15581-m-nanninga

CHAPTER 6 108 ABSTRACT Psychosocial care systems have been designed so that specific problems are treated by specific care types. There is insufficient evidence as to which problem types are actually presented to the various care types. This study assessed types and severity of problems among children and adolescents upon enrolment in psychosocial care, compared to children not enroled; also outcomes after three and twelve months, overall and per care type. We obtained data on a cohort of 1,382 Dutch children aged 4-18 years (response rate 56.6%), included upon enrolment in psychosocial care, and on 443 not-enroled children (response rate 70.3%), all fromone region. Results showed that enroled children had more problems than children not enroled in care. In child and adolescent mental healthcare (CAMH), relatively many children had internalizing problems, and in child and adolescent social care (CASC) relatively many children had externalizing, parenting, family and multiple problems. Regardless of the type of problem, care duration in preventive child healthcare (PCH) was relatively short; and in CASC and CAMH longer. After three and twelve months, rates of problem solution were highest in PCH. These rates were also substantial among children not in care. To conclude, our findings show that the system of psychosocial care functions as intended regarding the distribution of problems across care types. Extended demarcation of clients by problem type and severity towards type and contents of care may further improve the system.