15581-m-nanninga

CHAPTER 4 66 ABSTRACT Background: An up-to-date comprehensive literature review is lacking concerning the determinants of enrolment in and use of psychosocial care for children and adolescents. Therefore, the aim of this study was to systematically review the literature on this subject. Methods: We searched publications in Medline, PsycINFO, SocINDEX, and ERIC (January 2000 – February 2015). Studies that investigated determinants of enrolment in and use of psychosocial care for children and adolescents were included. Three reviewers independently assessed the eligibility and methodological quality of the studies. Only high-quality studies were included and categorized according to the four steps in the pathway to care -consultation/help-seeking, professional problem recognition, referral to specialized care, admission to inpatient care- and the actual use of care. Results: Twenty-two studies were included. Main child factors identified that increased the likelihood of enrolment in and use of care were psychosocial problems, urban area residence, life events, past treatment, and academic problems. Varying effects across care steps or use of care were found for age, gender, ethnicity, and place of residence. Main family factors identified that increased enrolment in and use were single-parent family and socioeconomic status (varying effects). Conclusions: Care enrolment and use are not only determined by children’s psychosocial problems but also by other child and family characteristics. Professionals and policymakers should be aware that the system of care is less accessible for children with specific characteristics. Further, additional high-quality evidence is needed on potential organizational, professional-related, psychological, and social determinants of enrolment in psychosocial care.