Availability and accessibility of primary mental health services for adolescents: an overview of national recommendations and services in EU

Three Decades of Adolescent Health: Unveiling Global Trends Across 41 Countries in Psychological and Somatic Complaints (1994-2022)

Objectives

This study examined (non-)monotonic time trends in psychological and somatic complaints among adolescents, along with gender differences.

Methods

Repeated cross-sectional Health Behaviour in School-aged Children (HBSC) data from 1994 to 2022 covering 15-year-old adolescents from 41 countries (N = 470,797) were analysed. Three polynomial logistic regression models (linear, quadratic, cubic) were tested for best fit, including separate analyses by gender and health complaints dimension.

Results

Time trend patterns varied by gender and health complaints dimension. Increases were found in 82.3% of cases (linear 25%, quadratic U-shaped 28.7%, cubic 28.7%), while 14% showed no clear trend, and 3.7% decreased. Boys typically showed linear increases or no clear trend over time, whereas girls generally showed cubic or U-shaped trends. Psychological complaints often displayed U-shaped or cubic patterns, whereas somatic complaints mostly showed linear increases.

Conclusion

Psychological and somatic complaints demonstrated diverse time trend patterns across countries, with non-monotonic patterns (U-shaped and cubic) frequently observed alongside linear increases. These findings highlight the complexity of changes within countries over three decades, suggesting that linear modelling may not effectively capture this heterogeneity.

The fearlessness about death scale's efficacy for differentiating suicide attempts from non-suicidal self-injury, a meta-analysis

We used multivariate meta-analysis modeling variances and covariances of suicidal ideation, suicide attempts, and non-suicidal self-injury to investigate if the Fearlessness About Death scale differentiated between suicide attempts and non-suicidal self-injury. The systematic search yielded 27 studies that fulfilled the inclusion criteria. The association of suicidal ideation with suicide attempts was comparable to the association of suicidal ideation with non-suicidal self-injury. The Fearlessness About Death scale weakened both associations to a comparative degree. These results cast doubt on the clinical utility of the Fearlessness About Death scale, as well as the self-assessment of suicidal ideation, suicide attempts and non-suicidal self-injury.

Leave no one behind: why WHO's regional office for Europe should prioritise children and adolescents in their program of work. A position statement from the European academy of paediatrics

Children and adolescents are no longer a priority in the most recent European Programme of Work (EPW) 2020-2025 of the World Health Organization (WHO) Regional Office for Europe. In this position statement we provide arguments for why we think this population should be explicitly addressed in this important and influential document. We firstly emphasize the persistent health problems and inequalities in access to care for children and adolescents that are challenging to solve, and thus require a continuous focus. Secondly, we urge the WHO to prioritize children and adolescents in their EPW due to the new and emerging health problems related to global issues. Finally, we explain why permanent prioritization of children and adolescents is essential for the future of children and of society.

Developmental monitoring: benefits of a preventive health care system

This study aims to assess the identification rates in a developmental monitoring system (i.e., preventive child healthcare, PCH system) regarding identification of emotional, behavioral (EB) problems, cognitive developmental and family problems in children, and the contribution of such a system to referral to (specialized) mental health and social care services. Over a predetermined period of 6 months, we retrieved data from a random sample of 1370 children aged 0 to 18 years from the registries of two PCH organizations in the Netherlands. We assessed the degree to which PCH professionals identify EB and cognitive developmental and family problems and invite children with these problems for follow-up PCH assessments or refer them to (specialized) mental health and social care services. Among preschool-aged children, we identified 22% with EB problems, cognitive developmental and/or family problems (mainly EB and family problems). Among school-aged children, numbers varied from 10 to 14% (mainly EB). PCH invited 3 to 10%, varying in proportions of child age, for a follow-up assessment, and referred 0 to 4% of the children to external services.

CONCLUSION

A developmental monitoring system with only preventive tasks may help to identify children with EB, cognitive developmental, and/or family problems. This can lead to early support for most of these children, with low referral rates to (more specialized) mental health and social care services. Our findings deserve validation in comparable settings and in other countries.

WHAT IS KNOWN

• Well-child care requires monitoring of the health and development of children for timely identification of problems and subsequent intervention. • The Dutch Preventive Child Healthcare system is an example of a developmental monitoring system with only preventive tasks.

WHAT IS NEW

• A developmental monitoring system with only preventive tasks may help to identify children with problems, resulting in early support for the majority. • This may reduce referral rates to (more specialized) mental/social health services.

The Impact of COVID on Adolescent Mental Health, Self-Harm and Suicide: How Can Primary Care Provider Respond? A Position Paper of the European Academy of Pediatrics

Adolescents aged 10 to 19 live a period of their life marked by opportunities and vulnerabilities during which the issue of mental health is of prime importance. Since several decades, and especially since the start of the COVID pandemic, mental health problems and disorders among adolescents have increased around the world. Depression, self-harm and suicidal behavior are common during this period of life, and pediatricians can play a pivotal role in identifying affected or vulnerable youngsters. This article describes risk factors for self-harm and suicidal behavior and reviews how primary care pediatricians and health professionals can respond to such situations. This scoping review is based on existing evidences as well as the authors clinical experience. It suggests concrete actions that can be taken to secure the life of at risk teenagers, and discusses how to organize the transfer to mental health professionals when needed.