دانلود مقاله تعیین مؤلفه‌های شناسایی مشکلات سلامت روان مدرسه
چکیده
مقدمه
روش
نتایج
بحث
منابع
Abstract
Introduction
Method
Results
Discussion
References
چکیده
فقط نیمی از کودکان و جوانان (CYP) با مشکلات سلامت روان به خدمات سلامت روان در انگلستان دسترسی دارند و نیاز به شناسایی ناکافی به عنوان یک عامل کمک کننده است. مدارس ممکن است یک محیط ایده آل برای شناسایی مشکلات سلامت روان در CYP باشند، اما عدم اطمینان در مورد فرآیندهایی که می توان از طریق آنها این نیازها را به بهترین نحو شناسایی و برطرف کرد، وجود دارد. در این مطالعه، ما یک مطالعه دلفی دو دور و سه پانل را با والدین، کارکنان مدرسه، پزشکان بهداشت روان و محققان انجام دادیم تا برنامه‌ای را برای شناسایی مشکلات سلامت روان در مدارس ابتدایی اعلام کنیم. هدف ما ارزیابی و ایجاد اجماع در مورد (الف) اهداف چنین برنامه‌ای، (ب) ترجیحات مدل شناسایی، (ج) ویژگی‌های کلیدی مدل شناسایی، و (د) ویژگی‌های کلیدی مدل پیاده‌سازی بود. در مجموع 54 و 42 شرکت کننده به ترتیب پرسشنامه های دور 1 و 2 را تکمیل کردند. به طور کلی، پاسخ ها نشان داد که هر سه پانل از ایده شناسایی مشکلات سلامت روان مبتنی بر مدرسه حمایت می کنند. به طور کلی، 53 مورد از 99 مورد ممکن، معیارهای گنجاندن به عنوان اجزای اصلی برنامه را برآورده کردند. پنج اولویت اصلی ظاهر شد، از جمله این که (الف) برنامه باید کودکانی را که مشکلات سلامت روانی را در سراسر شدت تجربه می‌کنند، و همچنین کودکانی که در معرض ناملایمات قرار دارند و در معرض خطر بیشتر مشکلات سلامت روان هستند، شناسایی کند. (ب) برنامه باید کارکنان را آموزش دهد و دانش آموزان را در مورد سلامت روان به طور موازی آموزش دهد. (ج) رضایت والدین باید بر اساس انصراف اخذ شود. (د) برنامه باید دارای مکانیسم‌های روشنی برای اتصال دانش‌آموزان شناسایی‌شده به مراقبت و حمایت باشد. و (ه) برای به حداکثر رساندن موفقیت اجرا، برنامه باید در فرهنگ مدرسه قرار گیرد که به سلامت و رفاه روانی اهمیت می دهد. در برجسته کردن این اولویت ها، مطالعه ما اجماع ذینفعان مورد نیاز را برای هدایت توسعه و ارزیابی بیشتر مداخلات سلامت روان در مدارس فراهم می کند.
توجه! این متن ترجمه ماشینی بوده و توسط مترجمین ای ترجمه، ترجمه نشده است.
Abstract
Only approximately half of children and young people (CYP) with mental health difficulties access mental health services in England, with under-identification of need as a contributing factor. Schools may be an ideal setting for identifying mental health difficulties in CYP, but uncertainty remains about the processes by which these needs can best be identified and addressed. In this study, we conducted a two-round, three-panel Delphi study with parents, school staff, mental health practitioners, and researchers to inform the development of a program to identify mental health difficulties in primary schools. We aimed to assess and build consensus regarding (a) the aims of such a program, (b) identification model preferences, (c) key features of the identification model, and (d) key features of the implementation model. A total of 54 and 42 participants completed the Round 1 and 2 questionnaires, respectively. In general, responses indicated that all three panels supported the idea of school-based identification of mental health difficulties. Overall, 53 of a possible 99 items met the criteria for inclusion as program core components. Five main priorities emerged, including that (a) the program should identify children experiencing mental health difficulties across the continuum of severity, as well as children exposed to adversity, who are at greater risk of mental health difficulties; (b) the program should train staff and educate pupils about mental health in parallel; (c) parental consent should be obtained on an opt-out basis; (d) the program must include clear mechanisms for connecting identified pupils to care and support; and (e) to maximize implementation success, the program needs to lie within a school culture that values mental health and wellbeing. In highlighting these priorities, our study provides needed stakeholder consensus to guide further development and evaluation of mental health interventions within schools.
Introduction
Mental health difficulties in children and young people (CYP) are an important public health challenge requiring urgent attention (Patel et al., 2007; Wolpert et al., 2018). Recent survey data suggest that one in eight CYP in England has a clinically diagnosable mental health disorder (Sadler et al., 2018), with many more experiencing sub-clinical difficulties. The health, education, social, occupational, and economic consequences of mental health difficulties in CYP are substantial, widespread, and lifelong (Sellers et al., 2019).
Prompt delivery of evidence-based interventions may reduce the negative effects of childhood mental health difficulties, the distress experienced by young people, and the development of more severe psychopathology (Greif Green et al., 2013; Malla et al., 2016; McGorry & Mei, 2018; Patton et al., 2014). However, there is a significant care gap as fewer CYP access mental health services than any other age group (McGorry & Mei, 2018; Wang et al., 2005), with evidence suggesting that less than half of English CYP with diagnosable mental health disorders access specialist treatment (Ford et al., 2007).
There are several factors that contribute to this care gap, including individual- and family-level factors (e.g., knowledge about mental health difficulties and services and attitudes toward treatment; Gould et al., 2009; Radez et al., 2021; Reardon et al., 2017) as well as service-level factors (e.g., unavailability of care, inflexible services, long waiting times; Anderson et al., 2017; O'Brien et al., 2016) and broader structural-level factors (e.g., inability to pay for services and lack of culturally-competent practitioners; Anderson et al., 2017; Owens et al., 2002). These factors, which may co-exist and interact with one another, serve as barriers to ensuring that CYP with mental health difficulties can receive prompt, high-quality care and support when needed.
Results and analyses
Fig. 1 provides a diagrammatic representation of study findings. A total of 58 participants responded in Round 1. Of these, 54 participants – including 18 parents (90.0% response rate), 18 school staff members (69.2% response rate), one school mental health practitioner (33.3% response rate), and 17 researchers (25.4% response rate) – completed the full questionnaire (46.5% overall response rate). We excluded from our analyses four participants who completed less than 50% of the questionnaire. School staff members included eight teachers/teaching assistants, four SENCos, three members of senior leadership teams, two school support or administrative team members, and a school governor.