Early Detection and Referral of Young Children with Psychosocial Problems in the Preventive Child Health Care

Abstract

The detection and treatment of psychosocial problems at an early age is increasingly recognized as being of the utmost importance [1], more so since we know that these problems can influence the daily lives of children negatively [2] and tend to become persistent if left untreated [3-4]. That is why the development of empirically informed public health policies in order to respond adequately to such problems in young children has become a health priority globally [5-6]. One way of treating psychosocial problems in young children is by offering specialist mental health care. However, before entering treatment children first need to be identified as having psychosocial problems and consequently need to be referred to proper care. In the Netherlands, early detection of psychosocial problems is a task of the preventive care system [7]. For this task the parent reported Strength and Difficulties Questionnaire (SDQ) is recommended by the Health care Inspectorate of the Dutch government [8]. The SDQ is widely used and it was validated in many countries with satisfying results. However, the SDQ has not yet been validated for children in the younger age groups, nor in children of different ethnic backgrounds. Furthermore, little is known about the process of identification of psychosocial problems and referral for these problems in young children by the preventive child health care professional (CHP) who are making use of early detection instruments. Therefore, the main aim of this thesis is to explore the role of the SDQ in identifying psychosocial problems in young children by the preventive youth health care professional as well as the role of the SDQ in referral for these problems. Initially, the reliability and validity of the parent and teacher reported SDQ was determined in 5 to 6 year old children as well as in subgroups with the same background characteristics. In the next paragraphs a theoretical model for help-seeking behaviour will be presented. Psychosocial problems, the Dutch preventive child health care, different ways of identification of psychosocial problems and the SDQ will be explained in more detail. Finally, the research questions and the outline of this thesis will be presented.