Perceptions about children and adolescents’ mental health crisis intervention: a qualitative systematic review

Telles, Nathalia Nakano; Cruz, Nathalia dos Santos; Cardoso, Marilia Mastrocolla de Almeida; Luz, Priscilla de Oliveira; Fernandes, Heloísa Garcia Claro; Oliveira, Márcia Aparecida Ferreira de

doi:10.1590/0102-311XEN016324

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REVIEW • Cad. Saúde Pública 40 (11) • 2024 • https://doi.org/10.1590/0102-311XEN016324 linkcopy

Perceptions about children and adolescents’ mental health crisis intervention: a qualitative systematic review

Percepções sobre a intervenção em crises de saúde mental de crianças e adolescentes: uma revisão sistemática qualitativa

Percepciones sobre la intervención en crisis de salud mental en niños y adolescentes: una revisión sistemática cualitativa

Authorship SCIMAGO INSTITUTIONS RANKINGS

This review aimed to identify and synthesize the perceptions of mental healthcare professionals, family members, and users about mental health crisis interventions for children and adolescents at hospitals and community mental health services. A qualitative systematic review was conducted following the Joanna Briggs Institution guidelines. The search was performed in 15 databases, with no temporal delimitation, and included studies in Portuguese, English, and Spanish. All works were assessed regarding methodological quality, credibility, and dependability according to the ConQual score and the recommendations were assessed following the Joanna Briggs Institution guidelines. In total, two independent reviewers screened and assessed the studies, extracted their data, developed categories, and conducted the thematic synthesis. A total of 13 studies met the inclusion and exclusion criteria. From these, five syntheses were developed: importance of relationships; importance of procedures during treatment; positive emotional responses to treatment; negative emotional responses to treatment; and issues with health professionals and health services. All five syntheses presented high dependability; two syntheses presented high credibility; and three presented moderate credibility. Mental healthcare professionals, family members and users had convergent perceptions about crisis intervention provided at healthcare services. Understanding their perceptions to improve care and the user experience in this vulnerable situation is crucial.

Keywords:
Mental Health; Crisis Intervention; Child; Adolescent; Perception

STUDY (YEAR)	COUNTRY	INTERVIEWED POPULATION	SEX	AGE (YEARS)	SAMPLE SIZE	STUDY CONTEXT
Bjønness et al. ²⁶ (2022)	Norway	Family members	Female and male	Do not apply	12	Community mental health services
Fu et al. ²⁷ (2021)	China	Staff and family members	Female and male	Do not apply	34 and 15	Hospital inpatient unit
Gill et al. ²⁸ (2016)	United Kingdom	Adolescents	Female and male	14-17	12	Hospital inpatient unit
Haynes et al. ²⁹ (2011)	United Kingdom	Adolescents	Female and male	13-19	10	Hospital inpatient unit
Moses ³⁰ (2011)	United States	Adolescents	Female and male	13-18	82	Hospital inpatient unit
Moura & Matsukara ¹² (2022)	Brazil	Staff and family members	Female and male	Do not apply	6 and 12	Community mental health service
Patterson et al. ³¹ (2015)	Australia	Adolescents	Female and male	13-17	43	Hospital inpatient unit
Rosado ³² (2019)	United States	Adolescents	Female	12-17	14	Hospital inpatient unit
Rossi et al. ³³ (2019)	Brazil	Adolescents	Female and male	16-17	5	Community mental health service
Salamone-Violi et al. ³⁴ (2015)	Australia	Adolescents	Female and male	15-17	11	Hospital inpatient unit
Stanton et al. ³⁵ (2020)	New Zealand	Adolescents	Female and male	12-20	15	Hospital inpatient unit
Thabrew et al. ¹⁵ (2020)	New Zealand	Adolescents	Female	15-17	9	Hospital inpatient unit
Walter et al. ³⁶ (2006)	United States	Family members	Female and male	Do not apply	14	Hospital inpatient unit

STUDY	QUESTIONS										TOTAL (%)
STUDY	1	2	3	4	5	6	7	8	9	10
Bjønness et al. ²⁶	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	100
Fu et al. ²⁷	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	100
Gill et al. ²⁸	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	100
Haynes et al. ²⁹	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	100
Moses ³⁰	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Yes	90
Moura & Matsukara ¹²	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Yes	90
Patterson et al. ³¹	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	100
Rosado ³²	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	100
Rossi et al. ³³	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Yes	90
Salamone-Violi et al. ³⁴	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	100
Stanton et al. ³⁵	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	No	80
Thabrew et al. ¹⁵	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	100
Walter et al. ³⁶	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	No	Yes	80
Total (%)	100	100	100	100	100	100	61	100	92	92

FINDINGS AND ILLUSTRATIONS	CATEGORY	SYNTHESIS	DEPENDABILITY	CREDIBILITY	ConQual SCORE ¹⁷
8U	Relationship with peers	Importance of relationship during treatment	High	Total: 37 findings (36U + 1C)	Moderate
9U	Relationship with health staff
10U	Family support
6U	Communication between staff, family members and users
1C + 3U	Family role during treatment
6U	Individual therapy	Importance of procedures during treatment	High	Total: 53 findings (51U + 2C)	Moderate
1C + 3U	Group therapy
1C + 6U	Personalized treatment
22U	Power of music therapy
3U	Psychotropic medication
3U	Family intervention
4U	Restraint
4U	Community mental health service treatment
5U	Lack of privacy	Negative emotional responses to treatment	High	Total: 28 findings (28U)	High
6U	Stigma
8U	Exclusion of daily life
5U	Hospital routine
3U	Distance from beloved ones
1U	Fear of returning to the inpatient unit
1C + 6U	Coping skills	Positive emotional responses to treatment	High	Total: 37 findings (35U + 2C)	Moderate
5U	Discharge planning
7U	Acceptance
1C + 7U	Adolescents’ decision-making
6U	Treatment outcomes
4U	Sense of security
2U	Improvement of labor process	Issues about health staff and health services	High	Total: 14 findings (14U)	High
4U	Relationship between family members and health services
4U	Emergency as mental health service
4U	Assessment of the staff

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[TFN1] Source: prepared by the authors.