journal of Psychiatry 64 4 246 -255
Godoy L., Hodgkinson S., Robertson H. A., Sham E., Druskin L., Wambach C. G., Beers L. S., and Long M. 2019 Increasing mental health engagement from primary care: The potential role of family navigation Pediatrics 143 4
Grenier J., Chomienne M. H., Gaboury I., Ritchie P., and Hogg W. 2008 Collaboration between family physicians and psychologists: What do family physicians know about psychologists’ work? Canadian Family Physician 54 2 232 -233
Grimes K. E., Kapunan P. E., and Mullin B. 2006 Children’s health services in a “system of care”: Patterns of mental health, primary and specialty use Public Health Reports 121 3 311 -323
Hurtig T., Ebeling H., Taanila A., Miettunen J., Smalley S. L., McGough J. J., Loo S. K., Jarvelin M. R., and Moilanen I. K. 2007 ADHD symptoms and subtypes: Relationship between childhood and adolescent symptoms Journal of the American Academy of Child and Adolescent Psychiatry 46 12 1605 -1613
Hutchison B. and Glazier R. 2013 Ontario’s primary care reforms have transformed the local care landscape, but a plan is needed for ongoing improvement Health Affairs (Millwood) 32 4 695 -703
Jensen P. S. 2016 It takes a (green) village… Journal of the American Academy of Child and Adolescent Psychiatry 55 7 540 -541
Kates N., Mazowita G., Lemire F., Jayabarathan A., Bland R., Selby P., Isomura T., Craven M., Gervais M., and Audet D. 2011 The evolution of collaborative mental health care in Canada: A shared vision for the future Canadian Journal of Psychiatry 56 5 1 -10
Kirby M. 2008 Mental health in Canada: Out of the shadows forever Canadian Medical Association Journal 178 10 1320 -1322
Kutcher S., Hampton M. J., and Wilson J. 2010 Child and adolescent mental health policy and plans in Canada: An analytical review Canadian Journal of Psychiatry 55 2 100 -107
Lai J. K. Y. and Weiss J. A. 2017 Priority service needs and receipt across the lifespan for individuals with autism spectrum disorder Autism Research 10 8 1436 -1447
Lancsar E., Louviere J., Donaldson C., Currie G., and Burgess L. 2013 Best worst discrete choice experiments in health: Methods and an application Social Science & Medicine 76 1 74 -82
Lecendreux M., Silverstein M., Konofal E., Cortese S., and Faraone S. V. 2019 A 9-year follow-up of attention-deficit/ hyperactivity disorder in a population sample Journal of Clinical Psychiatry 80 3
Liamputtong, P. (2013). Qualitative research methods. Australia and New Zealand: Oxford University Press.
Lipton H., Raivio E., Perrault E., Bryden B., Caputy V., Binding L., Pace D., Donsky A., Peters A., Plotsky K., Ayala J., and Pada C. 2008 Integrating children’s mental health in primary health care Canadian Journal of Community Mental Health 27 2 153 -163
Lubetsky M. J., Handen B. L., Lubetsky M., and McGonigle J. J. 2014 Systems of care for individuals with autism spectrum disorder and serious behavioral disturbance through the lifespan Child and Adolescent Psychiatric Clinics of North America 23 1 97 -110
MacDonald K., Fainman-Adelman N., Anderson K. K., and Iyer S. N. 2018 Pathways to mental health services for young people: A systematic review Social Psychiatry and Psychiatric Epidemiology 53 10 1005 -1038
Malla A., Iyer S., Shah J., Joober R., Boksa P., Lal S., Fuhrer R., Andersson N., Abdel-Baki A., Hutt-MacLeod D., Beaton A., Reaume-Zimmer P., Chisholm-Nelson J., Rousseau C., Chandrasena R., Bourque J., Aubin D., Levasseur M. A., Winkelmann I., Etter M., Kelland J., Tait C., Torrie J., and Vallianatos H. 2019 Canadian response to need for transformation of youth mental health services: ACCESS Open Minds (Esprits ouverts) Early Intervention Psychiatry 13 3 697 -706
Malterud K. 2001 Qualitative research: Standards, challenges, and guidelines The Lancet 358 9280 483 -488
Malterud K., Siersma V. D., and Guassora A. D. 2016 Sample size in qualitative interview studies: Guided by information power Qualitative Health Research 26 13 1753 -1760
Manderson B., McMurray J., Piraino E., and Stolee P. 2012 Navigation roles support chronically ill older adults through healthcare transitions: A systematic review of the literature Health and Social Care in the Community 20 2 113 -127
