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Trends in mental health problems among young people and the presence of youth clinics in Sweden: an ecological controlled interrupted time series analysis using the health on equal terms surveys (2004 to 2021): Tendencias en los problemas de salud mental entre los jóvenes y la presencia de clínicas juveniles en Suecia: un análisis ecológico controlado de series temporales interrumpidas utilizando las encuestas health on equal terms (2004 a 2021)
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0001-7234-3510
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-0253-5928
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-8114-4705
2024 (English)In: Journal of Community Systems for Health, E-ISSN 3035-692X, Vol. 1, no 1Article in journal (Refereed) Published
Abstract [en]

Introduction: In Sweden, youth clinics (YCs) address, among other things, issues related to the mental well-being among young people. However, YCs´ impact on their mental health have not been assessed. This study aimed to: i) analyse trends in mental health outcomes (stress, anxiety and psychological distress) among young people in Sweden according to the municipal availability of YCs; and ii) assess the impact on mental health outcomes of the presence of YCs with a first-line mental health (FLMH) assignment and YCs without this assignment, as compared to municipalities without YCs.

Methods: An ecological controlled interrupted time series design was applied. Annual data over 18 years (2004-2021) on self-reported stress, anxiety and psychological distress of individuals aged 16-25 were used. Thus, the mental health outcome trends in municipalities with YCs and those without YCs were compared. The prevalence ratio and their 95% confidence intervals were estimated.

Results: In total, 17,174 young people aged 16–25 participated in the study. A decrease in the reporting of stress, anxiety and psychological distress was observed from 2004 to 2010, followed by an increase in all three outcomes during the period 2011–2021. Trends were not statistically significant different in municipalities with or without YCs (even among YCs with the FLMH assignment). 

Conclusion: The prevalence of mental ill-health has been increasing among young people in Sweden since 2011. While YCs play an important role in the prevention of mental illness, their impact on these trends could not be determined. We recommend that structural factors such as education and the labour market for youth, which are outside the scope of YCs, should be addressed to curb these trends. 

Abstract [es]

Introducción: En Suecia, las clínicas para jóvenes se ocupan, entre otras cosas, de cuestiones relacionadas con el bienestar mental de los jóvenes. Sin embargo, no se han evaluado las repercusiones de dichos centros en su salud mental. El objetivo de este estudio fue: i) analizar las tendencias en salud mental (estrés, ansiedad y angustia psicológica) entre los jóvenes suecos en función de la disponibilidad municipal de las clínicas juveniles; y ii) evaluar el impacto en salud mental de la presencia de las clínicas juveniles con una asignación específica de salud mental de primera línea (First Line Mental Health en inglés) y aquellas clínicas sin esta asignación, en comparación con municipios que carecende clínicas para jóvenes.

Métodos: Se aplicó un diseño ecológico controlado de series temporales interrumpidas. Se utilizaron datos anuales a lo largo de 18 años (2004-2021) sobre el estrés, la ansiedad y la angustia psicológica auto-percividas por personas de entre 16 y 25 años. Así, se compararon las tendencias de los resultados de salud mental en los municipios con clínicas juveniles con los que no las tenían. Se estimaron la ratio de prevalencia y sus intervalos de confianza del 95

Resultados: En total, 17.174 jóvenes de entre 16 y 25 años participaron en el estudio. Se observó una disminución en la notificación de estrés, ansiedad y angustia psicológica de 2004 a 2010, seguida de un aumento en las tres variables durante el período 2011-2021. Las tendencias no fueron diferentes estadísticamente en los municipios con o sin clínicas juveniles (incluso comparando con las clínicas con la asignación FLMH).

Conclusiones: La prevalencia de una peor salud mental ha ido en aumento entre los jóvenes en Suecia desde 2011. Aunque las clínicas juveniles desempeñan un papel importante en la prevención de las enfermedades mentales, no se ha podido determinar su impacto en estas tendencias. Recomendamos que se aborden factores estructurales como la educación y el mercado laboral de los jóvenes, que están fuera del alcance de las clínicas juveniles, para frenar estas tendencias. 

Place, publisher, year, edition, pages
Umeå: Umeå University Library , 2024. Vol. 1, no 1
Keywords [en]
mental health, young people, youth clinics, Sweden
Keywords [es]
Salud mental, jóvenes, clínicas juveniles, Suecia
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:umu:diva-230560DOI: 10.36368/jcsh.v1i1.1035OAI: oai:DiVA.org:umu-230560DiVA, id: diva2:1903709
Funder
Public Health Agency of Sweden Available from: 2024-10-06 Created: 2024-10-06 Last updated: 2025-02-20Bibliographically approved

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San Sebastian, MiguelFonseca Rodriguez, OsvaldoGoicolea, Isabel

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