Detection Of Psychiatric Disorders Among Adolescents Attending Primary Healthcare Facility In Kiambu County And Related Clinician Factors.

Abstract

Introduction. Adolescence is a period of physical growth spurt and extensive changes. It is during this time that mental disorders such as anxiety, depression, and thought disorders, may first appear or become apparent. Studies have indicated that there is only a 4.1% detection rate of psychiatric disorders by clinicians in primary health care facilities. Aim: This study seeks to establish undetected psychiatric diagnosis among adolescents attending primary health care facilities. Objectives: The overall objective of this study was to determine the percentage of undetected diagnosis of psychiatric disorders among youth attending a primary health care facility. The specific objectives were to determine; the prevalence and pattern of adolescent psychiatric morbidity among adolescents attending Limuru rural health facility in Kiambu County-Limuru Sub-County; determine the percentage of missed psychiatric diagnosis; examine socio-demographic correlates of psychiatric disorders among adolescents; determine perceived health care provider factors that lead to undetected psychiatric diagnosis and establish government referral pathways Methods: The quantitative part of study used a cross-sectional design and was carried out in a rural primary health care facility, in Kiambu County, Limuru Sub-County. A sample size of 300 adolescents was randomly sampled and included adolescents aged 11-21 years who met the inclusion criteria. Data was collected over a period of 6 weeks using researcher developed xii sociodemographic questionnaire, MINI-KID tool, and researcher developed a semi-structured clinician assessment tool. Data Analysis: Descriptive and inferential analysis results was generated through SPSS V.25. Data was presented through tables, charts, graphs, and narratives. Results: The adolescents were aged between 11-21 years. Mean age was 16 years, standard deviation 3, mode 12 and median 16 years. Prevalence of psychiatric disorders was 67% according to MINI Kid. Clinicians were able to diagnose 9% of the adolescents with a psychiatric disorder. There was no correlation between socio demographic factors and detected psychiatric disorders. The perceived clinician factors that contributed to undetected psychiatric diagnosis included lack of adequate knowledge, Lack of communication skills, Time, Lack of assessment tools. Most commonly diagnosed psychiatric disorder was stress and psychosis. Most clinicians did not give a psychiatric diagnosis if they suspected one Conclusion: The study concluded that there was a prevalence of psychiatric disorders among adolescents attending primary health care facilities and the most prevalent psychiatric condition was depression. The study also found that the clinicians were not able to detect the psychiatric disorders and there were variety of factors that led to the low detection rate among the clinicians xiii Recommendation Continuous medical education among health workers Increase in health education on psychiatric disorders among patients attending outpatient department Mental health promotion among school going children through increase in school health mental health activity Training health workers on mental disorders and encouraging health workers to go back to school. Training community health workers/Volunteers on identification of psychological disorders and referral system and also instilling them with psychological first aid skills.