Markoulakis R., Weingust S., Foot J., and Levitt A. 2016 The Family Navigation Project: An innovation in working with families to match mental health services with their youth’s needs Canadian Journal of Community Mental Health 35 63 -66
Martin D., Miller A. P., Quesnel-Vallee A., Caron N. R., Vissandjee B., and Marchildon G. P. 2018 Canada’s universal health-care system: Achieving its potential The Lancet 11 -28
Martin P., Davies R., Macdougall A., Ritchie B., Vostanis P., Whale A., and Wolpert M. 2017 Developing a case mix classification for child and adolescent mental health services: The influence of presenting problems, complexity factors and service providers on number of appointments Journal of Mental Health 1 -8
McCaffrey E. S. N., Chang S., Farrelly G., Rahman A., and Cawthorpe D. 2017 Mental health literacy in primary care: Canadian research and education for the advancement of child health (CanREACH) Evidence-Based Medicine 22 4 123 -131
McMurray A. and Cooper H. 2017 The nurse navigator: An evolving model of care Collegian 24 205 -212
Melathopolous K. and Cawthorpe D. 2019 Impact of central intake development and system change on per capita child and adolescent mental health discharges from 2002 to 2017: Implications for optimizing system design by shaping demand Permanente Journal 23 18.215
Mental Health Commission of Canada. (2012). Changing directions changing lives: The mental health strategy for Canada. Calgary, AB: Mental Health Commission of Canada.
Mental Health Commission of Canada. (2016). Advancing the mental health strategy for Canada: A framework for action (2017-2022). Ottawa, ON: Mental Health Commission of Canada.
Ministry of Health. (2020). Roadmap to wellness: A plan to build Ontario’s mental health and addictions system. Government of Ontario. https://www.ontario.ca/page/roadmap-wellness-plan-build-ontarios-mental-health-and-addictions-system
Muhlbacher A. C., Kaczynski A., Zweifel P., and Johnson F. R. 2016 Experimental measurement of preferences in health and healthcare using best-worst scaling: An overview Health Economics Review 6 1 2
Olfson M., Kroenke K., Wang S., and Blanco C. 2014 Trends in office-based mental health care provided by psychiatrists and primary care physicians Journal of Clinical Psychiatry 75 3 247 -253
Ontario Ministry of Health and Long-Term Care [Website]. (2016). Family health teams. www.health.gov.on.ca/en/pro/programs/fht/
Paolozza, C., Packard, B., & Kulkarni, C. (2017). A call to action on behalf of maltreated infants and toddlers in Canada. https://www.imhpromotion.ca/Resources/A-Call-to-Action
Paskett E. D., Harrop J. P., and Wells K. J. 2011 Patient navigation: An update on the state of the science CA: A Cancer Journal for Clinicians 61 4 237 -249
Phillips S. D., Hargis M. B., Kramer T. L., Lensing S. Y., Taylor J. L., Burns B. J., and Robbins J. M. 2000 Toward a level playing field: Predictive factors for the outcomes of mental health treatment for adolescents Journal of the American Academy of Child and Adolescent Psychiatry 39 12 1485 -1495
Pryjmachuk S., Graham T., Haddad M., and Tylee A. 2011 School nurses’ perspectives on managing mental health problems in children and young people Journal of Clinical Nursing 21 5-6 850 -859
Rapp A. M., Chavira D. A., Sugar C. A., and Asarnow J. R. 2017 Integrated primary medical-behavioral health care for adolescent and young adult depression: Predictors of service use in the youth partners in care trial Journal of Pediatric Psychology 42 9 1051 -1064
Reid, G. J., Bennett, K., Bennett, T., Boyle, M., Butt, M., Duncan, L., Ferro,M., Georgiades, K., Georgiades, S., Kimber, M., Lewis, D., McLennan, J., Tobon, J. I., Waddell, C. (2020). Predictors and patterns of accessing health and mental health services in a community-based sample of children and youth. Manuscript in preparation.
Reid G. J. and Brown J. B. 2008 Money, case complexity and wait lists: Perspectives on problems and solutions at children’s mental health centers in Ontario Journal of Behavioral Health Services & Research 35 3 334 -346
