1. Department of Psychiatry, Saitama Children's Medical Center, Saitama, Japan.
3. Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan.
There are a substantial number of children with mental problems who do not visit medical institutions due to various reasons. The purpose of our research is to describe the barriers for such children in accessing hospitals which provide child psychiatric services. For the study, we recruited caregivers whose children first visited one of the 16 leading hospitals where child psychiatric service are provided, between September 2008 to March 2009 (n=4,323; average age: 13 years old). In terms of difficulty in finding services, 67.2% of the caregivers responded with "difficult" or "very difficult". It took an average of 2.4 years to visit a hospital after the first recognition of the signs of mental problems. Before visiting a children's psychiatric hospital, 86.3% had consulted other services such as general pediatricians (26.0%), educational institute (12.7%), and public health centers (18.7%); while only 13.7% of the respondents visited a hospital specializing in child psychiatric services right from the beginning. In terms of awareness of the availability of appropriate services and hospitals, 41.4% of the caregivers had prior knowledge while 22.9% obtained information from the internet; suggesting that online information is useful in offering guidance and support. The most common symptoms which attracted caregivers' attention include behavioral problems (21%), delay in development (18%), and problems interacting with other people (16%). We propose that an effective healthcare system for child mental problems be developed through the establishment of a network system comprising of medical, public health, welfare, and educational agencies.
Keywords: Children, mental health, developmental disabilities, cooperation