Mental Healthcare Utilization Among School-Based Adolescents in La Union, Philippines

2.50
Hdl Handle:
http://hdl.handle.net/10755/621682
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Mental Healthcare Utilization Among School-Based Adolescents in La Union, Philippines
Author(s):
Cruz, Jonas Preposi; Colet, Paolo C.; Iyisoy, Mehmet Sinan
Lead Author STTI Affiliation:
Non-member
Author Details:
Jonas Preposi Cruz, PhD, MAN, BSN, RN, Professional Experience: 2012-Present - Lecturer, Nursing Department, College of Applied medical Sciences, Shaqra University, Saudi Arabia 2008-2012 - Instructor, Nursing Department, Union Christian College, San Fernando City, La Union, Philippines Author Summary: He has been working as an educator since 2008. He is currently working as a lecturer for nursing in Shaqra University in Saudi Arabia. He has completed his PhD focused on educational management. At present, he is enrolled in the PhD Nursing program of Saint Louis University in the Philippines. He is also involved in various research studies on holistic nursing, transcultural nursing and nursing education.
Abstract:

Purpose: Mental health problems continue to contribute a significant fraction of the global disease burden (Whiteford, Ferrari, Degenhardt, Feigin & Vos, 2015). Globally, approximately 20 percent of children and adolescents experience mental health problems, while up to 50 percent of adult mental disorders begins in adolescents (Belfer, 2008). The Philippines share similar concern on mental health among adolescents with the rest of the world. In the Philippines, the most common mental health problems among youths are depression, anxiety and mood disorders. Despite this concern, utilization of mental health care facilities across the Philippines is uneven, favoring those living in or near the National Capital Region (World Health Organization [WHO], 2007). Adolescents' utilization of mental health care services, however, has not been carefully investigated especially those in provinces where mental health facilities are lacking. Thus, this study examined the mental health care utilization among school-based adolescents in the province of La Union, Philippines.

Methods: This study employed a descriptive, cross-sectional design in assessing the mental health care utilization among a convenience sample of 683 high school (HS) students in two secondary schools in the province of La Union, Philippines. A 2-part self-administered questionnaire was utilized to gather data from September to October 2016. Part 1 collected data on the socio-demographic characteristics, which include age, gender, grade level, religious affiliation, number of family members, family structure, type of community, perceived family financial status, number of friends, if involve in intimate relationship and involvement in extra-curricular activities (participation in sports team and school organizations and leadership involvement). Part 2 consisted of dichotomous questions with yes or no response option which asked the respondents if they have visited or talked or consulted to the listed mental health care personnel or facilities due to feelings of depression, anxiety or stress in the past six months. The list was based on existing questionnaires related to mental health care utilization, as well as the availability of the said personnel or facility in the research setting. Frequency count, percentage, and mean were used to describe the demographic characteristics and mental health care utilization of the respondents, as appropriate. Pearson's Chi-square test and Fisher’s exact test were used accordingly to examine the relationships between the socio-demographic characteristics and the mental health care utilization. A p-value less than 0.05 was considered significant.

Results: TThe average age of respondents was 14.52 years (SD= 1.37). The majority of the respondents were male (54.6%), were attending public high school (63.7 %), were Roman Catholic member (74.4%), had a nuclear family structure (74.4%), were living in an urban community (72.5%), had middle family financial status (88.0%), had more than 10 friends (68.7%) and were not involved in an intimate relationship (72.9%). Regarding involvement in extra-curricular activities in their school, more than half of the respondents were not a member of any school organization (67.9%), while 75.0% and 76.0% of them were not members of any school sports team and did not hold any leadership position, respectively.

For the utilization of mental health care, only 23.7 % and 46.9% of the respondents visited or consulted their guidance counselor and school clinic, respectively, due to feelings of depression, anxiety or stress in the last six months. More than half of the respondents did not visit or consulted their village health clinic (76.6%) and a general practitioner (65.5%) in the last six months for symptoms related to depression, anxiety or stress. Furthermore, almost all of the respondents did not consult a social worker (91.4%), a private practice psychologist, psychotherapist or psychiatrist (95.2 %), and a psychologist, psychotherapist or psychiatrist in an outpatient department of a hospital (94.7%).