Reid G.J., Cunningham C.E., Tobon J.I., Evans B., Stewart M., Brown J.B., Lent B., Neufeld R.W.J., Vingilis E., Zaric G.S., and Shanley D.C. 2011 Help-seeking for children with mental health problems: Parents’ efforts and experiences Adminstration and Policy in Mental Health 38 5 384 -397
Reid G. J., Irvine M. J., McCrindle B., Sananes R., Ritvo P., Siu S., and Webb G. 2004 Prevalence and correlates of successful transfer from pediatric to adult health care among a cohort of young adults with complex congenital heart defects Pediatrics 113 3 e197 -e205
Reid G.J., Stewart S.L., Barwick M., Carter J., Leschied A., Neufeld R.W.J, St. Pierre J., Tobon J., Vingilis E., and Zaric G. 2019 Predicting patterns of service utilization within children’s mental health agencies BMC Health Services Research Dec 23;19 1 993
Reid G.J., Stewart S.L., Barwick M., Cunningham C., Carter J., Evans B., Leschied A., Neufeld R., St. Pierre J., Tobon J., Vingilis E., and Zaric G. 2020 Exploring patterns of service utilization within children’s mental health agencies Journal of Child and Family Studies
Reid G.J., Stewart S., Zaric G.S., Carter J., Neufeld R.W.J., Tobon J.I., Barwick M., and Vingilis E.R. 2015 Defining episodes of care in children’s mental health using administrative data Adminstration and Policy in Mental Health 42 6 737 -747
Reid G. J., Webb G. D., McCrindle B. W., Irvine M. J., and Siu S. C. 2008 Health behaviors among adolescents and young adults with congenital heart disease Congenital Heart Disease 3 1 16 -25
Rickwood D., Paraskakis M., Quin D., Hobbs N., Ryall V., Trethowan J., and McGorry P. 2019 Australia’s innovation in youth mental health care: The headspace centre model Early Intervention Psychiatry 13 1 159 -166
Ronis S. T., Slaunwhite A. K., and Malcom K. E. 2017 Comparing strategies for providing child and youth mental health care services in Canada, the United States, and The Netherlands Administration and Policy in Mental Health 44 6 955 -966
Rosser W. W., Colwill J. M., Kasperski J., and Wilson L. 2011 Progress of Ontario’s family health team model: A patient-centered medical home Annals of Family Medicine 9 2 165 -171
Rushton J., Bruckman D., and Kelleher K. 2002 Primary care referral of children with psychosocial problems Archives of Pediatrics & Adolescent Medicine 156 6 592 -598
Sandelowski M. 2000 Whatever happened to qualitative description? Research in Nursing & Health 23 4 334 -340
Sandelowski M. 2010 What’s in a name? Qualitative description revisited Research in Nursing & Health 33 1 77 -84
Schraeder K. E., Brown J. B., and Reid G. J. 2018 Perspectives on monitoring youth with ongoing mental health problems in primary health care: Family physicians are “out of the loop” Journal of Behavioral Health Services & Research 45 2 219 -236
Schraeder K. E. and Reid G. J. 2017 Who should transition? Defining a target population of youth with depression and anxiety that will require adult mental health care Journal of Behavioral Health Services & Research 44 2 316 -330
Schraeder K. E., Reid G. J., and Brown J. B. 2018 “I think he will have it throughout his whole life”: Parent and youth perspectives about childhood mental health problems Qualitative Health Research 28 4 548 -560
Shanley, D. C. (2008). Understanding parents’ perceptions of their child’s mental health problem: Development of a parent-report measure. [Doctoral dissertation, Psychology, The University of Western Ontario].
Shanley, D. C., Brown, J. B., Reid, G. J., & Paquette-Warren, J. (2013). Parents’ perceptions about child mental health problems. In P. Barberis and S. Petrakis (Eds.) Parenting: Challenges, Practices and Cultural Influences (pp. 35–38). Hauppauge, NY: Nova Sciences.
Shanley D. C., Reid G. J., and Evans B. 2008 How parents seek help for children with mental health problems Administration and Policy in Mental Health 35 3 135 -146
Stewart, M., Brown, J. B., Weston, W. W., McWhinney, I. R., McWilliam, C. L., & Freeman, T. (2014). Patient-centered Medicine – Transforming the clinical method. Radcliffe Publishing.
