Mental Health Profile of Children and Adolescents Under Protective Health Measures: A Comprehensive Analysis of Clinical and Sociodemographic Variables

Year 2025, Volume: 6 Issue: 3, 77 - 87, 30.09.2025

Yüksel Sümeyra Naralan , Uğur Tekeoğlu , Merve Yazıcı

https://doi.org/10.56766/ntms.1747818

Abstract

Objective
To profile the psychiatric burden, sociodemographic risk factors, supplementary protective interventions, and outpatient follow up compliance of children and adolescents placed under court mandated protective health measures in a tertiary child and adolescent psychiatry clinic.
Materials and Methods
This retrospective review covered 138 youths (89 girls, 49 boys) assessed between January 2022 and July 2024 at Recep Tayyip Erdoğan University Training and Research Hospital. Sociodemographic data, reasons for the protective order, prior service use, and follow up attendance were extracted from medical and social service records. Psychiatric diagnoses were established through Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) interviews conducted at the index visit. Group differences were analysed with Pearson chi square or Fisher exact tests; significance was set at p < 0.05.
Results
The mean age was 14.4 ± 4.2 years, and the mean age at first psychiatric evaluation under the order was 12.9 ± 4.0 years. At least one DSM 5 diagnosis was documented in 82.6 % of participants; the most frequent were attention deficit/hyperactivity disorder (42.0 %), conduct disorders (34.8 %), and mood disorders (26.8 %). Psychotropic medication was prescribed in 73.9 %, predominantly antipsychotics (50.7 %) and antidepressants (42.0 %). Girls had significantly higher rates of sexual abuse, self harm, suicide attempts, substance use, prior psychiatric contact, current diagnosis, and medication use (p ≤ 0.043). Provision of in kind or financial aid was more common in boys (p = 0.017). Regular appointment adherence reached only 62.3 % and was compromised by parental loss or separation, school non attendance, and psychiatric comorbidity (p ≤ 0.033). Diagnostic prevalence and medication use rose steadily with age (p ≤ 0.006).
Conclusion
Children and adolescents under protective health measures exhibit an exceptionally high and complex psychiatric load, with service engagement further undermined by gender specific vulnerabilities, family instability, and educational disruption. Early, gender sensitive, and integrative care models—augmented by telepsychiatry and “service cascade” approaches—are essential to sustain treatment continuity and mitigate long term mental health risks in this vulnerable population.

Keywords

Children and Adolescents mental health , Protective Health Measures , forensic child and adolescent

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