A chi-square test of independence was performed to examine the relation between mental health care utilization and socio-demographic characteristics. The percentage of students who visited their guidance counselor for problems related to depression, anxiety or stress vary significantly between private and public schools, χ2(1, N = 683) = 6.08, p = .014. Public school students have less percentage/proportion (20.7%) of visiting a Guidance Counselor than private school students (29.0%). On the other hand, the proportion of the respondents who visited a village health clinic in the last 6 months differ by type of school (χ2(1, N = 683) = 22.23, p < .001), number of friends (χ2(2, N = 683) = 7.62, p = .022), perceived family financial status (χ2(2, N = 683) = 7.60, p = .022) and school organization membership (χ2(1, N = 683) = 4.79, p = .029). Private school students (13.3%) have less percentage of visiting a village health clinic than public school students (29.2%). Moreover, the percentage of the students who visited a village health clinic was higher among students with more than ten friends (26.4%) than students who had only 6 to 10 friends (17.4%) and less than five friends (16.1%). Students who perceived their family as poor (36.5%) had a higher proportion of visiting a village health clinic than those who perceived their family as rich (31.6%) and at the middle (21.8%). Also, students who were non-members of school organizations (25.9%) had a higher percentage of visiting a village health clinic than students who were involved in school organizations (18.3%).

On the other hand, the percentage of the students who consulted a general practitioner vary significantly by number of friends (χ2(2, N = 683) = 6.08, p = .047), by involvement to intimate relationship (χ2(1, N = 683) = 6.36, p = .012) and by membership to sports teams (χ2(1, N = 683) = 4.90, p = .027). Specifically, students who had less than five friends (24.7%) had a lesser proportion to consult a general practitioner than those who had 6-10 friends (31.4%) and more than ten friends (37.3%). Furthermore, the proportion of students who consulted a general practitioner was lesser in students who had a girlfriend (GF) or a boyfriend (BF, 27.0%) than those without GF or BF (37.4%), and higher in students who were members of sports team (41.5%) than those who were non-members (32.2%).

In terms of consultation to social workers, the proportions varies by community type (χ2(2, N = 683) = 6.37, p = .041) and financial status (χ2(2, N = 683) = 7.04, p = .030); the proportion is higher in students who were living in suburban communities (26.7%) than those living in rural (8.7%) or urban (8.1%) areas. Also, the percentage of students visiting a social worker is higher in students who perceived their family as poor (17.5%) than those who were rich (10.5%) or at the middle (7.7%).

Lastly, the percentage of the students who consulted a private practice psychologist, psychotherapist or psychiatrist were dependent on the school organization membership (χ2(1, N = 683) = 2.85, p = .09) and perceived financial status (χ2(2, N = 683) = 11.21, p = .004), while the percentage of students who visited an outpatient department of a hospital was dependent on school organization membership (χ2(1, N = 683) = 11.22, p < .001). The proportion of students who consulted a private practice psychologist, psychotherapist or psychiatrist was higher in students who were members of school organizations (7.9%) than those who were non-members (3.9%). Also, the proportion of students who visited an outpatient department of a hospital was higher in students who were members of school organization (10.4%) than those who were not members (3.7%). Students who perceived that they were rich (21.1%) had a higher proportion to consult a private practice psychologist, psychotherapist or psychiatrist than those who perceived that they were poor (4.8%) or at the middle (4.3%).

Conclusion: This study provided an overview of the status of mental health care utilization among school-based adolescents in the province of La Union in the Philippines. The findings suggest an underutilization of mental health care services among school-based adolescents, which is consistent with the results of a study conducted among college students in the Philippines (Tuliao, 2014). The findings also suggest existing disparities in mental health care utilization among the respondents when grouped according to their socio-demographic characteristics. The results of this study should be used to create a school-based, school nurse-led awareness program that aims to increase the awareness of the students regarding the existing mental health care services in their school and in the community, which they could utilize anytime. It should also be emphasized in the program the significance of seeking help for mental health-related problems. Lastly, collaboration with other stakeholders, such as the parents, the teachers, and the guidance counselors, should be initiated in the creation of such program, to identify their potential roles in ensuring good mental health among adolescents.