Stiffman A., Stelk W., Horwitz S., Evans M., Outlaw F., and Atkins M. 2009 A public health approach to children’s mental health services: Possible solutions to current service inadequacies Administration and Policy in Mental Health 37 120 -124
Storm M., Hausken K., and Knudsen K. 2011 Inpatient service providers’ perspectives on service user involvement in Norwegian community mental health centres International Journal of Social Psychiatry 57 6 551 -563
The Standing Senate Committee on Social Affairs, Science and Technology (2006). Out of the shadows at last: Transforming mental health, mental illness and addiction services in Canada. Ottawa, ON: Senate Canada.
Tobon, J. I. (2013). Continuity of care in children’s mental health: Development of a measure. [Doctoral dissertation, Psychology, The University of Western Ontario].
Tobon J. I., Reid G. J., and Brown J. B. 2015 Continuity of care in children’s mental health: Parent, youth and professional perspectives Community of Mental Health Journal 51 8 921 -930
Turcotte P., Mathew M., Shea L. L., Brusilovskiy E., and Nonnemacher S. L. 2016 Service across the lifespan for individuals with autism Journal of Autism and Developmental Disorders 46 7 2480 -2489
United States Dept. of Health and Human Services (1999). Mental health: A report of the surgeon general. http://www.surgeongeneral.gov/library/mentalhealth/home.html
Vostanis P., Martin P., Davies R., De F. D., Jones M., Sweeting R., Ritchie B., Allen P., and Wolpert M. 2015 Development of a framework for prospective payment for child mental health services Journal of Health Services Research Policy 20 4 202 -209
Walter H. J., Vernacchio L., Trudell E. K., Bromberg J., Goodman E., Barton J., Young G. J., DeMaso D. R., and Focht G. 2019 Five-year outcomes of behavioral health integration in pediatric primary care Pediatrics 144 1
Whitty J. A. and Oliveira Goncalves A. S. 2018 A systematic review comparing the acceptability, validity and concordance of discrete choice experiments and best-worst scaling for eliciting preferences in healthcare Patient 11 3 301 -317
Wissow L. S., van Ginneken N., Chandna J., and Rahman A. 2016 Integrating children’s mental health into primary care Pediatric Clinics of North America 63 1 97 -113
Wolraich M., Brown L., Brown R. T., DuPaul G., Earls M., Feldman H. M., Ganiats T. G., Kaplanek B., Meyer B., Perrin J., Pierce K., Reiff M., Stein M. T., and Visser S. 2011 ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents Pediatrics 128 5 1007 -1022
Yonek J. C., Jordan N., Dunlop D., Ballard R., and Holl J. 2018 Patient-centered medical home care for adolescents in need of mental health treatment Journal of Adolescent Health 63 2 172 -180
Zwaanswijk M., Van der E. J., Verhaak P. F., Bensing J. M., and Verhulst F. C. 2005 Help-seeking for child psychopathology: Pathways to informal and professional services in the Netherlands Journal of the American Academy of Child and Adolescent Psychiatry 44 12 1292 -1300

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Information

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cover image Canadian Journal of Community Mental Health
Canadian Journal of Community Mental Health
Volume 39Number 3November 2020
Pages: 51 - 73

History

Version of record online: 18 January 2021

Key Words

  1. children’s mental health
  2. children
  3. adolescents
  4. youth
  5. qualitative
  6. psychology
  7. primary care
  8. ongoing mental health problems
  9. complex mental health problems

Mots-clés

  1. santé mentale des enfants
  2. enfants
  3. adolescents
  4. jeunes
  5. qualitatif
  6. psychologie
  7. soins primaires
  8. problèmes de santé mentale permanents
  9. problèmes de santé mentale complexes

Authors

Affiliations

Graham J. Reid [email protected]
The University of Western Ontario
Judith B. Brown
The University of Western Ontario
Stephanie Mowat
The University of Western Ontario

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1. Mental Health Complexity Among Children and Youth: Current Conceptualizations and Future Directions

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