ArticleFrontiers in psychiatry2025
Beyond symptoms: a multi-perspective study on youth with severe and enduring mental health problems.
Article in Frontiers in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: A group of youth in child-and-adolescent psychiatry (CAP) experiences severe and enduring mental health problems (SEMHP) transcending current classification systems. To support these youth timely and effectively, their characteristics require further exploration in clinical practice. Hence, this study aims to deepen our understanding of SEMHP characteristics in youth, taking into account perspectives from multiple stakeholders. Materials and methods: Following an exploratory sequential design identifying SEMHP characteristics initially in depth (in a literature and qualitative study), digital questionnaires were completed in three subgroups of in total 155 participants, 1) 81 youth ( Results: The characteristics prolonged suffering, several areas of life affected, interpersonal distrust, internalization of SEMHP, limited daily functioning, and hopelessness were consistently recognized by the three participant groups. Youth tend to score higher on the individual characteristics, with a significant difference between groups in the recognition of masking behavior. Family characteristics and unsafe environments are far less recognized by caregivers, while societal characteristics including societal ignorance, stigma and overemphasis on classifying are significantly less recognized by clinicians. Discussion: Youth, caregivers, and clinicians shared common ground in recognizing the pervasiveness of SEMHP. However, differences in perspectives on characteristics present challenges for diagnostics of these youth. Masking behavior of youth is unsurprising and indicates that these youth need a specific approach in diagnostics. A holistic and multi-perspective understanding of SEMHP is crucial for effective support, as care for these youth must take a systemic and connection-focused approach. Additionally, clinicians must be critically aware of the societal context.
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