Keywords:
Adolescent Health; Mental Health; Mental Health Care
Repository Posting Date:
6-Jul-2017
Date of Publication:
6-Jul-2017
Other Identifiers:
INRC17PST581
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship
Note:
Item was accepted for presentation at the 2017 International Nursing Research Congress, but was not presented at the event.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleMental Healthcare Utilization Among School-Based Adolescents in La Union, Philippinesen_US
dc.contributor.authorCruz, Jonas Preposien
dc.contributor.authorColet, Paolo C.en
dc.contributor.authorIyisoy, Mehmet Sinanen
dc.contributor.departmentNon-memberen
dc.author.detailsJonas Preposi Cruz, PhD, MAN, BSN, RN, Professional Experience: 2012-Present - Lecturer, Nursing Department, College of Applied medical Sciences, Shaqra University, Saudi Arabia 2008-2012 - Instructor, Nursing Department, Union Christian College, San Fernando City, La Union, Philippines Author Summary: He has been working as an educator since 2008. He is currently working as a lecturer for nursing in Shaqra University in Saudi Arabia. He has completed his PhD focused on educational management. At present, he is enrolled in the PhD Nursing program of Saint Louis University in the Philippines. He is also involved in various research studies on holistic nursing, transcultural nursing and nursing education.en
dc.identifier.urihttp://hdl.handle.net/10755/621682-
dc.description.abstract<p><strong><strong>Purpose: </strong></strong><span>Mental health problems continue to contribute a significant fraction of the global disease burden (Whiteford, Ferrari, Degenhardt, Feigin & Vos, 2015). Globally, approximately 20 percent of children and adolescents experience mental health problems, while up to 50 percent of adult mental disorders begins in adolescents (Belfer, 2008). The Philippines share similar concern on mental health among adolescents with the rest of the world. In the Philippines, the most common mental health problems among youths are depression, anxiety and mood disorders. Despite this concern, utilization of mental health care facilities across the Philippines is uneven, favoring those living in or near the National Capital Region (World Health Organization [WHO], 2007). Adolescents' utilization of mental health care services, however, has not been carefully investigated especially those in provinces where mental health facilities are lacking. Thus, this study examined the mental health care utilization among school-based adolescents in the province of La Union, Philippines.</span></p> <p><strong>Methods: </strong>This study employed a descriptive, cross-sectional design in assessing the mental health care utilization among a convenience sample of 683 high school (HS) students in two secondary schools in the province of La Union, Philippines. A 2-part self-administered questionnaire was utilized to gather data from September to October 2016. Part 1 collected data on the socio-demographic characteristics, which include age, gender, grade level, religious affiliation, number of family members, family structure, type of community, perceived family financial status, number of friends, if involve in intimate relationship and involvement in extra-curricular activities (participation in sports team and school organizations and leadership involvement). Part 2 consisted of dichotomous questions with yes or no response option which asked the respondents if they have visited or talked or consulted to the listed mental health care personnel or facilities due to feelings of depression, anxiety or stress in the past six months. The list was based on existing questionnaires related to mental health care utilization, as well as the availability of the said personnel or facility in the research setting. Frequency count, percentage, and mean were used to describe the demographic characteristics and mental health care utilization of the respondents, as appropriate. Pearson's Chi-square test and Fisher’s exact test were used accordingly to examine the relationships between the socio-demographic characteristics and the mental health care utilization. A p-value less than 0.05 was considered significant.</p> <p><strong>Results: </strong>TThe average age of respondents was 14.52 years (SD= 1.37). The majority of the respondents were male (54.6%), were attending public high school (63.7 %), were Roman Catholic member (74.4%), had a nuclear family structure (74.4%), were living in an urban community (72.5%), had middle family financial status (88.0%), had more than 10 friends (68.7%) and were not involved in an intimate relationship (72.9%). Regarding involvement in extra-curricular activities in their school, more than half of the respondents were not a member of any school organization (67.9%), while 75.0% and 76.0% of them were not members of any school sports team and did not hold any leadership position, respectively.</p> <p>For the utilization of mental health care, only 23.7 % and 46.9% of the respondents visited or consulted their guidance counselor and school clinic, respectively, due to feelings of depression, anxiety or stress in the last six months. More than half of the respondents did not visit or consulted their village health clinic (76.6%) and a general practitioner (65.5%) in the last six months for symptoms related to depression, anxiety or stress. Furthermore, almost all of the respondents did not consult a social worker (91.4%), a private practice psychologist, psychotherapist or psychiatrist (95.2 %), and a psychologist, psychotherapist or psychiatrist in an outpatient department of a hospital (94.7%).