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Service use in adolescents at risk of depression and self-harm: prospective longitudinal study

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Although depression and self-harm are common mental health problems in adolescents, there are barriers to accessing help. Using a community-based sample, this study investigates predictors of service contacts for adolescents at high risk of depression and self-harm.

Methods

Three thousand seven hundred and forty-nine (3,749) 12- to 16-year-olds in UK secondary (high) schools provided baseline and 6 months’ follow-up data on mood, self-harm and service contacts with a range of primary and secondary healthcare services.

Results

Although most adolescents at high risk of depression or self-harm had seen their general practitioner (GP) in the previous 6 months, less than one-third had used primary or secondary healthcare services for emotional problems. 5 % of adolescents who reported self-harm had seen specialist child and adolescent mental health services in the previous 6 months. In longitudinal analyses, after adjustment for confounders, both depression and self-harm predicted the use of any healthcare services [adjusted odds ratio (AOR) = 1.34 (95 % CI 1.09, 1.64); AOR = 1.38 (95 % CI 1.02, 1.86), respectively] and of specialist mental health services [AOR = 5.48 (95 % CI 2.27, 13.25); AOR = 2.58 (95 % CI 1.11, 6.00), respectively]. Amongst those with probable depression, 79 % had seen their GP and 5 % specialist mental health services in the preceding year.

Conclusions

Most adolescents at high risk of depression or self-harm see their GP over a 6-month period although only a minority of them access specialist mental health services. Their consultations within primary care settings provide a potential opportunity for their identification and for signposting to appropriate specialist services.

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Acknowledgments

We thank the schools and students who participated in this project, the PROMISE research team for data collection, and the East Midlands Hub of the NIHR Mental Health Research Network for their administrative and research support. The PROMISE study was funded by the National Institute for Health Research Health Technology Assessment.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Psychiatry and Applied Psychology & Institute of Mental Health, University of Nottingham, E Floor, South Block, Queen’s Medical Centre, Nottingham, NG7 2UH, UK

    Kapil Sayal

  2. School of Social and Community Medicine, University of Bristol, Bristol, UK

    Nichola Yates

  3. Medical Research Council Clinical Trials Unit, London, UK

    Melissa Spears

  4. Child and Adolescent Mental Health Research Group, Department of Health, University of Bath, Bath, UK

    Paul Stallard

Authors
  1. Kapil Sayal
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  2. Nichola Yates
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  3. Melissa Spears
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  4. Paul Stallard
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Corresponding author

Correspondence to Kapil Sayal.

Appendix

Appendix

See Table 5.

Table 5 Comparison of those who had provided information relating to their use of healthcare services at both baseline and 6 months and those who had not provided information at one or both time points
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Sayal, K., Yates, N., Spears, M. et al. Service use in adolescents at risk of depression and self-harm: prospective longitudinal study. Soc Psychiatry Psychiatr Epidemiol 49, 1231–1240 (2014). https://doi.org/10.1007/s00127-014-0843-y

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  • DOI: https://doi.org/10.1007/s00127-014-0843-y

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