Child mental illness contributes significantly to the burden of disease worldwide, and many are left untreated due to factors on both the provider and user side. Recognising this, the Ugandan Ministry of Health recently released the Child and Adolescent Mental Health (CAMH) Policy Guidelines. However, for implementation to be successful the suggested policy changes must resonate with the service users. To better understand the sociocultural factors influencing parental mental help-seeking, we sought insights from parents in the Mbale district of eastern Uganda. In this qualitative study, eight focus group discussions were conducted with mothers and fathers in urban and rural communities. Parents of children younger than 10 years were purposively selected to discuss a vignette story about a child with symptoms of depression or ADHD as well as general themes relating to child mental illness. The data were analysed using qualitative content analysis. Descriptions of severe symptoms and epileptic seizures were emphasised when recognising problem behaviour as mental illness, as opposed to mere ‘stubbornness’ or challenging behaviour. A mixture of supernatural, biomedical, and environmental understandings as underlying causes was reflected in the help-seeking process, and different treatment providers and relevant institutions, such as schools, were contacted simultaneously. A notion of weakened community social support structures hampered access to care. Awareness of symptoms closer to normal behaviour must be increased in order to improve the recognition of common mental illnesses in children. Stakeholders should capitalise on the common recognition of the importance of the school when planning the upscaling of and improved access to services. Multifactorial beliefs within the spiritual and biomedical realms about the causes of mental illness lead to multisectoral help-seeking, albeit without collaboration between the various disciplines. The CAMH Policy Guidelines do not address traditional service providers or provide a strategy for better integration of services, which might mean continued fragmentation and ineffective service provision of child mental health care.

中文翻译：

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儿童精神疾病和寻求帮助的过程：乌干达社区父母的定性研究

儿童精神疾病在全球范围内显着增加了疾病负担，由于提供者和用户方面的因素，许多人没有得到治疗。认识到这一点，乌干达卫生部最近发布了儿童和青少年心理健康 (CAMH) 政策指南。然而，为了成功实施，建议的政策变更必须引起服务用户的共鸣。为了更好地了解影响父母心理求助的社会文化因素，我们从乌干达东部姆巴莱区的父母那里寻求见解。在这项定性研究中，与城市和农村社区的父母进行了八次焦点小组讨论。特意选择了 10 岁以下儿童的父母来讨论一个关于患有抑郁症或多动症症状的儿童的小插曲故事，以及与儿童精神疾病有关的一般主题。使用定性内容分析对数据进行分析。在将问题行为识别为精神疾病时，强调对严重症状和癫痫发作的描述，而不仅仅是“固执”或具有挑战性的行为。寻求帮助的过程反映了对超自然、生物医学和环境的理解作为根本原因的混合，同时联系了不同的治疗提供者和相关机构，如学校。削弱社区社会支持结构的概念阻碍了获得护理的机会。为了提高对儿童常见精神疾病的认识，必须提高对更接近正常行为的症状的认识。利益相关者在规划服务升级和改善获取服务时，应利用对学校重要性的普遍认识。精神和生物医学领域内关于精神疾病原因的多因素信念导致了多部门寻求帮助，尽管各学科之间没有合作。CAMH 政策指南没有针对传统服务提供者或提供更好地整合服务的策略，这可能意味着儿童精神保健服务的持续分散和无效。利益相关者在规划服务升级和改善获取服务时，应利用对学校重要性的普遍认识。精神和生物医学领域内关于精神疾病原因的多因素信念导致了多部门寻求帮助，尽管各学科之间没有合作。CAMH 政策指南没有针对传统服务提供者或提供更好地整合服务的策略，这可能意味着儿童精神保健服务的持续分散和无效。利益相关者在规划服务升级和改善获取服务时，应利用对学校重要性的普遍认识。精神和生物医学领域内关于精神疾病原因的多因素信念导致了多部门寻求帮助，尽管各个学科之间没有合作。CAMH 政策指南没有针对传统服务提供者或提供更好地整合服务的策略，这可能意味着儿童精神保健的持续分散和无效的服务提供。尽管没有不同学科之间的合作。CAMH 政策指南没有针对传统服务提供者或提供更好地整合服务的策略，这可能意味着儿童精神保健的持续分散和无效的服务提供。尽管没有不同学科之间的合作。CAMH 政策指南没有针对传统服务提供者或提供更好地整合服务的策略，这可能意味着儿童精神保健的持续分散和无效的服务提供。