</p> <p>A chi-square test of independence was performed to examine the relation between mental health care utilization and socio-demographic characteristics. The percentage of students who visited their guidance counselor for problems related to depression, anxiety or stress vary significantly between private and public schools, χ<sup>2</sup>(1, N = 683) = 6.08, <em>p</em> = .014. Public school students have less percentage/proportion (20.7%) of visiting a Guidance Counselor than private school students (29.0%). On the other hand, the proportion of the respondents who visited a village health clinic in the last 6 months differ by type of school (χ<sup>2</sup>(1, N = 683) = 22.23, <em>p</em> < .001), number of friends (χ<sup>2</sup>(2, N = 683) = 7.62, <em>p</em> = .022), perceived family financial status (χ<sup>2</sup>(2, N = 683) = 7.60,<em> p</em> = .022) and school organization membership (χ<sup>2</sup>(1, N = 683) = 4.79, <em>p</em> = .029). Private school students (13.3%) have less percentage of visiting a village health clinic than public school students (29.2%). Moreover, the percentage of the students who visited a village health clinic was higher among students with more than ten friends (26.4%) than students who had only 6 to 10 friends (17.4%) and less than five friends (16.1%). Students who perceived their family as poor (36.5%) had a higher proportion of visiting a village health clinic than those who perceived their family as rich (31.6%) and at the middle (21.8%). Also, students who were non-members of school organizations (25.9%) had a higher percentage of visiting a village health clinic than students who were involved in school organizations (18.3%).</p> <p>On the other hand, the percentage of the students who consulted a general practitioner vary significantly by number of friends (χ<sup>2</sup>(2, N = 683) = 6.08, <em>p</em> = .047), by involvement to intimate relationship (χ<sup>2</sup>(1, N = 683) = 6.36, <em>p</em> = .012) and by membership to sports teams (χ<sup>2</sup>(1, N = 683) = 4.90, <em>p</em> = .027). Specifically, students who had less than five friends (24.7%) had a lesser proportion to consult a general practitioner than those who had 6-10 friends (31.4%) and more than ten friends (37.3%). Furthermore, the proportion of students who consulted a general practitioner was lesser in students who had a girlfriend (GF) or a boyfriend (BF, 27.0%) than those without GF or BF (37.4%), and higher in students who were members of sports team (41.5%) than those who were non-members (32.2%).</p> <p>In terms of consultation to social workers, the proportions varies by community type (χ<sup>2</sup>(2, N = 683) = 6.37, <em>p</em> = .041) and financial status (χ<sup>2</sup>(2, N = 683) = 7.04, <em>p</em> = .030); the proportion is higher in students who were living in suburban communities (26.7%) than those living in rural (8.7%) or urban (8.1%) areas. Also, the percentage of students visiting a social worker is higher in students who perceived their family as poor (17.5%) than those who were rich (10.5%) or at the middle (7.7%).</p> <p>Lastly, the percentage of the students who consulted a private practice psychologist, psychotherapist or psychiatrist were dependent on the school organization membership (χ<sup>2</sup>(1, N = 683) = 2.85, <em>p</em> = .09) and perceived financial status (χ<sup>2</sup>(2, N = 683) = 11.21, <em>p</em> = .004), while the percentage of students who visited an outpatient department of a hospital was dependent on school organization membership (χ<sup>2</sup>(1, N = 683) = 11.22, <em>p</em> < .001). The proportion of students who consulted a private practice psychologist, psychotherapist or psychiatrist was higher in students who were members of school organizations (7.9%) than those who were non-members (3.9%). Also, the proportion of students who visited an outpatient department of a hospital was higher in students who were members of school organization (10.4%) than those who were not members (3.7%). Students who perceived that they were rich (21.1%) had a higher proportion to consult a private practice psychologist, psychotherapist or psychiatrist than those who perceived that they were poor (4.8%) or at the middle (4.3%).</p> <p><strong>Conclusion: </strong>This study provided an overview of the status of mental health care utilization among school-based adolescents in the province of La Union in the Philippines. The findings suggest an underutilization of mental health care services among school-based adolescents, which is consistent with the results of a study conducted among college students in the Philippines (Tuliao, 2014). The findings also suggest existing disparities in mental health care utilization among the respondents when grouped according to their socio-demographic characteristics. The results of this study should be used to create a school-based, school nurse-led awareness program that aims to increase the awareness of the students regarding the existing mental health care services in their school and in the community, which they could utilize anytime. It should also be emphasized in the program the significance of seeking help for mental health-related problems. Lastly, collaboration with other stakeholders, such as the parents, the teachers, and the guidance counselors, should be initiated in the creation of such program, to identify their potential roles in ensuring good mental health among adolescents.</p>en
dc.subjectAdolescent Healthen
dc.subjectMental Healthen
dc.subjectMental Health Careen
dc.date.available2017-07-06T15:17:56Z-
dc.date.issued2017-07-06-
dc.date.accessioned2017-07-06T15:17:56Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
dc.description.noteItem was accepted for presentation at the 2017 International Nursing Research Congress, but was not presented at the event.-
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